New Mexico 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

New Mexico Medicaid

New Mexico
Medicaid Program: New Mexico Medicaid

Medicaid Program Administrator: New Mexico Human Services Dept., Medical Assistance Division (MAD)

Regional Telehealth Resource Center:

Southwest Telehealth Resource Center
PO Box 245105

Tucson, AZ 85724
(520) 626-4498
www.southwesttrc.org

STATE LAW/REGULATIONS MEDICAID PROGRAM

Definition of telemedicine/telehealth

“Telemedicine means the practice of medicine across No reference found.
state lines.”

Source: NM Administrative Code, 16.10.2.7 (2012).

Telemedicine means the use of interactive simultaneous

audio and video or store-and-forward technology using
information and telecommunications technologies by a
health care provider to deliver health care services at a
site other than the site where the patient is located,
including the use of electronic media for consultation
relating to the health care diagnosis or treatment of the

patient in real time or through the use of store-and-
forward technology.

Source: NM Statute. 59A-22-49.3.

“The practice of medicine across state lines means the

rendering of a written or otherwise documented medical
opinion concerning diagnosis or treatment of a patient
within this state, by a physician located outside this
state, as a result of transmission of individual patient
data by electronic, telephonic or other means from within
this state, to the physician or the physician’s agent, OR

the rendering of treatment to a patient within this state,
by a physician located outside this state, as a result of
transmission of individual patient data by electronic,
telephonic or other means from within this state to the
physician or the physician’s agent.”

Source: NM Statutes Annotated, 1978 Sec. 61-6-6 (2012).

“Telehealth means the use of electronic information,

imaging and communication technologies, including
interactive audio, video and data communications as
well as store-and-forward technologies, to provide and
support health care delivery, diagnosis, consultation,
treatment, transfer of medical data and education.”

Source: NM Statutes Annotated Sec. 24-1G-3 (2012).

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

Speech-Language Pathology, Audiology and

Hearing Aid Dispensing Practices Board
“Telehealth” means the use of telecommunications and
information technologies for the exchange of information
from one site to another for the provision of audiology,
speech-language pathology or hearing aid dispensing
services to an individual from a provider through
hardwire or internet connection.
Source: NMAC 16.26.1, Sec. 7.

Live Video Reimbursement

New Mexico statute encourages the use and New Mexico Medicaid will reimburse for live video at the
reimbursement of telehealth, which includes live video. same rate as when the services are furnished without
Source: NM Statutes Annotated, Sec. 24-25-5 (2012). the use of a telecommunication system.

Private payers are required to provide coverage for Source: NM Administrative Code 8.310.2

services delivered through live video, equivalent to in- Telemedicine is also covered by NM Managed Care.
person coverage. Source: NM Medical Assistance Division Managed Care Policy

Source: NM Statute. 59A-22-49.3. Manual, p. 216. Apr. 2017. (Accessed Oct. 2017).
(also see Medicaid column) Alternative Benefits Program & Managed Care
Program

The benefits package includes telemedicine services.
Source: NM Admin Code Sec. 8.309.4.16 & 8.308.9.18.
School-based services provided via telemedicine are
covered.
Source: NM Administrative Code 8.320.6.13(H).

Store and Forward Reimbursement

New Mexico Statute defines telehealth as encompassing New Mexico Medicaid does reimburse for store and
Store and Forward. forward. To be eligible, the service must be provided
through the transfer of digital images, sounds, or
Source: NM Statutes Annotated Sec. 24-1G-3 (2012). previously recorded video from one location to another.
Private payers are required to provide coverage for It does not need to occur in real time.

services delivered through store and forward, equivalent Source: NM Administrative Code 8.310.2.
to in-person coverage.
Source: NM Statute. 59A-22-49.3.

Remote Patient Monitoring Reimbursement

No reference found. No reference found.

Email/Phone/FAX Restrictions

No reference found. No reference found.

Online Prescribing

Physicians are prohibited from prescribing, dispensing No reference found.
or administering drugs or medical supplies to a patient
when there is no established physician-patient

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

relationship.

This includes prescribing over the Internet, or via other

electronic means, based solely on an online
questionnaire.

Physicians may prescribe online during a live video

exam. The prescribing physician must:

Obtain a medical history;

Obtain informed consent;

Generate a medical record;

A physical exam is recorded as appropriate by

the telehealth practitioner or a practitioner such
as a physician, advance practice nurse, or
physician or anesthesiologist assistant; or the
exam is waived when a physical exam would
not normally be part of a typical physical face-
to-face encounter with the patient for the
services being provided.

Source: NM Statutes Annotated, 1978 Sec. 61-6-20(B).

Consent

No reference found. No reference found.

Location

No reference found. An interactive telehealth communication system must
include both interactive audio and video, and be
delivered on a real-time basis at both the originating and
distant sites.
The originating site can be any medically warranted site.
Source: NM Administrative Code 8.310.2.

Cross-State Licensing

NM issues telemedicine licenses to providers who hold a full, unrestricted license in another state and has good moral character.

Source: NM Statutes Annotated, 1978 Sec. 61-6-11.1 (Sunset date of July 1, 2016) and 16.10.2.11.

NM Board of Osteopathic Medicine will issue telemedicine license.

Source: NM Statute Chapter 61, Article 10, Sec. 19. (Repealed – Effective July 1, 2022)

When the originating site is in New Mexico and the distant site is outside New Mexico, the distant- site provider at the distant site must be licensed in New Mexico for telemedicine, or meet federal requirements for Indian Health Service or tribal contract facilities.

Source: NM Administrative Code 8.310.2.

Private Payers

Private payers are required to provide coverage for No reference found.
services delivered through telemedicine, consistent with
in-person coverage.
Source: NM Statute. 59A-22-49.3.

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

Site/Transmission Fee

Indian Health Services

A telemedicine facility fee is paid. Both the originating and distant sites may be IHS or tribal facilities with two different locations, or a distant site can be under contract to the IHS or tribal facility.

Source: NM Administrative Code 8.310.12.12.

Reimbursement is made to the originating site for an interactive telehealth system fee at the lesser of the following:

Provider’s billed charge;

Maximum allowed by MAD for the specific service or procedure.

A telemedicine originating-site communication fee is also covered if the eligible recipient was present at and participated in the telemedicine visit at the originating site.

Source: NM Administrative Code 8.310.2.

An originating site facility fee is not payable if telemedicine is used to connect an employee or staff member of a facility to the eligible recipient being seen at the same facility.

Source: NM Register. Volume XXV, No. 20. Oct. 30, 2014.

Miscellaneous

Comment: New Mexico offers out of state providers a “telemedicine license” to practice within its borders.

New Mexico is also the home of Project ECHO. The project’s mission is to develop the capacity to safely and effectively treat chronic, common, and complex diseases in rural and underserved areas, and to monitor outcomes of this treatment utilizing technology.

Professional regulation with telehealth specific standards

Speech Language Pathology, Audiology, and Hearing Aid Dispensing Practice Board (Source:

NMAC 16.26.1, Sec. 7)

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