Page 28 State Telehealth Laws and Reimbursement Policies A Comprehensive Scan of the 50 States and District of Columbia

Center for Connected Health Policy

California

Medicaid Program: Medi-Cal

Program Administrator: California Dept. of Health Care Services (DHCS)

Regional Telehealth Resource Center:
California Telehealth Resource Center (CTRC)
2001 P Street, Suite 100
Sacramento, CA 95811
(916) 341-3378 / (877) 590-8144
www.caltrc.org

STATE LAW/REGULATIONS MEDICAID PROGRAM

Definition of telemedicine/telehealth
“Telehealth means the mode of delivering health care Telehealth [according to the Telehealth Advancement
services and public health via information and Act of 2011] “is the mode of delivering health care
communication technologies to facilitate the diagnosis, services and public health utilizing information and
consultation, treatment, education, care management, communication technologies to facilitate the diagnosis,
and self-management of a patient's health care while the consultation, treatment, education, care management
patient is at the originating site and the health care and self-management of a patient’s health care while the
provider is at a distant site. Telehealth facilitates patient patient is at the originating site and the health care
self-management and caregiver support for patients and provider is at the distant site.”
includes synchronous interactions and asynchronous
store and forward transfers.” “Telemedicine [according to CMS] is the use of medical
information exchanged from one site to another using
Source: CA Business & Professions Code Sec. 2290.5 (2012). interactive telecommunications equipment that includes,
at a minimum, audio and video equipment permitting
Telemedicine is “the ability of physicians and patients to two-way, real-time, interactive communication between
connect via technology other than through virtual the patient and physician or practitioner at the distant
interactive physician/patient capabilities, especially site to improve a patient’s health. Medi-Cal uses the
enabling rural and out-of-area patients to be seen by term telemedicine when it makes a distinction from
specialists remotely.” telehealth.”

Source: CA Code of Reg. Title 10 Sec. 6410.
Source: CA Department of Health Care Services. Medi-Cal Part 2
General Medicine Manual. Telehealth. Pg. 1. (Dec. 2013).
Live Video Reimbursement
Private payers may reimburse for live video. (See Medi-Cal will reimbursement for services provided
“Private Payers” section). via live video.

Source: CA Health & Safety Code Sec. 1374.13 (2012). Source: CA Department of Health Care Services. Medi-Cal
Part 2 General Medicine Manual. Telehealth. Pg. 1. (Dec.
(also see Medicaid column) 2013).
Store and Forward Reimbursement
Private payers may reimburse for store and forward. Medi-Cal will reimburse for store and forward services
for tele-dermatology, tele-ophthalmology and
Source: CA Business & Professions Code Sec. 2290.5 (2012). teledentistry.

(also see Medicaid column)
Source: Sec. 14132.725 of the Welfare and Institutions Code.

Source (tele-dermatology & tele-ophthalmology): CA Department
of Health Care Services. Medi-Cal Part 2 General Medicine
Manual. Telehealth. Pg. 5. (Dec. 2013).

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