While telehealth grows in popularity among consumers, it remains difficult for physicians and healthcare systems to offer these services, due to the uncertainty regarding reimbursements. This is especially true when it comes to Medicaid reimbursement for telehealth.
Understanding the way that reimbursements work through the various payers is essential for getting physicians to embrace telehealth. The confusion surrounding these reimbursements causes many providers to decide that it makes more sense to continue only offering traditional, in-person services and not including telehealth in their practice.
In order to offer telehealth services, physicians and other healthcare systems need to understand how telehealth reimbursements work. The three major payers, Medicaid, Medicare, and commercial payers, all have different guidelines for dealing with telehealth.
Not only that, but as telehealth becomes more in demand and utilized, reimbursement policies are changing and progressing. Keeping educated and aware of the evolving policies regarding telehealth reimbursements will help a greater number of providers to be comfortable offering their patients these services.
Medicaid offers telehealth coverage in at least 48 states, as many Americans have Medicaid and telehealth services are becoming more and more in demand. For providers to offer telehealth services to their Medicaid patients, they need to be informed how Medicaid reimburses for telemedicine.
Medicaid reimbursement for telehealth
Medicaid policies for telehealth reimbursement vary by state. In fact, each state determines their specific reimbursement policies for Medicaid. This makes it a longer process for providers to understand how telehealth services are reimbursed, as they need to check the specific policies for their state. However, there are some basic factors that make up Medicaid reimbursement that are utilized on a wider level.
Medicaid reimbursement for telehealth tends to look at three components in their usual reimbursement policies; technology, patient setting, and type of provider.
Over half of the states where telehealth coverage is offered through Medicaid have no specific patient setting required for reimbursement. What this means for telehealth patients is that they do not have to be seen at a medical facility or clinic in order to be covered.
There is also no required technology for telehealth services. Visits can happen through a number of mediums including phone, video, remote monitoring, and more.
There is also a positive trend in provider type when it comes to telehealth reimbursement and Medicaid. Many states have no restrictions on the type of provider that can be reimbursed for telehealth services, and only a few restrict reimbursement to only physicians. However, even in the states that restrict telehealth reimbursement, change is on the horizon as telemedicine grows in popularity.
Final thoughts
Medicaid reimbursement for telehealth is unique to each state. Some have more restrictions than others which is why we recommend you reach out to your agency. Read more online or take free courses at Telehealthist.com.