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                                                                                 Center for Connected Health Policy

           Montana


           Medicaid Program:  Montana Medicaid

           Program Administrator:  MT Dept. of Public Health and Human Services

           Regional Telehealth Resource Center:
           Northwest Regional Telehealth Resource Center
                  th
           2900 12  Ave. N., Ste. 30W
           Billings, MT 59101
           (888) 662-5601
           www.nrtrc.org


            STATE LAW/REGULATIONS                              MEDICAID PROGRAM

            Definition of telemedicine/telehealth
            “Telemedicine means the practice of medicine by a   No reference found in Medicaid Manual.
            physician located outside the state, who performs an
            evaluative or therapeutic act relating to the treatment or
            correction of a patient's physical or mental condition,
            ailment, disease, injury, or infirmity, and who transmits
            that evaluative or therapeutic act into Montana through
            any means, method, device, or instrumentality under the
            following conditions:
               •   The information or opinion is provided directly to
                   a patient in Montana for compensation or with
                   the expectation of compensation;
               •   The physician does not limit the physician's
                   services to an occasional case;
               •   The physician has an established or regularly
                   used connection with the state, including but not
                   limited to: (i) an office or another place for the
                   reception of a transmission from the physician;
                   (ii) a contractual relationship with a person or
                   entity in Montana related to the physician's
                   practice of medicine; or (iii) privileges in a
                   Montana hospital or another Montana health
                   care facility.”

            Source: MT Code Annotated, § 37-3-342 (2011).

            Telemedicine means the use of interactive audio, video,
            or other telecommunications technology that is:
               •   Used by a health care provider or health care
                   facility to deliver health care services at a site
                   other than the site where the patient is located;
                   and
               •   Delivered over a secure connection that
                   complies with the requirements of HIPPA.
                      •   The term includes the use of electronic
                          media for consultation relating to the
                          health care diagnosis or treatment of a
                          patient in real time or through the use of


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                                                                                 Center for Connected Health Policy

            STATE LAW/REGULATIONS                              MEDICAID PROGRAM

                          store-and-forward technology.
                      •   The term does not include the use of
                          audio-only telephone, e-mail, or
                          facsimile transmissions.

            Source: MT Code Sec. 33-22-138.
            Live Video Reimbursement
            Private payers are required to provide coverage for   Montana Medicaid will reimburse for live video services
            services delivered through live video, equivalent to in-  when the consulting provider is enrolled in Medicaid.
            person coverage.
                                                               The requesting provider need not be enrolled in
            Eligible providers under this law include:         Medicaid nor be present during the telemedicine consult.
               •   Physicians
               •   Registered professional nurse               Source: MT Dept. of Public Health and Human Svcs., Medicaid
                                                               and Medical Assistance Programs Manual, Physician Related
               •   Advanced practice registered nurse          Svcs., p 25 (Jul. 2014).
               •   Genetic counselor certified by the American
                   board of genetic counseling
               •   Diabetes educator certified by the national
                   certification board for diabetes

            Eligible facilities under this law include:
               •   Critical access hospital
               •   Hospice
               •   Hospital
               •   Long-term care facility
               •   Mental health center
               •   Outpatient center for primary care
               •   Outpatient center for surgical services

            Source: MT Code Sec. 33-22-138.

            Store and Forward Reimbursement
            Private payers are required to provide coverage for   No reference found.
            services delivered through store and forward
            technology, equivalent to in-person coverage.

            Eligible providers under this law include:
               •   Physicians
               •   Registered professional nurse
               •   Advanced practice registered nurse
               •   Genetic counselor certified by the American
                   board of genetic counseling
               •   Diabetes educator certified by the national
                   certification board for diabetes

            Eligible facilities under this law include:
               •   Critical access hospital
               •   Hospice
               •   Hospital


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                                                                                 Center for Connected Health Policy

            STATE LAW/REGULATIONS                              MEDICAID PROGRAM

               •   Long-term care facility
               •   Mental health center
               •   Outpatient center for primary care
               •   Outpatient center for surgical services

            Source: MT Code Sec. 33-22-138.
            Remote Patient Monitoring Reimbursement

            No reference found.                                No reference found.
            Email/Phone/FAX

            No Email                                           No reference found.
            No Phone
            No Fax

            Source: MT Code Sec. 33-22-138.
            Online Prescribing

            No reference found.                                No reference found.
            Consent

            No reference found.                                No reference found.
            Location
            No reference found.                                The place of service is considered to be the location of
                                                               the provider providing the telemedicine service.

                                                               Source: MT Dept. of Public Health and Human Svcs., Medicaid
                                                               and Medical Assistance Programs Manual, Physician Related
                                                               Svcs., pg. 54 (Jul. 2014).
            Cross-State Licensing
            Montana issues telemedicine licenses to out-of-state   No reference found.
            physicians that only allows the physician to practice
            telemedicine in the specialty the physician is board
            certified or meets the current requirements to take the
            examination to become board certified.

            This license does not authorize the physician to practice
            medicine while physically present within the state.

            Source: MT Code Annotated, 37-3-343.

            Private Payers
            Private payers are required to provide coverage for   No reference found.
            services delivered through telemedicine, equivalent to
            in-person coverage.

            Source: MT Code Sec. 33-22-138.
            Site/Transmission Fee
            No reference found.                                No reimbursement for network use charges.

                                                               Source: MT Dept. of Public Health and Human Svcs., Medicaid

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                                                                                 Center for Connected Health Policy

            STATE LAW/REGULATIONS                              MEDICAID PROGRAM

                                                               and Medical Assistance Programs Manual, Physician Related
                                                               Svcs., pg. 25 (Jul. 2014).
            Miscellaneous



           Comments:
                         New Regulations Passed:
                             •  MT Board of Speech-Language Pathology (MT Admin Rules, Sec. 24.222.9)




































































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