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North Carolina Telehealth Laws & Reimbursement Policies

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.

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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.”

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Live Video

Policy

North Carolina Medicaid and NC Health Choice will reimburse for live video medical services and tele-psychiatry services.

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Eligible Services/Specialties

Click for a list of eligible services and specialties.

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Eligible Providers

Click for a list of eligible providers.

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Eligible Sites

No reference found.

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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.”

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Facility/Transmission Fee

Click to see a list of originating-site providers that may receive a facility fee.

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Store-and-Forward

Policy

North Carolina Medicaid will not reimburse for Store-and-forward.

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Eligible Services/Specialties

No reference found.

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Geographic Limits

No reference found.

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Transmission Fee

No reference found.

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Remote Patient Monitoring

Policy

No reference found.

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Conditions

No reference found.

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Provider Limitations

No reference found.

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Other Restrictions

No reference found.

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Email/Phone/Fax

No reimbursement for email.
No reimbursement for telephone.
No reimbursement FAX.
No reimbursement for video cell phone interaction.

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Consent

No reference found.

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Out of State Providers

No reference found.

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Miscellaneous

Click for a list of additional eligibility criteria and limitations.

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Private Payer Laws

Definitions

No reference found.

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Requirements

No reference found.

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Parity

No reference found.

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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.

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Consent

No reference found.

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Online Prescribing

No reference found.

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Cross State Licensing

Member of the following: Physical Therapy Compact, Nurse Licensure Compact

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Miscellaneous

Telemedicine may be utilized for neonatal or infant echocardiograms.

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