Washington DC Medicaid Telehealth Reimbursement

 Medicaid Reimbursement / Posted 1 year ago by Telehealthist

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Medicaid is required to pay for live video telehealth services if the same service would be covered when delivered in-person. Although this law was amended to expand reimbursement to store-and-forward and remote patient monitoring, it was not funded under an approved budget and financial plan and therefore did not go into effect.

Definitions
“Telehealth” means the delivery of healthcare services through the use of interactive audio, video, or other electronic media used for the purpose of diagnosis, consultation, or treatment; provided, that services delivered through audio-only telephones, electronic mail messages, or facsimile transmissions are not included.

Live Video
Policy
DC Medicaid must reimburse for health services through telehealth if the same service would be covered when delivered in person.

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

Eligible Providers
Click for a list of eligible providers.

Eligible Sites
Click for a list of eligible sites.

Geographic Limits
No reference found.

Facility/Transmission Fee
Although facility fees was included under enacted legislation B22-233, it did not become law because it was “not funded” under an approved budget.

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Store-and-Forward
Policy
No reimbursement for store-and-forward.

Eligible Services/Specialties
No reference found.

Geographic Limits
No reference found.

Transmission Fee
No reference found.

Remote Patient Monitoring
Policy
Although remote patient monitoring was included under enacted legislation B22-233, it did not become law because it was “not funded” under an approved budget.

Conditions
No reference found.

Provider Limitations
Click to see a list of provider limitations.

Other Restrictions
No reference found.

Email/Phone/Fax
DC Medicaid does not reimburse for service delivery using audio-only telephones, e-mail messages or facsimile transmissions.

Consent
Written consent required.

Out of State Providers
“For services rendered outside of the District, providers shall meet any licensure requirements of the jurisdiction where he/she is physically located and the jurisdiction where the patient is physically located.”

Miscellaneous
Where an FQHC provides an allowable healthcare service at the originating or distant site, the FQHC shall be reimbursed the applicable rate (PPS, APM or FFS). If an FQHC is both the originating and distant site, only the distant site will be reimbursed.

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