Page 89 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

• For the treatment of cardiovascular disease or
(See “Private Payers” section). stroke;
• In an emergency department setting; and
Source: MD Insurance Code Annotated Sec. 15-139 (2012). • When an appropriate specialist is not available.

Maryland law requires the state Medicaid program to Source: MD Insurance Code Sec. 15-105.2
provide coverage for live video telemedicine services
(subject to terms and conditions of contract), the same The Maryland Medical Assistance Program will
as it does for private payers. reimburse for medically necessary consultation services
rendered by an approved consulting provider.
Source: Health General Code 15-105.2.

The Department shall grant approval to allow originating Eligible Distant Site Providers:
and consulting site providers to receive State and • Free standing renal dialysis centers
federal funds for providing telemedicine services if the • Federally Qualified Health Centers
telemedicine provider meets certain requirements. • Hospitals, including EDs
• Local health departments
Telemedicine providers must be part of a private • Nursing facilities
practice, hospital or other health care system. • Physicians
• Nurse practitioners
Must be an agreement between a medical assistance- • Nurse midwives
approved originating site provider and consulting
provider. Source: MD Department of Health and Mental Hygiene, Maryland
Medicaid 2013 Telemedicine Provider Manual. September 2013, p.
Source: Code of Maryland Admin. Regs. Sec. 10.09.49.03-04. 4-6 & Code of Maryland Admin. Regs. Sec. 10.09.49.05-07.
http://www.dsd.state.md.us/comar/getfile.aspx?file=10.09.49.03.ht http://www.dsd.state.md.us/comar/getfile.aspx?file=10.09.49.05.ht
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Providers must have a written contingency plan when Managed Care
telemedicine is unavailable. MCOs shall provide coverage for medically necessary
telemedicine services.
Source: Code of Maryland Admin. Regs. Sec. 10.09.49.07.
http://www.dsd.state.md.us/comar/getfile.aspx?file=10.09.49.07.ht Source: Code of Maryland Admin. Regs. Sec. 10.09.67.31.
m http://www.dsd.state.md.us/comar/getfile.aspx?file=10.09.67.31.ht
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Mental Health
Maryland Medicaid will reimburse for telemental health
services.

A distant site provider must be a psychiatrist with either
a Medicaid provider number or is a psychiatrist in an
FQHC or outpatient mental health clinics. The distant
site must be in Maryland.

Eligible services:
• Psychiatric diagnostic interview examination
• Individual psychotherapy
• Pharmacologic management

Both the distant and originating telemedicine providers
must submit an application to the Maryland Mental
Health Administration describing how the originating and
distant site will comply with relevant regulations.

The originating site may bill for a “tele-presenter” if it is
medically necessary.

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