Page 68 50 State Telemedicine Gaps Analysis Coverage and Reimbursement
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50 State Telemedicine Gaps Analysis: Coverage & Reimbursement
Telemedicine in
Pennsylvania
PARITY:
Private Insurance F Bordered by MD and NY which have
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Medicaid B private insurance parity laws. 2015
State Employee Health Plan F legislation introduced to establish
MEDICAID SERVICE telemedicine parity for private
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COVERAGE & CONDITIONS insurance.
OF PAYMENT:
Patient Setting A Medicaid
Eligible Technologies C Medicaid imposes restrictions on the
Distance or Geography A covered services and designates
Restrictions eligible distant site providers as a
Eligible Providers F condition of payment.
Physician-provided B PA offers a number of telemedicine
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Services modalities in the home of qualified
Mental/behavioral Health B beneficiaries including sensors,
medication management, and RPM
Services under a CMS HCBS waiver.
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Rehabilitation N/A Coverage for interactive audio-video
Home Health C
Informed Consent B only for physician and mental health
services.
Telepresenter C
INNOVATIVE PAYMENT Requires written informed consent
and a telepresenter.
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
