Pennsylvania Telehealth Laws & Reimbursement Policies

Pennsylvania Telehealth Laws

Medicaid Telehealth Reimbursement

Summary

Definitions

Telemedicine is the use of real-time interactive telecommunications technology that includes, at a minimum, audio and video equipment as a mode of delivering consultation services.

Read More

Live Video

Policy
For FQHCs and RHCs: Telepsychiatry Services – Only applicable to Behavioral Health Managed Care delivery system claims and not fee-for-service delivery. Service is in real-time, interactive audio-video transmission and do not include phone, email or facsimile transmission. Consultation between two healthcare practitioners do not count as a qualifying service.

Read More

Eligible Services/Specialties
See listing for reimbursable procedure codes when the service is provided via interactive telecommunication technology.

Read More

Eligible Providers
Pennsylvania Medicaid will provide reimbursement for live video to all Medicaid enrolled physician specialists.

Read More

Eligible Sites
A patient is allowed to access a telemedicine consultation at any enrolled office of the referring provider or any other participating physicians, certified registered nurse practitioner, or certified nurse midwife.

Read More

Geographic Limits
Services should be rendered face-to-face whenever practical and appropriate. Providers may consider if the recipient must travel more than 60 minutes in a rural area or 30 minutes in an urban area.

Read More

Facility/Transmission Fee
Originating site may bill for facility fee.

Read More

Store-and-Forward

Policy
Pennsylvania Medicaid will not reimburse for store-and-forward because a telemedicine consultation must consist of a two-way, real time interactive communication between the patient and the physician at the distant site.

Read More

Eligible Services/Specialties
Geographic Limits
Transmission Fee

Remote Patient Monitoring

Policy
Conditions
Provider Limitations
Other Restrictions

Email/Phone/Fax

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

Read More

Consent

Informed consent is required from individuals participating in any services utilizing telepsych.

Read More

Out of State Providers

When services are provided from a location in another state, the psychiatrist/licensed psychologist must be licensed in Pennsylvania.

Read More

Miscellaneous

Private Payer Laws

Definitions

Requirements

Parity

Professional Regulation/Health & Safety

Definitions

Consent

Online Prescribing

Cross State Licensing

Pennsylvania issues extraterritorial licenses that allow practice in Pennsylvania to physicians residing or practicing with unrestricted licenses in an adjoining state, near the Pennsylvania boundary, and whose practice extends into Pennsylvania.

Read More

Miscellaneous

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

Reach out to us for all your Telehealth needs

What best describes you?

Currently serving all 50 states

Our telemedicine services can be applied to big cities as well as rural locations. We contract with the highest quality health professionals and partner with hospitals, clinics, and other healthcare facilities throughout the Nation.
Learn More About the States we Serve