Colorado Medicaid Telehealth Reimbursement

 Medicaid Reimbursement / Posted 6 months ago by Telehealthist

Colorado Medicaid reimburses for live video for medical and mental health services. They also provide reimbursement for remote patient monitoring for patients with certain chronic conditions. Colorado Medicaid requires a member to be present and participating in a telemedicine service, excluding the possibility of utilizing store-and-forward, except in the case of teledentistry for an interim therapeutic restoration.

Definitions
Telemedicine is the delivery of medical services and any diagnosis, consultation, treatment, transfer of medical data or education related to health care services using interactive audio, interactive video, or interactive data communication instead of in-person contact.

Live Video
Policy
CO Medicaid will cover medically necessary medical and surgical services furnished to eligible members via telemedicine which can involve up to two collaborating providers and the member. It is acceptable to use Telemedicine to facilitate live contact directly between a member and a distant provider via telecommunications equipment.

Eligible Services/Specialties
Colorado Medicaid will reimburse for medical and mental health services delivered through telemedicine that are otherwise eligible for reimbursement under the program.

Eligible Providers
Click to see list of eligible providers.

Eligible Sites
Services can be provided via telemedicine between a member and a distant provider when a member is located in their home or other location of their choice.

Geographic Limits
No reference found.

Facility/Transmission Fee
The originating site is eligible for a facility fee.

Store-and-Forward
Policy
The member must be present during any Telemedicine Services collaboration between two providers where there is an originating provider and a distant provider.

Eligible Services/Specialties
Limited reimbursement allowed for an interim therapeutic restoration in teledentistry.

Geographic Limits
No reference found.

Transmission Fee
No reference found.

Remote Patient Monitoring
Policy
The CO Medical Assistance Program will reimburse for home health care or home and community-based services through telemedicine at a flat fee set by the state board.

Conditions
Click for a list of requirements.

Provider Limitations
Any home health agency is eligible to provide services.

Other Restrictions
Click for a list of additional restrictions for home health services.

Email/Phone/Fax
No reimbursement for telephone.
No reimbursement for FAX.

Consent
The Medicaid requirement for face-to-face contact between provider and member may be waived prior to treating the member through telemedicine for the first time.

Out of State Providers
No reference found.

Miscellaneous
Managed care may or may not reimburse telemedicine costs.