Missouri Medicaid Telehealth Reimbursement

 Medicaid Reimbursement / Posted 6 months ago by Telehealthist

Missouri Medicaid will reimburse for services delivered via live video.

Definitions
“Telehealth” or “telemedicine”, the delivery of health care services by means of information and communication technologies which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care while such patient is at the originating site and the health care provider is at the distant site. Telehealth or telemedicine shall also include the use of asynchronous store-and-forward technology.

Live Video
Policy
The department of social services shall reimburse providers for services provided through telehealth if such providers can ensure services are rendered meeting the standard of care that would otherwise be expected should such services be provided in-person. Reimbursement for telehealth services shall be made in the same way as reimbursement for in-person contact; however, consideration shall also be made for reimbursement to the originating site.

Eligible Services/Specialties
Click for a list of eligible services and specialties.

Eligible Providers
Click for a list of eligible providers.

Eligible Sites
The department shall not restrict the originating site through rule or payment so long as the provider can ensure services are rendered meeting the standard of care that would otherwise be expected should such services be provided in-person.

Geographic Limits
Payment for services rendered via telehealth shall not depend on any minimum distance requirement between the originating and distant site.

Facility/Transmission Fee
Providers can bill Q3014 for the telehealth originating site facility fee.

Store-and-Forward
Policy
Reimbursement for asynchronous store-and-forward may be capped at the reimbursement rate had the service been provided in-person.

Eligible Services/Specialties
No reference found.

Geographic Limits
No reference found.

Transmission Fee
No reference found.

Remote Patient Monitoring
Policy
Subject to appropriations, the department shall establish a statewide program that permits reimbursement under the MO HealthNet program for home telemonitoring services.

Conditions
Click for a list of eligible conditions.

Provider Limitations
The program must ensure the home health agency or hospital shares telemonitoring clinical information with participant’s physician.

Other Restrictions
If, after implementation, the department determines that the program established under this section is not cost effective, the department may discontinue the program and stop providing reimbursement under the MO HealthNet program for home telemonitoring services. The department shall promulgate rules and regulations to implement the provisions of this section.

Email/Phone/Fax
No reference found.

Consent
Prior to the provision of telehealth services in a school, the parent or guardian of the child shall provide authorization for the provision of such service. Such authorization shall include the ability for the parent or guardian to authorize services via telehealth in the school for the remainder of the school year.

Out of State Providers
Payment cannot be made to entities outside of the US, and US territories.

Miscellaneous
Special documentation requirements apply.