Page 14 50 State Telemedicine Gaps Analysis Coverage and Reimbursement

50 State Telemedicine Gaps Analysis: Coverage & Reimbursement

Figure 4

Medicaid Service Coverage & Conditions of Payment

D. Patient Setting

In telemedicine policy, the place where the patient is located at the time of service is often
referred to as the originating site (in contrast, to the site where the provider is located and often
referred to as the distant site). A traditional approach to telemedicine coverage is to require that
the patient be served from a specific type of health facility, such as a hospital or physician's
office. Left out by these approaches are the sites where people predominantly spend their time,
such as homes, office/place of work, schools, or traveling around. With advances in
decentralized computing power, such as cloud processing, and mobile telecommunications, such
as 4G wireless, the current approach is to cover health services to patients wherever they are.

The location of the patient, often times referred to as the originating site, is a contentious
component of telemedicine policy

For this report, we measured components of state Medicaid policies that, for conditions of
coverage and payment, broaden or restrict the location of the patient when telemedicine is used.
The following sites are observed as qualified patient locations:

 Hospitals
 doctor’s office
 other provider’s office
 home
 federally qualified health center (FQHC)
 critical access hospital (CAH)
 rural health center (RHC)
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American Telemedicine Association
2015