Page 22 50 State Telemedicine Gaps Analysis Coverage and Reimbursement
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50 State Telemedicine Gaps Analysis: Coverage & Reimbursement
The lowest ranking states, which scored an F, are Connecticut and Rhode Island which have no
coverage for telemedicine under their Medicaid plans and Iowa and Ohio with limited service
coverage and other arbitrary restrictions.
I. Mental and Behavioral Health Services
According to ATA’s telemental health practice guidelines, telemental health consists of the
practice of mental health specialties at a distance using video-conferencing. The scope of
services that can be delivered using telemental health includes: mental health assessments,
substance abuse treatment, counseling, medication management, education, monitoring, and
collaboration. Forty-eight states have some form of coverage and reimbursement for mental
health provided via telemedicine video-conferencing. While the number of states with coverage
in this area suggests enhanced access to mental health services, it is important to note that state
policies for telemental health vary in specificity and scope.
We measured components of state Medicaid policies that broaden or restrict the types of
providers allowed to perform the telemedicine encounter, telemedicine coverage for mental and
behavioral health services.
Scale – Medicaid: Mental and
Behavioral Health Services
A 14 points
B 10-13 points
C 6-9 points
F ≤ 5 points
Generally the telemedicine-provided services that are most often covered under state Medicaid
plans include mental health assessments, individual therapy, psychiatric diagnostic interview
exam, and medication management. Eight states and D.C. rank the highest for coverage of
mental and behavioral health services (Figure 12). These states have no restrictions on service
coverage or additional conditions of payment for services provided via telemedicine.
Additionally, these states also classify at least one other medical professional (i.e. physician
assistant and advanced practice nurse) as an eligible distant site provider.
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American Telemedicine Association
2015