Connecticut Medicaid Telehealth Reimbursement

 Medicaid Reimbursement / Posted 6 months ago by Telehealthist

Connecticut Medicaid is required to cover telemedicine services for categories of health care that the commissioner determines are appropriate, cost effective and likely to expand access.

Definitions
Definition for Telemedicine Demonstration Program for FQHCs: “Telemedicine means the use of interactive audio, interactive video or interactive data communication in the delivery of medical advice, diagnosis, care or treatment…Telemedicine does not include the use of facsimile or audio-only telephone.”

Live Video
Policy
CT Medicaid is required to provide coverage for telehealth services for categories of health care services that the commissioner determines are clinically appropriate to be provided through telehealth, cost effective for the state and likely to expand access to services where there is a clinical need for those services to be provided by telehealth or for Medicaid recipients whom accessing healthcare poses an undue hardship.

Eligible Services/Specialties
Case management behavioral health services for clients age eighteen and under is the only service allowed.

Eligible Providers
Click for a list of eligible providers.

Eligible Sites
No reference found.

Geographic Limits
No reference found.

Facility/Transmission Fee
No telehealth provider shall charge a facility fee for telehealth services.

Store-and-Forward
Policy
Although CT Medicaid previously covered electronic consultations, as of January 1, 2020 and forward, the codes used to bill for electronic consultations are no longer payable under the CT Medical Assistance Program. This is due to guidance received by the Centers for Medicare and Medicaid Services (CMS), that reimbursement for electronic consultations does not meet the federal requirements.

Eligible Services/Specialties
No reference found.

Geographic Limits
No reference found.

Transmission Fee
No reference found.

Remote Patient Monitoring
Policy
No reference found.

Conditions
No reference found.

Provider Limitations
No reference found.

Other Restrictions
No reference found.

Email/Phone/Fax
The department shall not pay for information or services provided to a client over the telephone except for case management behavioral health services for patients aged 18 and under.

Consent
At the time of the telehealth provider’s first telehealth interaction with a patient, the telehealth provider shall inform the patient concerning the treatment methods and limitations of treatment using a telehealth platform and, after providing the patient with such information, obtain the patient’s consent to provide telehealth services.

Out of State Providers
No reference found.

Miscellaneous
The Commissioner is required to submit a report by Aug. 1, 2020 to the joint standing committees of the General Assembly on the categories of health care services in which the department is utilizing telehealth services, in what cities or regions of the state such services are being offered and any cost savings realized by the state by providing telehealth services.