Page 195 State Telehealth Laws and Reimbursement Policies A Comprehensive Scan of the 50 States and District of Columbia
P. 195
Center for Connected Health Policy
STATE LAW/REGULATIONS MEDICAID PROGRAM
• Rural Health Centers;
• Federally Qualified Health Center;
• Physician assistants;
• Nurse practitioners;
• Nurse midwives;
• Psychiatrists;
• Ph.D. psychologists.
Reimbursement is subject to the same restrictions as in-
person services.
Only one eligible provider may be reimbursed per
member per date of service (DOS), unless it is medically
necessary for the participation of more than one
provider.
Separate services provided by separate specialists for
the same patient at different times on the same date
may be reimbursed separately.
Providers may receive enhanced reimbursement for
pediatric services, for members 18 years old and under,
and for HPSA-eligible services.
HPSA-enhanced reimbursement is allowed when the
patient or the provider is located in a HPSA-designated
area.
Out-of-state providers, except border-status providers,
must obtain prior authorization (PA) before delivering
services to Wisconsin Medicaid members.
Source: WI Forward Health, Covered and non-covered services,
Physician, (accessed Jan. 21, 2015).
emedicine&adv=Y>
For mental/behavioral health services, BadgerCare Plus,
a plan under Forward Health, will reimburse mental
health and substance abuse services the same way it
reimburses for in-person.
BadgerCare Plus reimburses only one of the sites, not
both.
BadgerCare Plus will not accept claims from individual
professionals in private practice.
Source: WI Forward Health, Wisconsin Medicaid Provider Manual,
Adult Mental Health Day Treatment, Policy 510. (accessed Jan. 21,
2015)
Please note: The same information is repeated in other
mental/behavioral health provider manuals. <
https://www.forwardhealth.wi.gov/WIPortal/Online%20Handbooks/D
isplay/tabid/152/Default.aspx?ia=1&p=1&sa=1&s=2&c=61&nt=Tele
medicine>
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