Page 6 State Telehealth Laws and Reimbursement Policies A Comprehensive Scan of the 50 States and District of Columbia

Idaho, which will only reimburse for a limited number of mental health and developmental disability
services, to states like California, which reimburses for live video across a wide variety of medical
specialties. In addition to restrictions on specialty type, many states have restrictions on:

• The type of services that can be reimbursed, e. g. office visit, inpatient consultation, etc.;
• The type of provider that can be reimbursed, e. g. physician, nurse, physician assistant, etc.;
• The location of the patient, referred to as the originating site; and
• The location of the provider, referred to as the distant site at the time the live video interaction
takes place.

These restrictions have been noted within the report.

Store-and-Forward
Store-and-forward services are only defined and reimbursed by a handful of state Medicaid Programs. In
many states, the definition of telemedicine and/or telehealth stipulates that the delivery of services must
occur in “real time,” automatically excluding store-and-forward as a part of telemedicine and/or telehealth
altogether in those states. Of those states that do reimburse for store-and-forward services, some have
limitations on what will be reimbursed. For example, California only reimburses for teledermatology,
teleophthalmology and teledentistry. Currently, nine states reimburse for store-and-forward. South Dakota
had previously included reimbursement for store-and-forward, but that verbiage has been eliminated from
their manual. States that do reimburse for store-and-forward include:

• Alaska • Mississippi
• Arizona • New Mexico
• California • Oklahoma
• Illinois • Virginia
• Minnesota

Remote Patient Monitoring (RPM)
Only fourteen states have some form of reimbursement for RPM in their Medicaid programs, which is an
increase of three states since 2013. As with live video and store-and-forward reimbursement, many of the
states that offer RPM reimbursement have a multitude of restrictions associated with its use. The most
common of these restrictions include only offering reimbursement to home health agencies, restricting the
clinical condition for which symptoms can be monitored, and limiting the type of monitoring device and
information that can be collected.

For example, Colorado requires the patient to be receiving services for at least one of the following:
congestive heart failure, chronic obstructive pulmonary disease, asthma, or diabetes. Further, the patient
must still meet other conditions. In Minnesota, RPM reimbursement is only available for skilled nursing
visits and in the Elderly Waiver and Alternative Care programs. Utah, which previously only offered RPM
reimbursement through a Medicaid skilled nursing facility pilot program, recently opened reimbursement
up to stroke and transient ischemic attack patients, under certain circumstances. Alaska’s Medicaid
program has the least restrictive RPM reimbursement policy, requiring only that services be provided by a
telemedicine application based in the recipient’s home with the provider only indirectly involved in service
provision.

The states that currently offer some type of RPM reimbursement in their Medicaid program are:

• Alabama • Alaska • Colorado