Iowa State Telehealth Laws and Reimbursement Policies

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Information Provided ByCenter for Connected Health Policy

© Public Health Institute/ Center for
Connected Health Policy 2019: http://cchpca.org

Iowa Medicaid Enterprise (IME)

Iowa
Medicaid Program: Iowa Medicaid Enterprise (IME)

Program Administrator: IA Dept. of Human Services

Regional Telehealth Resource Center:

Great Plains Telehealth Resource and Assistance Center
University of Minnesota/Institute for Health Informatics

330 Diehl Hall
505 Essex Street S.E.
Minneapolis, MN 55455

(888) 239-7092
www.gptrac.org

STATE LAW/REGULATIONS MEDICAID PROGRAM

Definition of telemedicine/telehealth

“Telemedicine means use of a telecommunications No reference found.
system for diagnostic, clinical, consultative, data, and
educational services for the delivery of health care
services or related health care activities by licensed
health care professionals, licensed medical
professionals, and staff who function under the direction
of a physician, a licensed health care professional, or
hospital, for the purpose of developing a
comprehensive, statewide telemedicine network or
education.”
Source: IA Admin. Code, 751 7.1(8D) (2012).

Live Video Reimbursement

Department of Human Services is required to adopt In person contact between a health care professional
rules to provide telehealth coverage under Medicaid. and patient is not required for payment for services
Such rules must provide that in-person contact between otherwise covered and appropriately provided through
a health care professional and a patient is not required telehealth as long as it meets the generally accepted
as a prerequisite for payment. health care practices and standards prevailing in the
Source: IA Senate File 505 (2015). applicable professional community.

Services provided in-person or through telehealth shall
be treated as equivalent for purposes of reimbursement.
Source: IA Admin Code Sec. 441, 78.55 (249A).
https://www.legis.iowa.gov/docs/iac/rule/09-30-2015.441.78.55.pdf

Store and Forward Reimbursement

No reference found. No reference found.

Remote Patient Monitoring Reimbursement

No reference found. No reference found.

Email/Phone/FAX

No reference found. No reference found.

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

Online Prescribing

Pharmacists are prohibited from dispensing prescription No reference found.
drugs if the pharmacist knows or should have known
that the prescription was issued solely on the basis of
an Internet-based questionnaire, an Internet-based
consult, or a telephone consult, and was completed
without a pre-existing patient-provider relationship.
Source: IA Admin. Code, 657 8.19(124,126,155A) (2012).
A physician must be physically present with a woman at
the time an abortion-inducing drug is provided.
Source: IA Admin. Code, 653 13.10.

Consent

No reference found. No reference found.

Location

No reference found. No reference found.

Cross-State Licensing

Iowa adopted the Federation of State Medical Board No reference found.
(FSMB)’s model language for an interstate medical
licensure compact.
Source: IA Senate File 510 (2015).

Private Payers

No reference found. No reference found.

Site/Transmission Fee

No reference found. No reference found.

Miscellaneous

The legislative council is requested to establish a study Recently Adopted Regulation (Now Effective)
committee for the 2017 interim to examine issues Iowa Medicaid uses the 02 POS code adopted by
relating to telehealth parity for private insurers and state Medicare.
employee health plans. Source: IAC 441-79.1

Source: HF 653 (2017), Division XXI, Sec. 95.

Comments:

Professional Board Telehealth-Specific Regulations

IA Board of Medicine (Source: IA Admin Code Sec. 653.13.11)

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