Medicaid Telehealth Reimbursement
Forward Medicaid allows reimbursement for live video under some circumstances. There is no reimbursement for store-and-forward or remote patient monitoring as services must be delivered at the same functional equivalency as face-to-face care.
Telehealth enables a provider who is located at a distant site to render the service remotely to a member located at an originating site using a combination of interactive video, audio, and externally acquired images through a networking environment.
Out of State Providers
Out-of-state providers who do not have border status enrollment with WI Medicaid are required to obtain prior authorization (PA) before providing services. WI Medicaid is prohibited from paying providers located outside of the US and its territories.
Professional Regulation/Health & Safety
Telemedicine means the practice of medicine when patient care, treatment or services are provided through the use of medical information exchanged from one site to another via electronic communications.
When a physician uses a website to communicate with a patient located in this state, the physician may not provide treatment recommendations, including issuing a prescription unless certain requirements are met.