Page 182 State Telehealth Laws and Reimbursement Policies A Comprehensive Scan of the 50 States and District of Columbia

Center for Connected Health Policy

Virginia

Medicaid Program: Virginia Medicaid

Medicaid Program Administrator: State Dept. of Medical Assistance Services (DMAS)

Regional Telehealth Resource Center:
Mid-Atlantic Telehealth Resource Center
PO Box 800711
Charlottesville, VA 22908-0711
(434) 906-4960 / (855) MATRC4U
www.matrc.org

STATE LAW/REGULATIONS MEDICAID PROGRAM
Definition of telemedicine/telehealth
Telemedicine services means the use of interactive “Telemedicine is the real-time or near real-time
audio, video, or other electronic media used for the exchange of information for diagnosing and treating
purpose of diagnosis, consultation, or treatment. medical conditions. Telemedicine utilizes audio/video
‘Telemedicine services’ do not include an audio-only connections linking medical practitioners in one locality
telephone, electronic mail message, or facsimile with medical practitioners in another locality.”
transmission.”
Source: VA Dept. of Medical Assistant Svcs., Medicaid Provider
Source: VA Code Annotated Sec. 38.2-3418.16 (2012). Manual, Physician/Practitioner Manual, Covered Svcs. and
Limitations, p. 25 (Apr. 2, 2012).

“Telemedicine is the real-time or near real-time
exchange of information for diagnosing and treating
medical conditions.”
Source: VA Dept. of Medical Assistant Svcs., Medicaid Provider
Manual, Psychiatric Services Provider Manual, Covered Svcs. and
Limitations, p. 36 (Dec. 30, 2013).

Telemedicine service providers provide real-time two-
way transfer of medical data and information using an
interactive audio/video connection for the purposes of
medical diagnosis and treatment.

Source: Physician Provider Manual. Ch II: Provider Participation
Requirements (Jul., 18, 2014) pg. 11.
Live Video Reimbursement
Virginia statute requires coverage of telemedicine (which Yes, for all Medicaid recipients irrespective of fee-for-
includes live video) by private insurers, subject to their service or managed care organization coverage.
terms and conditions.
Eligible services:
Source: VA Code Annotated Sec. 38.2-3418.16 (2012).
• Office visits;
• Individual psychotherapy;
• Psychiatric diagnostic interview examinations;
• Pharmacologic management;
• Colposcopy;
• Obstetric ultrasound;
• Fetal echocardiography:
• Cardiography interpretation and report only;
• Echocardiography;

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