South Dakota Telehealth State Laws & Reimbursement Policies

Medicaid Telehealth Reimbursement

Summary

South Dakota Medicaid provides reimbursement for live video at the same rate as in-person services, under some circumstances. Reimbursement is not provided for store-and-forward or remote patient monitoring services.

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Definitions

“Telemedicine is the use of an interactive telecommunications system to provide two-way, real-time, interactive communication between a provider and a Medicaid recipient across a distance.”

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Live Video

Policy
South Dakota Medicaid will reimburse for limited services at the same rate as in-person services.  See manual for complete list of CPT codes.

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Eligible Services/Specialties
See manuals for specific CPT codes.

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Eligible Providers
Eligible Sites
Geographic Limits
An originating site may not be located in the same community as the distant site, unless the originating site is a nursing facility.

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Facility/Transmission Fee
Originating sites are eligible for a facility fee. Click to see list of sites eligible for fee.

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Store-and-Forward

Policy
South Dakota Medicaid defines telemedicine as occurring in “real-time”, excluding store-and-forward applications.

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Eligible Services/Specialties
Geographic Limits
Transmission Fee

Remote Patient Monitoring

Policy
The Office of Adult Services and Aging defines "telehealth services" as a home-based health monitoring system used to collect and transmit an individual's clinical data for monitoring and interpretation. However, no further information is provided.

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Conditions
Provider Limitations
Other Restrictions

Email/Phone/Fax

No reimbursement for phone. No reimbursement for email. No reimbursement for facsimile.

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Consent

Out of State Providers

Miscellaneous

Private Payer Laws

Definitions

Requirements

Parity

Professional Regulation/Health & Safety

Definitions

"Telehealth services" is a home-based health monitoring system used to collect and transmit an individual's clinical data for monitoring and interpretation.

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Consent

Online Prescribing

Cross State Licensing

Click to review criteria for an applicant to be licensed through reciprocity.

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Miscellaneous

Office of Adult Service and Aging: In-home services, which is defined as including “telehealth services”, may be provided to an individual who demonstrates a need for long-term supports and services through an assessment. Click to see the criteria.

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

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