New Mexico Telehealth Laws & Reimbursement Policies

North Dakota Telehealth Laws

Medicaid Telehealth Reimbursement

Summary

North Dakota reimburses for live video telemedicine for most services, with a few exceptions. They do not provide reimbursement for store-and-forward and no reference was found for remote patient monitoring.

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Definitions

Telemedicine is the use of interactive audio-video equipment to link practitioners and patients at different sites.

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Live Video

Policy
North Dakota Medicaid will reimburse for live video services as long as the patient is present during the service. Actual visual contact (face-to-face) must be maintained between practitioner and patient.

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Eligible Services/Specialties
Except for the Non Covered services noted below, telemedicine can be used for services covered by Medicaid, and otherwise allowed, per CPT, to be rendered via telemedicine.

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Eligible Providers
Reimbursement is made for services provided by licensed professional enrolled with ND Medicaid and within the scope of practice per their licensure only.

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Eligible Sites
Geographic Limits
Facility/Transmission Fee
Reimbursement will be made to the originating site as a facility fee only in place of service office, inpatient hospital, outpatient hospital, or skilled nursing facility/nursing facility. There is no additional reimbursement for equipment, technicians or other technology or personnel utilized in the performance of the telemedicine service.

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Store-and-Forward

Policy
North Dakota Medicaid does not reimburse for store-and-forward.

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Eligible Services/Specialties
Geographic Limits
Transmission Fee

Remote Patient Monitoring

Policy
While there is no indication that telehealth may be used to deliver home health services, a visit to demonstrate medical necessity for those services may be performed via telehealth or in-person.

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Conditions
Provider Limitations
Other Restrictions

Email/Phone/Fax

No reference found for email.
No reimbursement for telephone.
No reference found for FAX.

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Consent

Out of State Providers

Miscellaneous

Private Payer Laws

Definitions

Click for private payer law definitions.

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Requirements

An insurer must provide coverage for telehealth delivered health services which is the same coverage for health services delivered by in-person means.
A policy is not required to provide coverage for health services that are not medically necessary, subject to the terms and conditions of the policy.

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Parity

An insurer must provide coverage for telehealth delivered services to the same extent as the same coverage for in-person services. They are not required to provide coverage for health services that are not medically necessary.

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Professional Regulation/Health & Safety

Definitions

"Telemedicine" means the practice of medicine using electronic communication, information technologies, or other means between a licensee in one location and a patient in another location, with or without an intervening health care provider. The term includes direct interactive patient encounters as well as asynchronous store-and-forward technologies and remote monitoring.

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Consent

Physical Therapy: The physical therapist may use telehealth technology as a vehicle for providing only services that are legally or professionally authorized. The patient's written or verbal consent will be obtained and documented prior to such consultation.

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Online Prescribing

A valid prescription via e-prescribing means a prescription has been issued for a legitimate medical purpose, in the usual course of professional practice, by a practitioner who has first conducted an in-person medical evaluation of the patient. An in-person medical evaluation can include the referring practitioner having performed the exam, in the case of telemedicine.

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Cross State Licensing

The ND Medical Board may engage in reciprocal licensing agreements with out-of-state licensing agencies, but is not required to do so.

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Miscellaneous

Under the Worker’s Compensation Act, the originating sites may receive a facility fee, not to exceed $20.

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

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