Page 190 State Telehealth Laws and Reimbursement Policies A Comprehensive Scan of the 50 States and District of Columbia

Center for Connected Health Policy

West Virginia

Medicaid Program: West Virginia Medicaid

Medicaid Program Administrator: Bureau for Medical Services, under the West Virginia Dept. of Health and
Human Resources

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

“The practice of telemedicine means the use of “A tele-consultation is an interactive member encounter
electronic information and communication technologies that meets specific criteria. This service requires the use
to provide health care when distance separates of interactive telecommunications systems, defined as
participants. It includes one or both of the following: multimedia communication equipment that involves at
least audio and video equipment, and which permits
1. The diagnosis of a patient within this state by a two-way consultation among the member, consultant
physician located outside this state, as a result and referring provider. Telephones, facsimile machines,
of the transmission of individual patient data, and electronic mail systems do not qualify as interactive
specimens or other material by electronic or telecommunication systems.”
other means from within this state to the
physician or his or her agent; Source: WV Dept. of Health and Human Svcs., Medicaid Provider
Manual, Chapter–519 Covered Svcs., Limitations, And Exclusions
2. The rendering of treatment to a patient within For Practitioner Svcs. – Including Physicians, Physician
Assistants, And Advanced Registered Nurse Practitioners, p. 25
this state by a physician located outside this (Jan. 16, 2012).
State as a result of transmission of individual
patient data, specimens or other material by
electronic or other means from within this State
to the physician or his or her agent.”

Source: WV Code Sec. 30-3-13.
Live Video Reimbursement

No reference found. West Virginia Medicaid reimburses for live video
consultations for medical services and nutrition and
exercise services.

Requirements:

• The consult must involve real-time consultation
as appropriate for the member‘s medical needs,
and as needed to provide information to and at
the direction of the consulting physician;
• Coverage of consult is limited to members in
non-metropolitan statistical professional
shortage areas as defined by the Centers for
Medicare & Medicaid Services. The referring
provider must be located in the same non-

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