Tennessee Medicaid Telehealth Reimbursement

 Medicaid Reimbursement / Posted 1 year ago by Telehealthist

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

Tennessee Medicaid (TennCare) reimburses for live video only for crisis-related services. TennCare services are offered through managed care entities. Each MCO has its own telehealth policy. Coverage and reimbursement for live video and store-and-forward may vary between MCOs.

Definitions
Telehealth means the use of real-time interactive audio, video telecommunications or electronic technology, or store-and-forward telemedicine services by a healthcare services provider to deliver healthcare services to a patient within the scope of practice of the healthcare services provider when such provider is at a qualified site other than the site where the patient is located; and the patient is at a qualified site at a school clinic staffed by a healthcare services provider and equipped to engage in the telecommunications described in this section or a public elementary or secondary school staffed by a health care services provider and equipped to engage in the telecommunications described in this section and does not include audio only conversation; an electronic mail message or facsimile transmission.

Live Video
Policy
Health insurance entities (including managed care organizations) participating in the medical assistance program are required to provide coverage for telehealth (which includes live video) delivered services in a manner that is consistent with the health insurance policy or contract provided for in-person services.

Eligible Services/Specialties
Mental Health & Substance Abuse Services: TennCare will reimburse for live video for crisis-related services or an assessment for emergency admission by an in-patient psychiatric facility.

Eligible Providers
No reference found.

Eligible Sites
Click to view list of eligible sites.

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

Geographic Limits
Reimbursement and coverage must be provided for telehealth services without any distinction or consideration of the geographic location or any federal, state, or local designation, or classification of the geographic area where the patient is located.

Facility/Transmission Fee
No reference found.

Store-and-Forward
Policy
Telehealth systems must be live and interactive, however TN Medicaid Managed Care plans must cover and reimburse for store-and-forward telemedicine services. Click for details.

Eligible Services/Specialties
No reference found.

Geographic Limits
Reimbursement and coverage must be provided for telehealth services without any distinction or consideration of the geographic location or any federal, state, or local designation, or classification of the geographic area where the patient is located.

Transmission Fee
No reference found.

Remote Patient Monitoring
Policy
No reference found.

Conditions
No reference found.

Provider Limitations
No reference found.

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

Consent
Privacy policies must be reviewed with the individual before beginning a telehealth assessment and the review must be documented in the patient record. The patient must be informed about privacy policies and given an opportunity to request an in-person assessment before receiving a telehealth assessment.

Out of State Providers
No reference found.

Miscellaneous
No reference found.

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