Page 32 State Telehealth Laws and Reimbursement Policies A Comprehensive Scan of the 50 States and District of Columbia

STATE LAW/REGULATIONS
Store and Forward Reimbursement
No reimbursement based upon definition of
“telemedicine” which describes telemedicine as
“interactive” implying that it happens in real time.
Source: CO Revised Statutes 12-36-102.5 (2012).
Remote Patient Monitoring Reimbursement
(see Medicaid column)
Email/Phone/FAX
Private payers and the managed care system are not
required to cover telephone or FAX services.
Source: CO Revised Statutes 10-16-123 and Colorado Revised
Statutes 25.5-5-414 (2012).
Online Prescribing
Center for Connected Health Policy
MEDICAID PROGRAM
The use of telemedicine is not required when in-person
care by a participating provider is available to an
enrolled client within a reasonable distance.
Source: CO Medical Assistance Program, Telemedicine Manual,
p. 3-4 (Sept. 2013).
The CO Medical Assistance Program will only
reimburse for “live” telemedicine, excluding store and
forward. Peripherals, such as transmission of a live
ultrasound exam, may be reimbursed.
Source: CO Medical Assistance Program, Telemedicine Manual,
p. 3 (Sept. 2013).
The CO Medical Assistance Program will reimburse for
Remote Patient Monitoring at a flat fee set by the state
board when all these requirements are met:
• The patient is receiving services from a home
health provider for at least one of the following:
congestive heart failure, chronic obstructive
pulmonary disease, asthma, or diabetes;
• The patient requires monitoring at least five
times weekly to manage the disease, as ordered
by a physician or podiatrist;
• The patient has been hospitalized two or more
times in the last 12 months for conditions related
to the disease;
• The patient or caregiver misses no more than
five monitoring events in a 30-day period;
• The patient’s home has space for all program
equipment and full transmission capability.
Source: (Reimbursement): CO Revised Statutes 25.5-5-321 (2012).
Source: (Requirements): 10 CO Code of Regulation 2505-10.
Additional restrictions apply. See Colorado Code of
Regulations for more information.
Medicaid Home Health will reimburse for services only if
the patient has no other insurance.
Source: 10 CO Code of Regulation 2505-10.
No reimbursement for telephone.
No reimbursement for FAX.
Source: CO Medical Assistance Program, Telemedicine Manual,
p. 3 (Sept. 2013).
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