Alabama Medicaid Telehealth Reimbursement

 Medicaid Reimbursement / Posted 1 year ago by Telehealthist

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Alabama Medicaid reimburses for live video under some circumstances. The Agency will not reimburse providers for origination site or transmission fees. For all telemedicine services, an appropriately trained staff member or employee familiar with the patient’s treatment plan must be immediately available in-person to the patient. They make no reference to store-and-forward reimbursement, but the program reimburses for In-Home Monitoring through the Alabama Coordinated Health Network program for diabetes and Chronic Heart failure, although it’s not considered to fall under the telemedicine program.

Definitions
There is no explicit definition of “telemedicine” given in state Medicaid policy. However, the provider manual states service requirements similar to telemedicine.

Live Video
Alabama Medicaid reimburses for live video for certain services.

Eligible Services/Specialties
Click for a list of eligible specialties.

Eligible Providers
All physicians with an Alabama license, enrolled as a provider with the Alabama Medicaid Agency, regardless of location, are eligible to participate in the Telemedicine Program to provide medically necessary telemedicine services to Alabama Medicaid eligible recipients.

Eligible Sites
Click for a list of eligible sites.

Geographic Limits
For rehabilitative services, the originating site must be located in Alabama. The distant site may be located outside of Alabama as long as the physician has an Alabama license and is enrolled as an Alabama Medicaid provider.

Facility/Transmission Fee
No reimbursement for originating site or transmission fees.

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Store-and-Forward
Policy
No reference found.

Eligible Services/Specialties
No reference found.

Geographic Limits
No reference found.

Transmission Fee
No reference found.

Remote Patient Monitoring
Policy
Alabama Medicaid will reimburse remote patient monitoring for specified conditions through the In-Home Remote Patient Monitoring Program. The program is administered by the Alabama Coordinated Health Network (ACHN). Patients may be referred to the program by any source including a physician, ACHN Care Coordinators, patient or caregiver, the Health Department, hospitals, home health agencies or community-based organizations. Orders for In-Home Monitoring along with the specific parameters for daily monitoring must be obtained from the patient’s primary medical provider prior to evaluation and admission.

Conditions
Click for a list of eligible conditions.

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
Physician must obtain prior consent from the recipient before services are rendered, this will count as part of each recipient’s benefit limit of 14 annual physician office visits currently allowed.

Out of State Providers
Providers must have an Alabama license.

Miscellaneous
All procedure codes billed for telemedicine services must be billed with modifier GT.

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