Page 38 50 State Telemedicine Gaps Analysis Coverage and Reimbursement

50 State Telemedicine Gaps Analysis: Coverage & Reimbursement

Telemedicine in

D.C.

PARITY:
57
Private Insurance A  D.C. parity law was enacted in 2013
Medicaid A and requires coverage for
58
State Employee Health Plan A telemedicine-provided services under
MEDICAID SERVICE private plans and Medicaid.
COVERAGE & CONDITIONS
OF PAYMENT: Medicaid
Patient Setting A  The law requires Medicaid to cover

Eligible Technologies F and reimburse for services via
Distance or Geography A telemedicine if they are covered in-
Restrictions person. However, provider manuals
Eligible Providers A have not been updated to reflect the
Physician-provided Services A current law.
Mental/behavioral Health A  No explicit coverage of store-and-
Services forward or remote patient monitoring.
Rehabilitation N/A  DC Medicaid will draft and publish
Home Health C rulemaking to further define
Informed Consent A appropriate billing conditions for
Telepresenter A telemedicine in summer 2015.
INNOVATIVE PAYMENT
OR SERVICE DELIVERY
MODELS:
State-wide Network

Medicaid Managed Care ✔
Medicare-Medicaid Dual
Eligibles
Health Home
HCBS Waiver
Corrections
Other

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American Telemedicine Association
2015