Mississippi Medicaid Telehealth Reimbursement

 Medicaid Reimbursement / Posted 6 months ago by Telehealthist

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.

Definitions
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.

Live Video
Policy
Mississippi Medicaid and private payers are required to provide coverage for live video consultations.

Eligible Services/Specialties
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.

Eligible Providers
Any enrolled Medicaid provider may provide telehealth services at the originating site.

Eligible Sites
Click for a list of eligible sites.

Geographic Limits
No reference found.

Facility/Transmission Fee
The Division of Medicaid reimburses the originating site the Mississippi Medicaid telehealth originating site facility fee for telehealth services per completed transmission.

Store-and-Forward
Policy
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.

Eligible Services/Specialties
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.

Geographic Limits
MS Medicaid only covers teleradiology when there are no geographically local radiologist providers to interpret images.

Transmission Fee
No transmission fee.

Remote Patient Monitoring
Policy
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.

Conditions
Click for a list of criteria conditions.

Provider Limitations
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.

Other Restrictions
Remote patient monitoring prior authorization request form must be submitted to request telemonitoring services.

Email/Phone/Fax
No reimbursement for email.
No reimbursement for telephone.
No reimbursement for facsimile

Consent
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.

Miscellaneous
See documentation requirements.