Connecticut State Telehealth Laws and Reimbursement Policies
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Connecticut Medicaid Program
Connecticut
Medicaid Program: Medical Assistance Program
Program Administrator: Connecticut Dept. of Social Services
Regional Telehealth Resource Center:
Northeast Telehealth Resource Center
11 Parkwood Drive
Augusta, ME 04330
(800) 379-2021
www.netrc.org
STATE LAW/REGULATIONS MEDICAID PROGRAM
Definition of telemedicine/telehealth
“Telemedicine means the use of interactive audio, No reference found.
interactive video or interactive data communication in
the delivery of medical advice, diagnosis, care or
treatment…Telemedicine does not include the use of
facsimile or audio-only telephone.”
Source: CT General Statute 17b-245c.
“Telehealth” means the mode of delivering health care
or other health services via information and
communication technologies to facilitate the diagnosis,
consultation and treatment, education, care
management and self-management of a patient’s
physical and mental health, and includes (A) interaction
between the patient at the originating site and the
telehealth provider at a distant site, and (B) synchronous
interactions, asynchronous store and forward transfers
or remote patient monitoring. Telehealth does not
include the use of facsimile, audio-only telephone,
texting or electronic mail.” See private payers section.
Source: CT General Statute 19a, Sec. 906
Live Video Reimbursement
CT Medicaid is required (within available state and federal resources) provide coverage for telehealth services for categories of health care services that the commissioner determines are clinically appropriate to be provided through telehealth, cost effective for the state and likely to expand access to services for whom accessing healthcare poses an undue hardship.
Source: CT Public Act No. 16-198 (SB 298 – 2016).
Reimbursement for services provided via live video.
Source: CT Public Act No. 15-88 (2015); SB 467.
Connecticut’s Medical Assistance Program will not pay for information or services provided to a client by a provider electronically or over the telephone.
Source: CT Provider Manual. Physicians and Psychiatrists. Sec.
17b-262-342. Pg. 9, Aug, 2013 and CT Provider Manual.
Psychologists. Sec. 17b-262-472. Pg. 7. (Accessed Oct. 2017).
Exception:
Case management behavioral health services for clients age eighteen and under.
Source: CT Provider Manual. Behavioral Health. Sec. 17b-262-918. Feb. 1, 2013. Pg. 6. (Accessed Oct. 2017).
Store and Forward Reimbursement
© 2017 Public Health Institute Center for Connected Health Policy
Reimbursement for services provided via store-and- Federally Qualified Health Centers, outpatient office
forward. See private payers section. settings, outpatient hospital settings and clinic settings
can be reimbursed for electronic consults (e-consults)
Source: CT Public Act No. 15-88 (2015); SB 467. for specialty care (provider to provider communication).
Source: CT Policy Transmittal 2017-07. Effective July 1, 2017.
(Accessed Oct. 2017).
Remote Patient Monitoring Reimbursement
No reference found. No reference found.
Email/Phone/FAX
There is no reimbursement for telephone or FAX. The department shall not pay for information or services
Source: CT General Statutes17b-245c & CT Public Act No. 15-88 provided to a client over the telephone.
(2015); SB 467. Source: CT Provider Manual. Clinic. Sec. 17b-262-823. Ch. 8, pg.
20, July 17, 2014. (Accessed Oct. 2017).
Online Prescribing
No telehealth provider shall prescribe schedule I, II or III No reference found.
controlled substances through the use of telehealth.
Source: CT Public Act No. 15-88 (2015); SB 467.
Consent
At the time of the telehealth interaction, the provider No reference found.
shall provide information to the patient treatment
information, limitations of the telehealth platform, and
obtain consent from the patient to provide telehealth
services and disclose to the patient’s primary care
provider records of the telehealth interaction.
Source: CT Public Act No. 15-88 (2015); SB 467.
Location
No reference found. No reference found.
Cross-State Licensing
Department of Public Health may establish a process of No reference found.
accepting an applicant’s license from another state and
may issue that applicant a license to practice medicine
in the state without examination, if certain conditions are
met.
Source: CT General Statutes Sec. 20-12 (2012).
Private Payers
Each individual health insurance policy and group health No reference found.
insurance policy providing coverage of the type specified
in subdivisions (1), (2), (4), (11) and (12) of section 38a-
469 shall provide coverage for treatment provided via
telehealth if that it was covered if provided in-person and
shall be subject to the same terms and conditions of the
policy.
Source: CT Public Act No. 15-88 (2015); SB 467.
© 2017 Public Health Institute Center for Connected Health Policy
Site/Transmission Fee
No telehealth provider can charge a facility fee. No reference found.
Source: CT Public Act No. 15-88 (2015); SB 467.
Miscellaneous
Comments: In 2012, a new law allowed the Commissioner of Social Services to establish a demonstration project to offer telemedicine as a Medicaid-covered service at Federally Qualified Health Centers. The Commission is considering design options for a pilot.
Source: CT General Statutes17b-245c.