Page 6 50 State Telemedicine Gaps Analysis Coverage and Reimbursement

50 State Telemedicine Gaps Analysis: Coverage & Reimbursement

Executive Summary

Payment and coverage for services delivered via telemedicine are one of the biggest challenges
for telemedicine adoption. Patients and health care providers may encounter a patchwork of
arbitrary insurance requirements and disparate payment streams that do not allow them to fully
take advantage of telemedicine.

The American Telemedicine Association (ATA) has captured the complex policy landscape of
50 states with 50 different telemedicine policies, and translated this information into an easy to
use format. This report extracts and compares telemedicine coverage and reimbursement
standards for every state in the U.S. ultimately leaving each state with two questions:

 “How does my state compare regarding policies that promote telemedicine adoption?”
 “What should my state do to improve policies that promote telemedicine adoption?”

Based on 13 indicators related to coverage and reimbursement, our analysis reveals that decades
of evidence-based research highlighting positive clinical outcomes and increasing telemedicine
utilization have been met with a mix of strides and stagnation in state-based policy. When
considering the numerous payment and service delivery options that enable telemedicine
adoption, overall five states maintained the highest composite score suggesting a supportive
policy landscape that accommodates telemedicine adoption. Maryland and Mississippi have
dropped from an ‘A’ to ‘B’ as a result of additional restrictions being placed on telehealth
coverage under their Medicaid plans. Connecticut and Rhode Island continue to average the
lowest composite score suggesting many barriers and little opportunity for telemedicine
advancement (Figure 1 and Table 1).

Figure 1

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American Telemedicine Association
2015