Mississippi Medicaid Telehealth Reimbursement
Mississippi Medicaid reimburses certain providers for live video telehealth when there is a telepresenter with the patient. They also reimburse for store-and-forward teleradiology, and for remote patient monitoring for patients with certain chronic conditions.
Telemedicine means the delivery of health care services such as diagnosis, consultation, or treatment through the use of interactive audio, video or other electronic media. Telemedicine must be “real-time” consultation, and it does not include the use of audio-only telephone, e-mail or facsimile.
Mississippi Medicaid and private payers are required to provide coverage for live video consultations.
The Division of Medicaid covers medically necessary telehealth services as a substitution for an in-person visit or encounter for consultations, office visits and/or outpatient visits.
Any enrolled Medicaid provider may provide telehealth services at the originating site.
Click for a list of eligible sites.
No reference found.
The Division of Medicaid reimburses the originating site the Mississippi Medicaid telehealth originating site facility fee for telehealth services per completed transmission.
Private payers, MS Medicaid and employee benefit plans are required to provide coverage at the same extent as in-person consultation for store-and-forward telemedicine services.
Store-and-forward includes, but is not limited to teleradiology. The Division of Medicaid covers one technical and one professional component for each teleradiology procedure only for providers enrolled in MS Medicaid and when there are no geographically local radiologist providers to interpret the images.
MS Medicaid only covers teleradiology when there are no geographically local radiologist providers to interpret images.
No transmission fee.
Remote Patient Monitoring
Private payers, MS Medicaid and employee benefit plans are required to provide coverage for remote patient monitoring services for Mississippi-based telehealth programs affiliated with a Mississippi health care facility.
Click for a list of criteria conditions.
Remote patient monitoring services must be delivered by an enrolled Medicaid provider acting within their scope-of-practice and license and in accordance with state and federal guidelines. Must be ordered by a physician, physician assistant or nurse practitioner.
Remote patient monitoring prior authorization request form must be submitted to request telemonitoring services.
No reimbursement for email.
No reimbursement for telephone.
No reimbursement for facsimile
Signed consent for using telehealth is required.
Out of State Providers
For teleradiology, consulting and referring provider is a licensed physician (or PA or NP for referring providers) who interprets the radiological image, at the distant site and who must be licensed in the state within the United States in which he/she practices.
See documentation requirements.