Page 23 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

Private payers are required to provide coverage when Eligible hub or spoke sites for Indian Health Services or
the originating site is located in a rural region, which is tribal providers:
defined as:
• An area that is located in a county with a • Indian Health Service clinic;
population of less than nine hundred thousand • Tribally-governed facility;
persons; or • Urban clinic for American Indians;
• A city or town that is located in a county with a • Physician or other provider office;
population of nine hundred thousand persons or • Hospital;
more and whose nearest boundary is more than • Federally Qualified Health Center (FQHC).
thirty miles from the boundary of a city that has Source: AHCCCS, HIS/638 AHCCCS Telehealth Training Manual,
a population of five hundred thousand persons p. 8 (Dec. 2014).
or more. Fee for service manual definitions:

Source: AZ Statutes 20-841.09.
Hub site – “the location of the telemedicine consulting
provider, which is considered the place of service.”

Spoke site – “the location where the recipient is
receiving the telemedicine service.”

Source: AZ Health Care Cost Containment System, AHCCCS Fee-
For- Service Provider Manual, Ch. 10: Professional and Technical
Services, p. 38 (Nov. 2014).
Cross-State Licensing
An out-of-state doctor may engage in a single or Fee for Service and Managed Care
infrequent consultation with an Arizona physician. A consultation by a non-Arizona licensed provider may
occur if:
Source: AZ Revised Statute Sec. 32-1421 (2012).
• It is to a specific patient in the AHCCCS
program;
• The provider is registered with AHCCCS;
• The provider is licensed in the state the
consultation is being provided from, or the
provider is employed by an Indian Health
Services, Tribal or Urban Indian Health program
and appropriately licensed based on IHS and
Tribal facility requirements.

Source: AZ Health Care Cost Containment System, AHCCS
Medical Policy Manual, Medical Policy for AHCCCS Covered
Services, Ch. 300, Policy 320: Services With Special
Circumstances, page 179, (Apr. 2012).
Private Payers

Private payers are required to provide coverage for live No reference found.
video consultations when treating specific conditions
and the originating site is located in a rural region.
Allowed Conditions
• Trauma
• Burn
• Cardiology
• Infectious diseases
• Mental health disorders

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