New Mexico Telehealth Laws & Reimbursement Policies

New Mexico TeleHealth Laws

Medicaid Telehealth Reimbursement

Summary

New Mexico Medicaid reimburses for live video telehealth at the same rate as when services are provided in-person as well as store-and-forward. There is no reference to remote patient monitoring.

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Definitions

Telemedicine is defined as “the use of electronic information, imaging and communication technologies, including interactive audio, video, data communications as well as store-and-forward technologies, to provide and support health care delivery, diagnosis, consultation, treatment, transfer of medical data and education”

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Live Video

Policy
New Mexico Medicaid will reimburse for live video at the same rate as when the services are furnished without the use of a telecommunication system.

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Eligible Services/Specialties
Eligible Providers
Eligible Sites
School-based services provided via telemedicine are covered.

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Geographic Limits
Facility/Transmission Fee
Reimbursement is made to the originating site for an interactive telehealth system fee.

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Store-and-Forward

Policy
New Mexico Medicaid does reimburse for store-and-forwardstore-and-forward. To be eligible, the service must be provided through the transfer of digital images, sounds, or previously recorded video from one location to another. It does not need to occur in real time.

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Eligible Services/Specialties
Geographic Limits
Transmission Fee
Reimbursement is made to the originating site for an interactive telehealth system fee.

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Remote Patient Monitoring

Policy
Conditions
Provider Limitations
Other Restrictions

Email/Phone/Fax

Consent

To prescribe medication via telehealth, a prescribing clinician must obtain informed consent, obtain a medical history, and generate a medical record.

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Out of State Providers

When the originating site is in New Mexico and the distant site is outside New Mexico, the distant-site provider at the distant site must be licensed in New Mexico for telemedicine, or meet federal requirements for Indian Health Service or tribal contract facilities.

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Miscellaneous

Click for a list of additional requirements.

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Private Payer Laws

Definitions

Telemedicine means the use of interactive simultaneous audio and video or store-and-forward technology using information and telecommunications technologies by a health care provider to deliver health care services at a site other than the site where the patient is located, including the use of electronic media for consultation relating to the health care diagnosis or treatment of the patient in real time or through the use of store-and-forward technology.

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Requirements

An insurer shall allow covered benefits to be provided through telemedicine services.

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Parity

An insurer shall allow covered benefits to be provided through telemedicine services.

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Professional Regulation/Health & Safety

Definitions

Click for a list of telehealth definitions from professional regulations.

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Consent

Hearing, Speech and Audiology Practitioners: A licensed audiologist, speech-language pathologist or hearing aid dispenser using telecommunication technology to deliver services to a client shall provide notice to the client, guardian, caregiver and multi-disciplinary team as appropriate, including but not limited to the right to refuse telehealth services, options for service delivery and instruction on filing and resolving complaints.

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Online Prescribing

Prescribing, dispensing or administering drugs or medical supplies to a patient when there is no established physician-patient relationship, including prescribing over the internet or via other electronic means that is based solely on an on-line questionnaire is unprofessional conduct, except under specific circumstances.

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Cross State Licensing

NM issues telemedicine licenses to providers who hold a full, unrestricted license in another state and has good moral character.

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Miscellaneous

Click for a list of professional regulations with telehealth-specific standards.

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

 

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