Medicaid Telehealth Reimbursement
Summary
NC Medicaid reimburses live video telemedicine for medical and tele-psychiatry services as long as certain conditions are met. They do not provide reimbursement for store-and-forward, and make no reference to remote patient monitoring.
Definitions
“Telemedicine is the use of two-way real-time interactive audio and video between places of lesser and greater medical capability or expertise to provide and support health care, when distance separates participants who are in different geographical locations.”
Live Video
Policy
North Carolina Medicaid and NC Health Choice will reimburse for live video medical services and tele-psychiatry services.
Eligible Services/Specialties
Click for a list of eligible services and specialties.
Eligible Providers
Click for a list of eligible providers.
Eligible Sites
No reference found.
Geographic Limits
“The distant site of the service must be of a sufficient distance from the originating site to provide services to a beneficiary who does not have readily available access to such specialty services.”
Facility/Transmission Fee
Click to see a list of originating-site providers that may receive a facility fee.
Store-and-Forward
Policy
North Carolina Medicaid will not reimburse for Store-and-forward.
Eligible Services/Specialties
No reference found.
Geographic Limits
No reference found.
Transmission Fee
No reference found.
Remote Patient Monitoring
Policy
No reference found.
Conditions
No reference found.
Provider Limitations
No reference found.
Other Restrictions
No reference found.
Email/Phone/Fax
No reimbursement for email.
No reimbursement for telephone.
No reimbursement FAX.
No reimbursement for video cell phone interaction.
Consent
No reference found.
Out of State Providers
No reference found.
Miscellaneous
Click for a list of additional eligibility criteria and limitations.
Private Payer Laws
Definitions
No reference found.
Requirements
No reference found.
Parity
No reference found.
Professional Regulation/Health & Safety
Definitions
Maternal and Child Health and Women’s Health: Telemedicine is the use of audio and video between places of lesser and greater medical capability or expertise to provide and support health care when distance separates participants who are in different geographical locations.
Consent
No reference found.
Online Prescribing
No reference found.
Cross State Licensing
Member of the following: Physical Therapy Compact, Nurse Licensure Compact
Miscellaneous
Telemedicine may be utilized for neonatal or infant echocardiograms.
Source: Center for Connected Health Policy
https://www.cchpca.org