Page 84 State Telehealth Laws and Reimbursement Policies A Comprehensive Scan of the 50 States and District of Columbia

Center for Connected Health Policy

Maine

Medicaid Program: MaineCare

Medicaid Program Administrator: Maine Dept. of Health and Human Services

Regional Telehealth Resource Center:
Northeast Telehealth Resource Center
11 Parkwood Drive
Augusta, ME 04330
(207) 622-7566 / (800) 379-2021
www.netrc.org

STATE LAW/REGULATIONS MEDICAID PROGRAM

Definition of telemedicine/telehealth
“Telemedicine, as it pertains to the delivery of health “Telehealth” is interactive, visual, real-time
care services, means the use of interactive audio, video telecommunication, and must be a medically appropriate
or other electronic media for the purpose of diagnosis, means of provider-patient interaction.
consultation or treatment. ‘Telemedicine’ does not
include the use of audio-only telephone, facsimile Source: MaineCare Benefits Manual, General Administrative
machine or e-mail.” Policies and Procedures, 10-144 Ch. 101, p. 20 (Jan. 1, 2014).

Source: ME Revised Statutes Annotated. Title 24, Sec. 4316
(2012).
Live Video Reimbursement

Maine law requires coverage for services provided MaineCare will reimburse for live video when there is a
through telemedicine, which includes live video. compelling benefit for the patient in order for telehealth
services to be appropriate and related to physical, social
Source: ME Revised Statutes Annotated. Title 24 Sec. 4316 (2012). or geographic issues that make delivering the service in
person difficult. This includes:
(See Medicaid column & “Private Payers” section)
• For physical issues, a member's medical
condition makes a face-to-face encounter that
entails significant travel inadvisable or
impossible;
• For social issues, the family or other support
system does not support a member traveling a
distance for a face-to-face encounter, or does
not allow the member to take the time that travel
will require;
• For geographic issues, there is a lack of
medical/psychiatric/mental health expertise
locally, limited transportation resources, or a
long wait for such local care.

Source: Code of ME Rules. 10-144-101 & MaineCare Benefits
Manual, General Administrative Policies and Procedures, 10-144
Ch. 101, p. 20 (Jan. 1, 2014).

Providers must receive pre-authorization from the
Department for telehealth services.

Source: Code of ME Rules. 10-144-101 & MaineCare Benefits
Manual, General Administrative Policies and Procedures, 10-144

1