Texas Telehealth Laws & Reimbursement Policies

Texas Telehealth Laws

Medicaid Telehealth Reimbursement

Summary

Texas Medicaid reimburses for live video and store-and-forward in some circumstances. Home telemonitoring is reimbursable for some conditions when a provider is approved to deliver those services.

Read More

Definitions

"Telehealth service" means a health service, other than a telemedicine medical service, that is delivered by a licensed or certified health professional acting within the scope of the health professional's license or certification who does not perform a telemedicine medical service and that requires the use of advanced telecommunications technology, other than telephone or facsimile technology.

Read More

Live Video

Policy
Synchronous audiovisual interaction is reimbursable under Texas Medicaid.

Read More

Eligible Services/Specialties
Click for a list of reimbursable services.

Read More

Eligible Providers
Click for a list of eligible distant site providers.

Read More

Eligible Sites
Click for a list of eligible originating sites.

Read More

Geographic Limits
Facility/Transmission Fee
Patient-site providers that are enrolled in Texas Medicaid may only be reimbursed for the facility fee using procedure code Q3014. Procedure code Q3014 is payable to NP, CNS, PA, physicians, and outpatient hospital providers. Charges for other services that are performed at the patient site may be submitted separately. Procedure code Q3014 is not a benefit if the patient site is the client’s home.

Read More

Store-and-Forward

Policy
Asynchronous store and forward technology, including asynchronous store and forward technology in conjunction with synchronous audio interaction between the distant site provider and the patient in another location is reimbursable under Texas Medicaid.

Read More

Eligible Services/Specialties
Geographic Limits
Transmission Fee

Remote Patient Monitoring

Policy
Texas Medicaid will reimburse for home telemonitoring in the same manner as their other professional services provided by a home health agency.

Read More

Conditions
Click to see list of patient eligibility.

Read More

Provider Limitations
Providers must be enrolled and approved as home telemonitoring services providers.

Read More

Other Restrictions
Patients that meet the condition criteria must exhibit two or more of certain risk factors. Click to view the risk factors.

Read More

Click to see a list of risk factor criteria.

Read More

Email/Phone/Fax

No reimbursement for audio-only telephone consultation.
No reimbursement for text-only email message.
No reimbursement for facsimile transmission.

Read More

Consent

Written or verbal consent must be obtained to allow any other individual (besides the distant site provider, patient site presenter or representative) to be present during a telemedicine or telehealth visit.

Read More

Out of State Providers

An out-of-state physician who is a distant site provider may provide episodic telemedicine medical services without a Texas medical license as outlined in Texas Statute and Regulation.

Read More

Miscellaneous

Click for a list of miscellaneous requirements for Texas Medicaid.

Read More

Private Payer Laws

Definitions

"Telehealth service" means a health service, other than a telemedicine medical service, delivered by a health professional licensed, certified, or otherwise entitled to practice in this state and acting within the scope of the health professional's license, certification, or entitlement to a patient at a different physical location than the health professional using telecommunications or information technology.

Read More

Requirements

Each issuer of a health benefit plan must adopt and display in a conspicuous manner on their website the policies and payment practices for telemedicine medical services and telehealth services. They, however, are not required to list payment rates.

Read More

Parity

Prohibits a health benefit plan from excluding from coverage a service delivered as a telemedicine medical service or a telehealth service solely because the service is not provided in-person. A health plan is not required to provide coverage for services provided by only synchronous or asynchronous audio interaction including audio-only telephone; email or facsimile.

Read More

Professional Regulation/Health & Safety

Definitions

Telehealth service means a health service, other than a telemedicine medical service, delivered by a health professional licensed, certified, or otherwise entitled to practice in this state and acting within the scope of the health professional’s license, certification, or entitlement to a patient at a different physical location than the health professional using telecommunications or information technology.

Read More

Consent

Consent required prior to telemedicine or telehealth services.

Read More

Online Prescribing

A valid practitioner-patient relationship is present between a practitioner providing a telemedicine medical service and a patient receiving the telemedicine medical service as long as the practitioner complies with the same standard of care as would apply in an in-person setting, and complies with specified standards.

Read More

Cross State Licensing

A telemedicine license may be issued for out of state providers.

Read More

Miscellaneous

Click for additional professional and health & safety requirements.

Read More

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 47 states

with the ability to service 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
AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY DC
linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram