Page 175 State Telehealth Laws and Reimbursement Policies A Comprehensive Scan of the 50 States and District of Columbia

Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

attack with no identifiable cause
• 24 hour monitoring done previously
• Not be currently anti-coagulated on Warfarin.
• Not have a known contra-indication for Warfarin
• Only authorized for the 30-day test

Source: UT Physician Manual. Section 2. Pg. 64 (Jan. 2015).

Skilled Nurse Pilot Project for Patients in Rural
Areas
There is reimbursement in the UT Medicaid Telehealth
Skilled Nurse Pilot Project for Patients in Rural Areas.

Patient eligibility requirements:

• Reside in underserved rural areas;
• Would have to travel more than 50 paved road
miles to obtain these services in person;
• Be eligible for Medicaid coverage;
• Require medical monitoring for diabetes;
• Be willing and able to use required technology.

Home health agency service delivery requirements:

• The service is delivered through secure, HIPAA-
compliant transmission lines, and takes place
between the home health agency and the patient’s
home;
• Patient and provider are able to see and hear each
other in real time;
• An assessment at the patient’s home by a home
health agency registered nurse finds that the patient
is unable to leave the home; is suitable for
participation in the program; and requires at least
two skilled nursing home visits a week;
• Formulates a nursing care plan.

The following services are covered for Telehealth home
care patients:
• Monitoring for compliance in taking medications,
foot condition/assessment of wounds or
inflamed areas, blood glucose monitoring
• Education which may include a review in
knowledge of the disease process, diet or
nutritional counseling
• Exercise and activity, diet /activity adjustment in
illness/stress, medication, and glucometer use
evaluation
• RN visits are covered for Telehealth home care
reimbursement.

Home health care has a four-hour limit for all education
purposes, which may include some diabetes training.

2