New Jersey 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 Jersey Medicaid

New Jersey
Medicaid Program: New Jersey Medicaid

Program Administrator: New Jersey Dept. of Human 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 delivery of a health care No reference found.

service using electronic communications, information
technology, or other electronic or technological means to
bridge the gap between a health care provider who is
located at a distant site and a patient who is located at
an originating site, either with or without the assistance
of an intervening health care provider. Telemedicine
does not include the use, in isolation, of audio-only
telephone conversation, electronic mail, instant
messaging, phone text or facsimile transmission.
Telehealth means the use of information and
communications technologies, including telephones,
remote patient monitoring devices or other electronic
means to support clinical health care, provider
consultation, patient and professional health related
education, public health, health administration and other
services.
Source: NJ Statute C.45:1-61 (SB 291-2017).

Live Video Reimbursement

NJ Medicaid must provide coverage and payment for Telepsychiatry may be utilized by mental health clinics
telemedicine or telehealth delivered services. and/or hospital providers of outpatient mental health
Reimbursement rate may not exceed the rate of in- services to meet their physician related requirements
person contact. including but not limited to intake evaluations, periodic
psychiatric evaluations, medication management and/or
The commissioner will apply for a State Plan psychotherapy sessions for clients of any age.
amendment as necessary to implement this. Before any telepsychiatry services can be provided,

Source: NJ Statute C.30:4D-6k. each participating program must establish related
policies and procedures.
Source: NJ Division of Medical Assistance and Health Services.
Newsletter. Vol. 23, No. 21, December 2013 (accessed Oct. 2017).

Store and Forward Reimbursement

Insurers and NJ Medicaid must provide reimbursement No reference found.
for telemedicine or telehealth. Store and forward is not

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

explicitly included, but could fit into these definitions.

Source: NJ Statute C.30:4D-6k.

Remote Patient Monitoring Reimbursement

Insurers and NJ Medicaid must provide reimbursement No reference found.

for telemedicine or telehealth. Remote patient
monitoring included within definition of telehealth.
Source: NJ Statute C.30:4D-6k.

Email/Phone/FAX

Telemedicine does not include the use, in isolation, of No reference found.
audio-only telephone conversation, electronic mail,
instant messaging, phone text or facsimile transmission.
Telehealth means the use of information and
communications technologies, including telephones,
Source: NJ Statute C.45:1-61 (SB 291-2017).

Online Prescribing

The prescription of Schedule II controlled substances through telemedicine or telehealth is authorized only after an initial in person examination, and subsequent in person visit with the patient every three months for the duration of prescription. Does not apply when prescribing stimulant for use by a minor provided by live video when treating the patient and the health care provider has obtained written consent for the waiver form the minor patient’s parent or guardian.

Source: NJ Statute C.45:1-62.

A provider patient relationship shall include:

Properly identifying the patient

Disclosing and validating the provider’s identity and credentials

Review of patient’s medical records, prior to initiating contact.

Determining whether the provider will be able to meet the standard of care, prior to initiating contact.

See statute for exceptions.

Source: NJ Statute C.45:1-63.

A psychiatrist or psychiatric APN must be licensed in the State of New Jersey.

Source: NJ Division of Medical Assistance and Health Services.
Newsletter. Vol. 23, No. 21, December 2013 (accessed Oct. 2017).

Consent

No reference found. Informed consent is required for telepsychiatry.
Source: NJ Division of Medical Assistance and Health Services.
Newsletter. Vol. 23, No. 21, December 2013 (accessed Oct. 2017).

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

Location

No reference found. No reference found.

Cross-State Licensing

Must be licensed in the State of New Jersey. Subject to No reference found.
New Jersey jurisdiction if either the patient or the
provider is located in NJ at the item services are
provided.
Source: NJ Statute C.45:1-62.

Private Payers

Insurers must provide coverage and payment for health No reference found.
services delivered through telemedicine or telehealth.
Reimbursement rate may not exceed the provider
reimbursement rate for in-person contact.
Source: NJ Statute C.26:2S-29.

Site/Transmission Fee

No reference found. No reference found.

Miscellaneous

Each telehealth or telemedicine organization operating
in the State shall annually register with the Department
of Health and submit an annual report. See statute for
details.
Six months after the effective date, a Telemedicine and
Telehealth Review Commission will be established
which will review reports and make recommendations.
Source: NJ Statute C.45:1-65.
Telemedicine practice standards indicate live video is
allowed. Store and forward allowed when used in
combination with two way audio without video, if after
assessing and reviewing the patient’s medical records,
the provider determines that the provider is able to meet
the same standard of care as if the health care service
was being provided in person.
See statute for additional telemedicine/telehealth
practice standards.
Source: NJ Statute C.45:1-62.

Comments: New Jersey’s Medicaid Program is managed care, with five participating health plans. The health plans may or may not have their own telehealth related policies.

Source: NJ Medicaid & Managed Care. Division of Medical Assistance and Health Services. (Accessed Oct. 2017)

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