Nebraska State Telehealth Laws and Reimbursement Policies

[gview file=”https://mtelehealth.com/wp-content/uploads/2020/05/State-Telehealth-Laws-and-Reimbursement-Policies-Nebraska.pdf”]
AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Information Provided ByCenter for Connected Health Policy

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

Nebraska Dept. of Health and Human Services

Nebraska
Medicaid Program: Nebraska Medicaid

Program Administrator: NE Dept. of Health and 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

Telehealth means the use of medical information Telehealth consultation means any contact between a
electronically exchanged from one site to another, client and a health care practitioner relating to the health
whether synchronously or asynchronously, to aid a care diagnosis or treatment of such client through
health care practitioner in the diagnosis or treatment of a telehealth. For the purposes of telehealth, a
patient. Telehealth includes services originating from a consultation includes any service delivered through
patient’s home or any other location where such patient telehealth.
is located, asynchronous services involving the
acquisition and storage of medical information at one Source: NE Admin. Code Title 471, Ch. 1, Manual Letter #52-2016.
site that is then forwarded to or retrieved by a health (Accessed Oct. 2017).
care practitioner at another site for medical evaluation, Telemonitoring is the remote monitoring of a client’s vital
and telemonitoring.
signs, biometric data, or subjective data by a monitoring

Source: NE Rev. Statute, 71-8503. (LB 1076) & LB 257 (2015). device which transmits such data electronically to a
health care practitioner for analysis and storage.

Telehealth consultation means any contact between a Source: NE Admin. Code Title 471, Ch. 1,
patient and a health care practitioner relating to the

health care diagnosis or treatment of such patient
through telehealth.
Source: NE Rev. Statute, 71-8503. (LB 1076)

Live Video Reimbursement

In-person contact is not required for reimbursable Nebraska Medicaid provides coverage for telehealth at
services under the Medicaid program, subject to the same rate as in-person services when the
reimbursement policies developed. This policy also technology meets industry standards and is HIPAA
applies to managed care plans who contract with the compliant.
Department only to the extent that: Medicaid will reimburse a consulting health care
Services delivered via telehealth are covered
and reimbursed under the fee-for-service provider if after obtaining and analyzing the transmitted
program and information, the consulting provider reports back to the
Managed care contracts are amended to add referring health care practitioner. Payment is not made
coverage of services delivered via telehealth to the referring health care practitioner who sends the
Reimbursement shall, at a minimum, be set at the same medical documentation.
Practitioner consultation is not covered for behavioral
rate as a comparable in-person consult and the rate
must not depend on the distance between the health health when the client has an urgent psychiatric
care practitioner and the patient. condition requiring immediate attention by a licensed

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

Source (authorization and reimbursement): NE Revised Statutes mental health practitioner.

Sec. 71-8506. Source: NE Admin. Code Title 471, Ch. 1, Manual Letter #52-2016.
Children’s Behavioral Health (Accessed Oct. 2017).
ACT Team interventions may be provided via telehealth.

The Department shall adopt rules and regulations
providing for telehealth services for children’s behavioral
health. Source: NE Admin. Code Title 471, Ch. 35, Manual Letter #89-
2008. (Accessed Oct. 2017).
Source: Revised Statutes of NE. Sec. 71-8509.. A safety plan must be developed for clients, (except

A trained staff member must be immediately available to children receiving behavioral health services).
a child receiving telehealth behavioral health service. Source: Physician Provider Handbook, Manual Letter 63-2014
This requirement may be waived by a legal guardian
and in cases where there is a threat that the child may (accessed Oct. 2017).

harm themselves, a safety plan must be developed. Federally Qualified Health Centers & Rural Health
Source: Revised Statutes of NE. Sec. 71-8509 Clinics
FQHC & RHC core services provided via telehealth are

not covered under the encounter rate.
Source: NE FQHC Provider Handbook, Manual Letter 11-2010 &
NE RHC Provider Handbook, Manual Letter 11-2010. (Accessed
Oct. 2017).
Assertive Community Treatment (ACT)

ACT Team Interventions may be provided via telehealth
when provided according to certain regulations.
Source: NE Mental Health & Substance Abuse Provider
Handbook, Ch. 35 Rehabilitative Psychiatric Services, Manual
Letter 89-2008. (Accessed Aug, 2016).

Store and Forward Reimbursement

(see Medicaid column) Nebraska Medicaid will reimburse for tele-radiology
when it meets the American College of Radiology
standards for tele-radiology. There is no other reference
to reimbursing for other specialties.
Source: NE Admin. Code Title 471, Ch. 1, Manual Letter #52-2016.
(Accessed Oct. 2017).

