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Forty-eight state Medicaid programs and the District of Columbia have some type of telemedicine coverage. However, Medicaid differs from Medicare in that its policies vary from state to state; each state has the flexibility to determine how it will reimburse for telehealth, and many have gone well beyond the scope of Medicare.  Each year, additional states expand their scope of reimbursement, and new proposals are filed constantly. 

Here are some key high-level insights, although it’s important for medical professionals and administrators managing the systems they work in to review state-specific resources. The American Telemedicine Association’s (ATA) report, State Telemedicine Gaps Analysis, is one particularly comprehensive and accurate resource. The following overview of Medicaid policies is broken down by the determining factors of patient setting, technology, and provider type. 

Patient Setting: According to the ATA’s report, 24 states and the District of Columbia do not specify a patient setting as a condition for reimbursement, and 25 states recognize the home as an originating site. This means that many Medicaid patients do not have to travel to a traditional healthcare setting, allowing them to take advantage of the convenience afforded by telemedicine. While some state Medicaid regulations do still require a telepresenter, the overall trend is favorable for reimbursement across diverse patient settings. 

Technology: Similar to the patient setting, no one policy dictates reimbursable technology across all state Medicaid programs. A broad span of modalities—from telephone to video to remote monitoring and store-and-forward technologies—is in play. According to the ATA, states are slowly but surely embracing a variety of new technologies for the delivery of telemedicine. 

Provider Type: While states can vary with regard to the provider types they reimburse, generally the outlook is positive. Fifteen states place no restriction on the provider type, according to the Berkeley Research Group. In addition, only four states restrict reimbursement to physicians. There is also an overall encouraging trend toward Medicaid coverage for mental and behavioral health services delivered via telemedicine.