Kentucky Medicaid Telehealth Reimbursement

 Medicaid Reimbursement / Posted 6 months ago by Telehealthist

Kentucky Medicaid is required to reimburse for covered services provided to a Medicaid recipient through telehealth. The Department must establish requirements for telehealth coverage and reimbursement which are equivalent to the coverage for the same service provided in-person unless the telehealth provider and the Medicaid program contractually agree to a lower reimbursement rate for telehealth services, or the Department establishes a different reimbursement rate.

Definitions
Telehealth means the delivery of health care-related services by Medicaid provider who is a health care provider licensed in Kentucky to a Medicaid recipient through a face-to-face encounter with access to real-time interactive audio and video technology or store-and-forward services that are provided via asynchronous technologies as the standard practice or care where images are sent to a specialist for evaluation.

Live Video
Policy
Kentucky Medicaid will reimburse for a ‚Äútelehealth consultation‚ÄĚ, which includes live video. Reimbursement shall not be denied solely because an in-person consultation between a provider and a patient did not occur.

Eligible Services/Specialties
Click to see a list of covered services.

Eligible Providers
Click for a list of eligible providers.

Eligible Sites
Place of service is anywhere the patient is located at the time a telehealth service is provided, and includes telehealth services provided to a patient at home or office, or a clinic, school or workplace.

Geographic Limits
No reference found.

Facility/Transmission Fee
No reference found.

Store-and-Forward
Policy
KY Medicaid reimburses for telehealth consultations, the definition of which encompasses store-and-forward.

Eligible Services/Specialties
Click to see list of specialties.

Geographic Limits
No reference found.

Transmission Fee
No reference found.

Remote Patient Monitoring
Policy
Remote patient monitoring shall not be an eligible telehealth service within the fee-for-service Medicaid program except under specific circumstances.

Conditions
No reference found.

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
The Cabinet for Health and Family Services must ensure informed consent among Medicaid providers using telehealth.

Out of State Providers
KY Medicaid program required to only allow providers licensed in Kentucky to receive reimbursement for telehealth services.

Miscellaneous
The Cabinet for Health and Family Services is required to have certain telehealth policies. Click to see list of requirements.