What are the Pennsylvania telehealth laws?
The Pennsylvania Department of Health regulates telemedicine in the state. Pennsylvania telehealth solutions can provide patients with convenient access to care, even if they live in rural areas or have transportation challenges. Telehealth can also help reduce healthcare costs by reducing the need for in-person visits. If you are interested in using Pennsylvania telehealth solutions, you can contact your doctor or a telemedicine provider to see if they offer this service.
Medicaid Telehealth Reimbursement
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
Remote Patient Monitoring
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
Professional Regulation/Health & Safety
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
Source: Center for Connected Health Policy
https://www.cchpca.org
