The expansion of telehealth is changing the landscape of health care. This is the third in a four-part series exploring what providers should know about this growing area.

Medicaid programs pay for telemedicine, telehealth and telemonitoring services delivered through a range of interactive video, audio or data transmission (telecommunications). Various state Medicaid programs are experiencing a significant increase in claims for these services and expect this trend to continue.

Telehealth providers participating in the Medicaid program for telehealth services should take note of the project announced at the end of 2017 that was started to review state Medicaid payments for telemedicine and other remote services.

The Medicaid Services Delivered Using Telecommunication Systems project was initiated by the Office of Inspector General (OIG) and included in the OIG’s November 2017 Work Plan update. The OIG notes the “significant increase in [Medicaid] claims” for telehealth, telemedicine and telemonitoring services” and indicates that the OIG expects that to continue.

Compliance with the Medicaid requirements that apply to telehealth differs from state to state. The coverage, coding and documentation rules are not necessarily easy to find. Most telehealth requirements are found in policy manuals and transmittals rather than in regulations. Medicaid providers should also continue to monitor the OIG’s Medicaid Services Delivered Using Telecommunication Systems for any updates and reports that can serve to provide guidance for the provision of telehealth to Medicaid patients. The OIG is expected to issue a report on the Medicaid Services Delivered Using Telecommunication Systems project in 2019, providing further guidance on Medicaid requirements and reimbursement for telehealth providers.  

Next in our telehealth series: Telehealth Models and Provider Arrangements. Read the previous installments here and here.