Nevada Telehealth State Laws & Reimbursement Policies

Medicaid Telehealth Reimbursement

Summary

Nevada Medicaid and the Nevada Check Up (NCU) program reimburses for live video and store-and-forward services under specific conditions. There is no reimbursement for remote patient monitoring.

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Definitions

“Telehealth is the use of a telecommunications system to substitute for an in-person encounter for professional consultations, office visits, office psychiatry services, and a limited number of other medical services.”

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Live Video

Policy
Nevada Medicaid and Nevada Check Up program will reimburse for live video, as long as services have parity with face-to-face services and health care professionals follow Medicaid’s policies for specific services they are providing, as well as practice standards established by licensing agencies.

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Eligible Services/Specialties
Click for a list of eligible services and specialties.

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Eligible Providers
Telehealth may be used by any Nevada Medicaid and Nevada Check Up provider working within their scope of practice.

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Eligible Sites
Click for a list of eligible sites.

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Geographic Limits
A Medicaid Managed Care Organization may not refuse to provide coverage of telehealth services because of the distant or originating site.

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Facility/Transmission Fee
Originating site is qualified to receive a facility fee if they are an enrolled Medicaid provider. If a patient is receiving telehealth services at a site not enrolled in Medicaid, the originating site is not eligible to receive a facility fee.

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Store-and-Forward

Policy
Reimbursement is available for services delivered via asynchronous telehealth. Photographs must be specific to the patient’s condition and adequate for rendering or confirming a diagnosis or a treatment plan.

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Eligible Services/Specialties
Geographic Limits
Transmission Fee
Store-and-forward services are not eligible for originating site facility fees.

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Remote Patient Monitoring

Policy
Conditions
Provider Limitations
Other Restrictions

Email/Phone/Fax

No reimbursement for email.
No reimbursement for telephone, except psychiatric treatment in crisis intervention.
No reimbursement for FAX.

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Consent

Out of State Providers

Miscellaneous

Private Payer Laws

Definitions

“Telehealth” means the delivery of services from a provider of health care to a patient at a different location through the use of information and audio-visual communication technology, not including standard telephone, facsimile or electronic mail.

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Requirements

Click for a list of private payer requirements.

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Parity

Every health plan policy issued must include coverage for services provided through telehealth to the same extent as through provided in-person or by other means.

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Professional Regulation/Health & Safety

Definitions

Telehealth means the delivery of services from a provider of health care to a patient at a different location through the use of information and audio-visual communication technology, not including standard telephone, facsimile or electronic mail.

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Consent

Online Prescribing

A provider of health care who is located at a distant site and uses telehealth to direct or manage the care or render a diagnosis of a patient who is located in Nevada or write a treatment order or prescription for such a patient must comply with all state and federal laws that would apply if the provider was located within the state including holding a valid license or certificate to practice in Nevada.

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Cross State Licensing

A practitioner must hold a valid Nevada License or certificate to practice his or her profession, including a special purpose license before providing services via telehealth unless he or she is a provider of health care services who is providing services within the scope of his or her employment by or pursuant to a contract entered into with an urban Indian organization.

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Miscellaneous

The Board of Medicine is required to adopt regulations regarding a physician assistant’s use of equipment that transfers information concerning the medical condition of a patient electronically, telephonically or by fiber optics, including, without limitation, through telehealth, from within or outside Nevada or the United States.

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Source: Center for Connected Health Policy
https://www.cchpca.org

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