Nevada 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

Nevada Medicaid

Nevada
Medicaid Program: Nevada M edicaid

Program Administrator: Division of Health Care Financing and Policy (DHCFP)

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

Telehealth means the delivery of services from a provider of health care to a patient at a different location through the use of information and audio-visual communication technology, not including standard telephone, facsimile or electronic mail.

Source: NV Bill AB 292 (2015).

“Telehealth is the use of a telecommunications system to substitute for an in-person encounter for professional consultations, office visits, office psychiatry services, and a limited number of other medical services.”

“Telehealth” is defined as the delivery of service from a provider of health care to a patient at a different location through the use of information and audio-visual communication technology, not including standard telephone, facsimile, or electronic mail.

Source: NV Dept. of Health and Human Svcs.,Medicaid Services Manual, Section 3400, p. 1 (Jul. 27, 2017). (Accessed Oct. 2017).

Live Video Reimbursement

Live video reimbursement is available, including for dental plans. See Private Payers section below.

Source: NV Bill AB 292 (2015).

Nevada Medicaid and Nevada Check Up (NCU) program will reimburse for live video, as long as services have parity with face-to-face services and health care professionals follow Medicaid’s policies for specific services they are providing, as well as practice standards established by licensing agencies.

Telehealth services follow the same prior authorization requirements as services provided in person.

Licensed Clinical Psychologists, Licensed Clinical Social Workers and clinical staff may bill and receive reimbursement for psychotherapy, but not for medical evaluation and management services.

End Stage Renal Disease requires at least one in-person visit.

Services NOT Covered:

Basic skills training and peer-to-peer services provided by a Qualified Behavioral Assistant

Personal care services provided by a Personal Care Attendant

Home Health Services provided by a RN,

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STATE LAW/REGULATIONS MEDICAID PROGRAM

therapist, dietician or Home Health Aide
Private Duty Nursing services provided by a RN
Source: NV Dept. of Health and Human Svcs., Medicaid Services
Manual, Section 3403.3, p. 3-6 (Jul. 27, 2017). (Accessed Oct.
2017).

Store and Forward Reimbursement

No reference found. Reimbursement is available for services delivered via
asynchronous telehealth, however these services are
not eligible for originating site facility fees.
Source: NV Dept. of Health and Human Svcs., Medicaid Services
Manual, Section 3403.4, p. 9 (Jul. 27, 2017). (Accessed Oct. 2017).

Remote Patient Monitoring Reimbursement

No reference found. No reference found.

Email/Phone/FAX

No reimbursement for email. No reimbursement for email.
No reimbursement for telephone. No reimbursement for telephone, except psychiatric
No reimbursement for FAX. treatment in crisis intervention.
Source: NV Revised Statutes Annotated Sec. 633.165 (2012). No reimbursement for FAX.

Source: NV Dept. of Health and Human Svcs., Medicaid Services
Manual, Section 600, p. 10 (July 15, 2016) & NV Dept. of Health
and Human Svcs., Medicaid Services Manual, Section 3403.4, p. 9
(Jul. 27, 2017). (Oct. 2017).

Online Prescribing

A provider of health care who is located at a distant site No reference found.
and uses telehealth to direct or manage the care or
render a diagnosis of a patient who is located in Nevada
or write a treatment order or prescription for such a
patient must comply with all state and federal laws that
would apply if the provider was located within the state.
Source: NV Bill AB 292 (2015).
Osteopathic Medicine
A bona fide relationship between a patient and
osteopathic physician (needed for a prescription) can be
established via telemedicine.
Source: NV Revised Statutes Annotated Sec. 633.165

Consent

No reference found.

Location

No reference found. An originating site must be located within the state.
Nevada Dept. of Health and Human Services Billing Guidelines
Telehealth Billing Instructions, p.2 (Aug. 11, 2016).

Cross-State Licensing

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STATE LAW/REGULATIONS MEDICAID PROGRAM

A practitioner must hold a valid Nevada License or No reference found.

certificate to practice his or her profession before
providing services via telehealth unless he or she is a
provider of health care services who is providing
services within the scope of his or her employment by or
pursuant to a contract entered into with an urban Indian
organization.

Source: NV Bill AB 292 (2015).

Nevada adopted the Federation of State Medical Boards

(FSMB)”s model language for an interstate medical
licensure compact.

Source: NV Bill SB 251 (2015).

Nevada adopted the Psychology Interjurisdictional

Compact of the Association of State and Provincial
Psychology Boards. (The Compact is not yet function
because not enough states have joined.)

Source: NV Bill AB 429 (2017). 269.550.
https://www.leg.state.nv.us/Session/79th2017/Bills/AB/AB429_EN.

pdf

Private Payers

A health plan must include coverage for services No reference found.
provided to an enrollee through telehealth to the same
extent as through provided in-person.
Sour ce: NVBill AB 292 (20 15 ).

Site/Transmission Fee

No reference found. Originating site is qualified to receive a facility fee if they
are an enrolled Medicaid provider.
Facilities that are eligible for encounter reimbursement
may bill for an encounter in lieu of an originating site
facility fee, if the distant site is for ancillary services.
Source: NV Dept. of Health and Human Svcs.,Medicaid Services
Manual, Section 3400, p. 1 (Jul. 27, 2017). (Accessed Oct. 2017).
Eligible sites:
Office of provider
Critical Access Hospital (CAH)
Rural Health Clinic (RHC)
Federally Qualified Health Center (FQHC)
Hospital
End Stage Renal Disease (ESRD) Facility
Skilled Nursing Facility (SNF)
Community Mental Health Centers (CMHC)
Indian Health Services/Tribal
Organization/Urban Indian Organization
School-Based Health Centers
Schools

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

Family Planning Clinics

Public Health Clinics

Comprehensive Outpatient Rehabilitation

Facilities

Community Health Clinics (State Health

Division)

Special Children’s Clinics

Human Immunodeficiency Virus (HIV) Clinics

Therapy offices

Chiropractic offices

Recipient smart phones and recipient home computers

cannot bill the facility fee.

Source: Nevada Dept. of Health and Human Services Billing
Guidelines Telehealth Billing Instructions, p.2 (Jul. 27, 2017) (Mar

2017).

Miscellaneous

Before an osteopathic physician may use telemedicine:

A bona fide relationship between the osteopathic physician and the patient must exist which must include, without limitation, a history and physical examination or consultation which occurred in person and which was sufficient to establish a diagnosis and identify any underlying medical conditions of the patient.
The osteopathic physician must obtain informed, written consent from the patient or the legal representative of the patient to engage in telemedicine with the patient. The osteopathic physician shall maintain the consent form as part of the permanent medical record of the patient.

Source: NV Revised Statutes Annotated Sec. 633.165 (2012).

Telehealth services do not require prior authorization. However, individual services may require prior authorization, whether delivered in person or by telehealth.

Nevada Dept. of Health and Human Svcs., Medicaid Services Manual, Section 3403.8, p. 9 (Jul. 27, 2017). (Accessed Oct. 2017).

Comments: In 2011, the Nevada Legislature defined telemedicine and established practice requirements.

Professional Board Telehealth-Specific Regulations

Board of Occupational Therapy (Source: LCB File No. R017-14 & Ch. 640A of NE Admin. Code)

New Law Passed Establishing Standards for telepractice for speech language pathology and audiology.

Source: NV Bill AB 115 (2015)

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