Remote Patient Monitoring Reimbursement

No reference found. Medicaid will reimburse for telemonitoring when all of

the following requirements are met:
Telemonitoring is covered only when the
services are from the originating site;
The client is cognitively capable to operate the
equipment or has a willing and able person to
assess in the transmission of electronic data;
The originating site has space for all program
equipment;
The provider maintains a client’s record
supporting the medical necessity of the service.
Paid at daily per diem-rate and includes:
Review and interpretation of client data;

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

Equipment and all supplies;
Medically necessary visits to the home by a
health care practitioner;
Training on the use of the equipment.
No additional or separate payment is allowed.
Source: NE Admin. Code Title 471, Ch. 1, Manual Letter #52-2016.
(Accessed Oct. 2017).

Email/Phone/FAX

(see Medicaid column) No reimbursement for email.
No reimbursement for telephone.
No reimbursement for FAX.
Source: NE Admin. Code Title 471, Ch. 1.

Online Prescribing

Prescribing drugs to individuals the physician has never met, based solely on answers to questions provided by the internet, telephone, or FAX, or without first establishing a proper physician-patient relationship, is prohibited.

Source: NE Admin. Code Title 172, Ch. 88.

(also see Medicaid column)

Prescriptions over the Internet: Neither the prescribing health care practitioner service nor the pharmacy service is covered when the health care practitioner prescribing the medication has only reviewed an e-mail message or e-mail questionnaire about the client.

Source: NE Admin. Code Title 471, Ch. 1.

Consent

Written patient consent required prior to any service delivery.

Source: NE Revised Statutes Sec. 71-8505 (2012).

(also see Medicaid column)

Written or email consent required before initial service delivery. Must include this information:

A list of alternative care options, including in-person services;

All existing laws and protections including: confidentiality protections; patient access to all medical information from the consult; Whether the telehealth consultation will be recorded.

Patient shall be informed of all parties present at both ends of the consult, and the patient may exclude anyone from either site;

For telehealth behavioral health services, a safety plan must be developed.

Special rules apply for a child who is receiving telehealth behavioral health services.

Sample patient consent form available in Manual Appendix.

Source: NE Admin. Code Title 471, Ch. 1, Manual Letter #52-2016.
(Accessed Oct. 2017).

Location

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

Health care practitioners must assure that the originating
sites meet the standards for telehealth, including
providing a place where the client’s right for confidential
and private services is protected.
Out-of-State Telehealth Services are covered:
When the distant site is located in another state
and the originating site is located in Nebraska.
When the Nebraska client is located at an
originating site in another state, whether or not
the provider’s distant site is located in or out of
Nebraska.
Source: NE Admin. Code Title 471, Ch. 1, Manual Letter #52-2016.
(Accessed Oct. 2017).

Cross-State Licensing

NB adopted the Interstate Medical Licensure Compact. No reference found.
Source: LB 88 (2017)

Private Payers

Insurers prohibited from denying coverage solely No reference found.
because a service is delivered through telehealth.
Source: LB 92 (2017).
Private payers and self-funded employee benefit plans
must provide, upon request, a description of the
telehealth and telemonitoring services covered under
the relevant policy. The description must include:
Description of services in telehealth and
telemonitoring;
Exclusions or limitations (including limitation on
transmission costs);
Requirements for licensing status;
Requirements for signed written consent.
Source: LB 257 (2015).

Site/Transmission Fee

(see Medicaid column) Nebraska Medicaid reimburses for transmission costs
for two-way, real-time interactive communication, unless
provided by an internet service provider.
An originating site fee is paid to the Medicaid-enrolled
facility hosting the client.
Source: NE Admin. Code Title 471, Ch. 1, Manual Letter #52-2016.
(Accessed Oct. 2017).
Federally Qualified Health Centers & Rural Health
Clinics
Telehealth transmission cost related to non-core
services will be the lower of:

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

The provider’s submitted charge; or

The maximum allowable amount

Source: NE FQHC Provider Handbook, Manual Letter 11-2010 &

NE RHC Provider Handbook, Manual Letter 11-2010. (Accessed
Oct. 2017).

Managed Care

Telehealth transmission is covered as a part of the
behavioral health benefits package.

Source: NE Admin. Code Title 482, 5-004.

Miscellaneous

A stroke system of care task force shall recommend

eligible essential health care services for acute stroke
care provided through telehealth.

Source: LB 722 (2016).

Comments:

NE Medicaid does provide an outpatient cardiac rehabilitation program consisting of physical exercise or conditioning and concurrent telemetric monitoring are considered a valuable therapeutic modality. When a program is provided by a hospital to its outpatients, the service is covered as an outpatient service.

Source: NE Admin. Code Title 471, Ch. 10 Hospital Services & Physician Provider Handbook, Manual Letter 48-95.
(Accessed Aug., 2016).

© 2020 mTelehealth, Inc. All rights reserved.