Page 59 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

Distant Site providers may not seek reimbursement for
their services when the Originating Site is an encounter
clinic. The Originating Site encounter clinic is
responsible for reimbursement to the Distant Site
provider.
Non-enrolled providers rendering services as a Distant
Site provider shall not be eligible for reimbursement from
the department, but may be reimbursed by the
Originating Site provider.
Under the department’s telehealth policy, providers will
be paid as either an Originating Site or Distant Site.
Source: IL Dept. of Healthcare and Family Svcs., Expansion of
Telehealth Services, Informational Notice, Jan. 1, 2010.
http://www.hfs.illinois.gov/html/011210n2.html,

Source: IL Dept. of Healthcare and Family Svcs. Handbook for
Practitioners. Ch. A-200 Policy and Procedures, p. 38.

Psychiatric Services

With the exception of group psychotherapy, tele-psychiatry
is covered, if all of the conditions stated above are met.

Tele-psychiatry eligible originating site providers:

• Physician;
• Other licensed healthcare professional or other
licensed clinician;
• Mental health professional;
• Qualified mental health professional

Source: IL Dept. of Healthcare and Family Svcs., Expansion of
Telehealth Services, Informational Notice, Jan. 1, 2010.
http://www.hfs.illinois.gov/html/011210n2.html,

Source: IL Dept. of Healthcare and Family Svcs., Handbook for
Practitioners. Ch. A-200 Policy and Procedures, p. 38.
Store and Forward Reimbursement
(see Medicaid column) Illinois Medicaid will reimburse a provider at a distant site
when they “review the medical case without the patient
being present.”

Source: IL Administrative Code, Title 89 ,140.403 (2012).

The Illinois Medicaid definition encompasses store and
forward. “The information or data exchanged can occur
in real time (synchronous) through interactive video or
multimedia collaborative environments or in near real
time (asynchronous) through “store and forward”
applications.”

Source: IL Dept. of Healthcare and Family Svcs., Expansion of
Telehealth Services, Informational Notice, Jan. 1, 2010.
http://www.hfs.illinois.gov/html/011210n2.html,

Source: IL Dept. of Healthcare and Family Svcs., Handbook for
Practitioners. Ch. A-200 Policy and Procedures, p. 38.

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