New Jersey Medicaid Telehealth Reimbursement

 Medicaid Reimbursement / Posted 1 year ago by Telehealthist

(adsbygoogle = window.adsbygoogle || []).push({});

New Jersey Medicaid reimburses for live video and remote patient monitoring under certain circumstances. Store-and-forward is not explicitly included in reimbursement; however, it could be covered within the definition of telemedicine. Individual Medicare managed care plans may have their own individual policies regarding telehealth and telemedicine.

Definitions
Telemedicine means the delivery of a health care service using electronic communications, information technology, or other electronic or technological means to bridge the gap between a health care provider who is located at a distant site and a patient who is located at an originating site, either with or without the assistance of an intervening health care provider.

Live Video
Policy

NJ Medicaid must provide coverage and payment for telemedicine or telehealth delivered services on the same basis as when the services are delivered through in-person contact and consultation in NJ.

Eligible Services/Specialties
Psychiatric Services: Telepsychiatry may be utilized by mental health clinics and/or hospital providers of outpatient mental health services to meet their physician related requirements including but not limited to intake evaluations, periodic psychiatric evaluations, medication management and/or psychotherapy sessions for clients of any age.

Eligible Providers
Click for a list of eligible providers.

Eligible Sites
Psychiatric Services: A patient may receive services at the mental health clinic or outpatient hospital program.

Geographic Limits
No reference found.

Facility/Transmission Fee
No reference found.

(adsbygoogle = window.adsbygoogle || []).push({});

Store-and-Forward
Policy
Healthcare providers using engaging in telehealth services may use asynchronous store-and-forward technology for the transmission of medical information. Providers may use interactive, real-time, two- way audio in combination with asynchronous store-and-forward technology if they determine that they are able to meet the accepted standard of care provided in a face-to-face visit.

Eligible Services/Specialties
No reference found.

Geographic Limits
No reference found.

Transmission Fee
No reference found.

Remote Patient Monitoring
Policy
Insurers and NJ Medicaid must provide reimbursement for telemedicine or telehealth on the same basis as, and at a provider reimbursement rate that does not exceed the provider reimbursement rate that is applicable, when services are delivered through in-person contact and consultation. Remote patient monitoring is included within definition of telehealth.

Conditions
No reference found.

Provider Limitations
No reference found.

Other Restrictions
No reference found.

Email/Phone/Fax
Telemedicine does not include the use, in isolation, of audio-only telephone conversation, electronic mail, instant messaging, phone text or facsimile transmission.

Consent
Informed consent is required for telepsychiatry. If a patient chooses not to participate in telepsychiatry, they must be made aware of other face-to-face options and services. If they choose to participate, they must be informed of the location of the psychiatrist/advanced practice nurse providing the telepsychiatry service.

Out of State Providers
A psychiatrist or psychiatric APN may be off-site, but must be licensed in the State of New Jersey.

Miscellaneous
New Jersey’s Medicaid Program is managed care, with five participating health plans. The health plans may or may not have their own telehealth related policies.

(adsbygoogle = window.adsbygoogle || []).push({});