Medicaid Telehealth Reimbursement
Summary
Wyoming Medicaid reimburses for live video under some circumstances. There is no reference to store-and-forward or remote patient monitoring reimbursement.
Definitions
“Telehealth is the use of an electronic media to link beneficiaries with health professionals in different locations…This means that the patient must be able to see and interact with the off-site physician at the time services are provided via telehealth technology.”
Live Video
Policy
Reimbursement is made for exams performed via a real time interactive audio and video telecommunications system. The patient must be able to see and interact with the off-site practitioner during the exam.
Eligible Services/Specialties
See manual for list of eligible hub site billing codes. Group psychotherapy is not a covered service.
Eligible Providers
Click to view list of eligible providers.
Eligible Sites
Click to view list of eligible sites.
Geographic Limits
No reference found.
Facility/Transmission Fee
Yes, for originating site fees. No reimbursement for transmission fees.
Store-and-Forward
Policy
Wyoming Medicaid states that reimbursement is made for exams performed via a real-time interactive audio and video.
Eligible Services/Specialties
No reference found.
Geographic Limits
No reference found.
Transmission Fee
No reference found.
Remote Patient Monitoring
Policy
No reference found.
Conditions
No reference found.
Provider Limitations
No reference found.
Other Restrictions
No reference found.
Email/Phone/Fax
No reimbursement for email. No reimbursement for telephone. No reimbursement for FAX.
Consent
If the patient and/or legal guardian indicates at any point that he/she wants to stop using the technology, the service should cease immediately and an alternative appointment set up.
Out of State Providers
Out-of-state providers are allowed if they are enrolled as a Wyoming Medicaid provider.
Miscellaneous
A single pay to provider can bill both the originating site (spoke site) and the distant site provider (hub site) when applicable.
Private Payer Laws
Definitions
No reference found.
Requirements
No reference found.
Parity
No reference found.
Professional Regulation/Health & Safety
Definitions
Physicians and Surgeons: “Telemedicine means the practice of medicine by electronic communication or other means from a physician in a location to a patient in another location, with or without an intervening health care provider.”
Consent
Written or oral consent required for physical therapy.
Online Prescribing
Prescribing a controlled substance through the Internet, World Wide Web or any similar proprietary or common carrier electronic system without a documented physician-patient relationship is subject to review, discipline and consequences to license.
Cross State Licensing
Member of the following: Nurse Licensure Compact and Interstate Medical Licensure Compact.
Miscellaneous
Boards have power to adopt telehealth/telemedicine definitions applicable to their regulated profession and standards for the practice of telemedicine/telehealth.
Source: Center for Connected Health Policy
https://www.cchpca.org