Page 85 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

Ch. 101, p. 20 (Jan. 1, 2014).

Pre-authorization information must include:

• The names, provider numbers and licensure
level of individual providers who utilize
telehealth to provide services;
• A list of the procedure codes to be used;
• A rationale for needing telehealth capabilities for
the services being proposed;
• The specific criteria used in determining when
telehealth services are more appropriate than
face-to-face services;
• A plan for quality assurance activities
specifically related to patient satisfaction and
outcomes for telehealth services;
• Educational information that will be provided to
the patient at the time of the member's visit.

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

Telehealth can substitute for a face-to-face encounter
under the Home Health Services program.

Source: MaineCare Benefits Manual, Home Health Services, Ch.
III, Sec. 40, p. 1 (Sept. 1, 2011).

Store and Forward Reimbursement
No reference found. No reimbursement based upon definition of telehealth,
which is described as occurring in “real-time”.

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

Remote Patient Monitoring Reimbursement
No reference found. No reference found.
Email/Phone/FAX

No reimbursement for email. No reimbursement for email.
No reimbursement for telephone. No reimbursement for telephone.
No reimbursement for FAX. No reimbursement for FAX.

Source: ME Revised Statutes Annotated. Title 24 Sec. 4316 (2012). Source: Code of ME Rules. 10-144-101 (2012).

For Indian Health Services, a second tier consultation
can utilize direct email communications or telephone
consultation.

Source: MaineCare Benefits Manual, Indian Health Services, 10-
144 Ch. II, p. 5 (Mar. 21, 2012).

Telephone is also covered for:
• Targeted Case Management Services for
purposes of monitoring and follow up activities
can take place over the telephone.

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