Telehealth regulations by the state are becoming more clearly identified by state and federal policymakers every day. Telehealth reimbursement and the expansion of virtual care has changed dramatically, with state and federal policymakers removing restrictions and expanding Medicare reimbursement for telehealth, teletherapy, and other forms of virtual care. States and commercial health plans also responded with their own many changes to accommodate local demands. Although some of the reimbursement expansions are temporary and slated to end when the Public Health Emergency expires, many have already become permanently codified into state law.
Telehealth Regulations by State
Foley & Lardner recently published a report of telehealth regulations by state, entitled, 50-State Survey of Telehealth Commercial Insurance Laws that discusses recent updates to state telehealth legislation that affects telehealth coverage, payment for services, and other forms of service delivery as health plans offer more coverage of telemedicine and digital health. The Foley & Lardner report summarizes the state regulation of telehealth reimbursement and makes it clear that the providers need to be aware that payment parameters vary widely from state to state.
Below is an abbreviated list of the reports’ findings of telehealth regulations by state:
- 43 states and the District of Columbia have some form of state telehealth commercial payer law
- 14 states now require true payment parity for telehealth
- Massachusetts offers payment parity for behavioral health services only
- 30 states have laws against charging more for a telehealth visit than for an in-person visit
- Tennessee is the only state that maintains restrictions on the patient’s originating site
- 3 states have telehealth laws that do not require health plans to cover virtual services
Full details are available in the free download of the report here: 50 State Survey of Telehealth Commercial Insurance Laws.
Telehealth State Regulation of Asynchronous Telehealth and Remote Patient Monitoring Services
More than 50% of the states now require coverage for asynchronous telehealth, that is, telehealth that allows a client’s or patient’s data to be collected, stored in a secure cloud-based platform, and later retrieved by another treating professional or staff, often in a different location. Remote patient monitoring services are now required to be covered by commercial health plans in 17 states. Remote Patient Monitoring (RPM) enables providers to record and monitor a patient’s health data remotely. It uses technological devices to get vital signs needed to monitor a patient’s condition. RPM is usually recommended for patients with chronic diseases like diabetes, asthma, and cardiovascular illnesses. An important advantage of RPM is that it provides frequent monitoring at less cost. Telehealth Regulations by state exist for reimbursement and remote patient monitoring. On other fronts, telemedicine laws and telehealth licensure laws by states are also being updated to meet the growing needs for behavioral health.
On the national scene, federal telehealth and telemedicine regulations have also been changing. Several aspects of Medicare telehealth reimbursement have been announced. Nearly 100 telehealth service codes now being covered through the duration of Public Health Emergency (PHE). Payment for telephone-only treatment is also covered through the end of the PHE. Group therapy codes have been published.
Continued progress on multiple telehealth fronts is expected, particularly since the U.S. Department of Health and Human Services has announced the Biden-Harris administration staff appointments.