Tool: Telehealth Policy Finder

Across the country, no two states are alike in how they define and regulate telehealth. To help policymakers, health advocates and other health care professionals understand the policies and trends throughout the nation, the Telehealth Policy Finder tool compiles telehealth-related laws and regulations across all 50 states and the District of Columbia, as well as at the federal level.

Spring 2023 Updates

CCHP found many state Medicaid programs are expanding the modalities of telehealth that are reimbursed beyond just live video, and broadening policies for audio-only, such as allowing for additional providers and services. The most notable shift observed in this Spring 2023 edition was the expanded inclusion of additional telehealth modalities for specific use cases in many Medicaid programs. In most instances states already reimbursed for these modalities in a limited capacity, but we saw the policies broaden or refined in this Spring 2023 update. For example, Nebraska Medicaid announced coverage for continuous glucose monitoring (CGM) for eligible beneficiaries with diabetes beginning Jan. 1, 2023. While coverage was already available in the state for telemonitoring, this is the first time CGM specifically has been available through Nebraska Medicaid.

The addition of audio-only reimbursement in Medicaid has been trending for the past two years. In most cases, audio-only reimbursement started out as temporary policy tied to the COVID-19 emergency, however in many states it has already become incorporated into Medicaid permanent reimbursement policy, often through the addition of the 93-modifier to signify the audio-only modality was used. Nevada Medicaid is an example of a Medicaid program that recently announced that audio-only will be allowed outside of the COVID-19 PHE for certain telephone evaluation and management codes.

Medicaid programs continue to refine and add detail to their policies, often providing additional instructions to help providers navigate nuances associated with specific billing scenarios and situations, such as for FQHCs and Rural Health Clinics (RHCs).

Since telehealth started becoming more commonplace, more state professional boards have adopted regulations related to telehealth. Recently, professions that are not typically associated with telehealth delivery of care have been adopting such regulations as professionals find use cases within their profession for the technology.

Interstate licensure compacts continue to be the most popular way to address cross-state licensing issues.

Unlike in the Fall 2022 findings when more states than ever before adopted cross state licensure exceptions, registrations or licenses specific to telehealth, in the Spring 2023 update CCHP only found the state of Washington provided for a new very specific allowance to its in-state licensing requirements. Similarly, CCHP did not find any states with significant changes to their private payer laws in this Spring 2023 reporting period. This lack of change to both private payer laws and cross-state licensing laws may potentially be attributed to the fact that the review of states transpired prior to the culmination of the legislative session in many states, with the majority of bills yet to be enacted. More activity on these topics may occur later in the year and will be noted in our Fall 2023 edition of our report.

Read the full Spring 2023 report, and explore the state summary chart showing where states stand on many key telehealth policies, as well as an infographic highlighting key findings.

Additional findings:

• Fifty states and Washington DC provide reimbursement for some form of live video in Medicaid fee-for-service. Both the jurisdictions of Puerto Rico and Virgin Islands do not explicitly indicate they reimburse for live video in their permanent Medicaid policies.
• Twenty-eight state Medicaid programs reimburse for store-and-forward. Wisconsin, Rhode Island and Illinois are the states which added reimbursement for store-and-forward, although each in a limited capacity.
• Thirty-four state Medicaid programs provide reimbursement for remote patient monitoring (RPM). No states have added RPM reimbursement since Fall 2022, though some states did add additional eligible services, and conditions to their existing RPM reimbursement.
• Thirty-six states and DC Medicaid programs reimburse for audio-only telephone in some capacity; however, often with limitations. Hawaii and Georgia are the two states that added reimbursement in some capacity for audio-only telehealth since Fall 2022.
• Forty-three states, the District of Columbia and Virgin Islands have a private payer law that addresses telehealth reimbursement. Not all of these laws require reimbursement or payment parity. Twenty-four states have explicit payment parity. There has been no movement in private payer laws since Fall 2022.

Getting started with the Policy Finder

Launched in Spring 2021 by PHI’s Center for Connected Health Policy (CCHP), the Policy Finder tool is a searchable, easy-to-use database that is updated consistently throughout the year. Formerly known as the State Telehealth Laws and Reimbursement Report, the information from the online database can be exported for each state into a PDF document using the most current information available on CCHP’s website.

Use the Policy Finder tool to:

• Look up telehealth-related laws and regulations by topic, including COVID-19, Medicaid & Medicare, Private Payer and Professional Requirements
• Explore all current laws, temporary COVID-19 actions, and pending legislation in all 50 states and the District of Columbia, as well as at the federal level
• Compare the policy of any of the topic areas for any two states
• View color-coded maps recapping policy trends by state across topic areas, including Medicaid reimbursement for live video, store and forward and remote patient monitoring

The Policy Finder is designed to provide timely policy information that is easy for users to navigate and understand. Watch a quick tutorial to explore the tool, see how to use it and learn about its features:

Please note: this information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.

Originally published by Center for Connected Health Policy