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SPA’s & telemedicine

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CMS reviews state plan amendments (SPA) when changes are made.

  • States are not required to submit a (separate) SPA for coverage or reimbursement of telemedicine services if they decide to reimburse for telemedicine services the same way/amount that they pay for face-to-face services/visits/consultations. 
  • States must submit a (separate) reimbursement (attachment 4.19-B) SPA if they want to provide reimbursement for telemedicine services or components of telemedicine differently than is currently being reimbursed for face-to-face services. 
  • States may submit a coverage SPA to better describe the telemedicine services they choose to cover, such as which providers/practitioners are, where it is provided, how it is provided, etc. In this case, and to avoid unnecessary SPA submissions, it is recommended that a brief description of the framework of telemedicine be placed in an introductory section of the State Plan and then a reference made to telemedicine coverage in the applicable benefit sections of the State Plan.