Page 74 State Telehealth Laws and Reimbursement Policies A Comprehensive Scan of the 50 States and District of Columbia
P. 74
Center for Connected Health Policy
STATE LAW/REGULATIONS MEDICAID PROGRAM
between the patient and the practitioner at the
originating and distant-sites.”
Source: KY State Plan Amendment. Attachment 3.1-B. Approved
3/9/2011.
Live Video Reimbursement
Kentucky law states that insurers may not deny Kentucky Medicaid will reimburse for a “telehealth
coverage because it is “provided through telehealth and consultation”, which includes live video.
not provided through face-to-face consultation” therefore
requiring reimbursement for live video. Source: KY Revised Statutes 205.559 (2012).
Source: KY Revised Statutes § 304.17A-138 (2012). Reimbursement shall not be denied solely because an
in-person consultation between a provider and a patient
(See Medicaid column and “Private Payers” section) did not occur.
Source: KY Revised Statutes § 205.559 (2012).
Except for a telehealth consultation provided by an
Advanced Registered Nurse Practitioner or Community
Mental Health Clinic, an amount equal to the amount
paid for a comparable in-person service.
Source: KY Admin. Regs., Title, 907, 3:170, Sec. 4(a) (2011).
Telehealth is covered to the same extent the service and
provider are covered when furnished face-to-face.
Providers must be approved through the Kentucky e-
Health Network Board. Must be approved member of KY
telehealth network.
Coverage is limited to:
• Consultation
• Mental health evaluation and management
services
• Individual and group psychotherapy
• Pharmacologic management
• Psychiatric/psychological/mental health
diagnostic interview examinations
• Individual medical nutrition services
All telehealth services are subject to utilization review.
Prior authorization is needed for select telehealth
procedures.
Eligible providers for services NOT in a Community
Mental Health Center:
• A psychiatrist;
• A licensed clinical social worker;
• A psychologist;
• A licensed professional clinical counselor;
• A licensed marriage and family therapist;
• A physician*;
• An ARNP*;
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