Maryland Medicaid Telehealth Reimbursement

 Medicaid Reimbursement / Posted 6 months ago by Telehealthist

Maryland Medicaid covers live video telehealth conducted by specific providers and specific originating sites.

Telemedicine means, as it relates to the delivery of health care services, the use of interactive audio, video, or other telecommunications or electronic technology.

Live Video
Reimbursement for telehealth is required for services appropriately delivered through telehealth and may not exclude from coverage a health care service solely because it is through telehealth.

Eligible Services/Specialties
Covered Services – Somatic and behavioral health services: Providers must contact the participant’s Healthchoice MCO or behavioral health ASO with questions regarding prior authorization requirements for telehealth services.

Eligible Providers
Click for a list of eligible providers.

Eligible Sites
Click for a list of eligible sites.

Geographic Limits
Mental Health: To be eligible a beneficiary must reside in one of the designated rural geographic areas or whose situation makes person-to-person psychiatric services unavailable.

Facility/Transmission Fee
Facility charges related to the use of telemedicine services. This revenue code is payable for dates of service 10/1/13 forward.

The department may provide reimbursement for services delivered through store-and-forward technology.

Eligible Services/Specialties
MD Medicaid does not cover store-and-forward. However, dermatology, ophthalmology and radiology are excluded from definition of store-and-forward. They do reimburse for these services according to COMAR

Geographic Limits
No reference found.

Transmission Fee
No reference found.

Remote Patient Monitoring
The department may provide reimbursement for services delivered through remote patient monitoring technology.

Click for a list of eligible conditions.

Provider Limitations
Click for a list of eligible providers.

Other Restrictions
Preauthorization required.

No reimbursement for email.
No reimbursement for telephone.
No reimbursement for FAX.

The originating site must obtain consent from the patient prior to engaging in telehealth and be documented in the medical record. If the participant is unable to provide consent, the medical record must contain in writing an explanation as to why the participant was unable to consent to services rendered via telehealth.

Out of State Providers
No reference found.

Click for a list of miscellaneous requirements.