Virginia Medicaid reimburses for live video, store-and-forward, and remote patient monitoring under certain circumstances. Plans participating in the Medicare-Medicaid Demonstration Waiver are permitted to use store-and-forward and remote patient monitoring in rural and urban locations and to provide reimbursement for services.
Telemedicine in your state
Virginia Telehealth State Laws & Reimbursement Policies
Medicaid Telehealth Reimbursement
Summary
Definitions
“Telemedicine is the real-time or near real-time two-way transfer of medical data and information using an interactive audio/video connection for the purposes of medical diagnosis and treatment.”
Live Video
Policy
Reimbursement is provided subject to coverage requirements.
Eligible Services/Specialties
See billing information for specific codes. Click to see list of eligible services.
Eligible Providers
Click to view list of eligible providers.
Eligible Sites
Click to view list of eligible originating sites.
Geographic Limits
Physicians may be physically located outside of VA but must be located within the continental US to deliver telemedicine services. Telemedicine out-of-state coverage does not include other out-of-state providers such as nurse practitioners.
Facility/Transmission Fee
Reimburses a facility fee.
Store-and-Forward
Policy
DMAS reimburses for diabetic retinopathy screening through telemedicine for Medicaid members with Type 1 or 2 diabetes. Radiology related procedures are also included under telemedicine coverage as well as certain codes for teledermatology.
Eligible Services/Specialties
Click to view services covered.
Geographic Limits
Physicians may be physically located outside of VA but must be located within the continental US to deliver telemedicine services. Telemedicine out-of-state coverage does not include other out-of-state providers such as nurse practitioners.
Transmission Fee
Reimburses a facility fee.
Email/Phone/Fax
No reimbursement for email. No reimbursement for telephone. No reimbursement for FAX.
Consent
No reference found.
Out of State Providers
Newly enrolling out-of-state physicians who enter on their enrollment application a service address that is within 50 miles of the Virginia border may be enrolled as in-state providers.
Miscellaneous
Use of telemedicine must be noted in the service documentation of the patient record.
Private Payer Laws
Definitions
Telemedicine services means the use of electronic technology or media, including interactive audio or video for the purpose of diagnosing or treating a patient or consulting with other health care providers regarding a patient’s diagnosis or treatment. ‘Telemedicine services’ does not include an audio-only telephone, electronic mail message, facsimile transmission, or online questionnaire.
Requirements
An insurer shall not exclude a service for coverage solely because the service is provided through telemedicine services.
Parity
The treating provider or consulting provider must be reimbursed on the same basis that the insurer is responsible for coverage for the provision of services face-to-face.
Professional Regulation/Health & Safety
Definitions
Telemedicine services means the use of electronic technology or media, including interactive audio or video for the purpose of diagnosing or treating a patient or consulting with other health care providers regarding a patient’s diagnosis or treatment.
Consent
Informed consent must be obtained and maintained.
Online Prescribing
Effective until July 1, 2020: Practitioners prescribing controlled substances must have a “bona fide” relationship with the patient.
Cross State Licensing
VA adopted the Nurses Licensure Compact.
Miscellaneous
Click to see details on the telemedicine guidance released by the VA Medical Board.
Can I access telehealth services with a Virginia psychiatrist?
Absolutely, many Virginia psychiatrists now offer telehealth services. This allows you to attend appointments from your home or work – wherever you have a private space and a reliable internet connection. Telehealth makes it easier for you to access the mental health services you need, when you need them. Remember it is always important to verify whether your chosen Virginia psychiatrist accepts your health insurance for telehealth sessions.