North Carolina Telehealth State 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
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
Geographic Limits
Transmission Fee

Remote Patient Monitoring

Policy
Conditions
Provider Limitations
Other Restrictions

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

Out of State Providers

Miscellaneous

Click for a list of additional eligibility criteria and limitations.

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Private Payer Laws

Definitions

Requirements

Parity

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

Online Prescribing

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

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