West Virginia Telehealth State Laws & Reimbursement Policies
Medicaid Telehealth Reimbursement
West Virginia Medicaid reimburses for live video under some circumstances. Reimbursement is only made for real time communications, therefore there is no reimbursement for store-and-forward or remote patient monitoring.
“Telehealth: The use of electronic information and telecommunications technologies to provide professional health care; is often used to connect practitioners and clinical experts in large hospitals or academic medical centers with patients in smaller hospitals or critical access hospitals which are typically located in more remote locations; and can assure that these remotely located patients enjoy the same access to potentially life-saving technologies and expertise that are available to patients in more populated parts of the country.”
West Virginia Medicaid reimburses for a limited number of telehealth services that are provided to enrolled members by enrolled practitioners via a telecommunication system. WV Medicaid utilizes CMS guidance on Telehealth Services.
Out of State Providers
Additional instructions regarding telehealth standards and billing available in the following manuals: Licensed Behavioral Health Center Services (Ch. 503); Behavioral Health Outpatient Services (Ch. 521); School-Based Health Services (Ch. 538). Limited to specific CPT codes.
Professional Regulation/Health & Safety
Practice of telemedicine means the practice of medicine using communication tools such as electronic communication, information technology or other means of interaction between a licensed health care professional in one location and a patient in another location, with or without an intervening health care provider, and typically involves secure real time audio/video conferencing or similar secure audio/video services, remote monitoring, interactive video and store-and-forward digital image or health data technology to provide or support health care delivery by replicating the interaction of a traditional in person encounter between a provider and a patient.
Cross State Licensing
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