Live Video
POLICY
The Director shall include in the State Plan for Medicaid:
- A requirement that the State shall pay for the nonfederal share of expenses for services provided to a person through telehealth to the same extent and, except for services provided through audio-only interaction, in the same amount as though provided in person or by other means;
- A requirement that the State shall pay the nonfederal share of expenses for services described in paragraph (a) in the same amount as though provided in person or by other means:
- If the services:
- Are received at an originating site described in 42 U.S.C. § 1395m(m)(4)(C) or furnished by a federally-qualified health center or a rural health clinic; and
- Except for services described in subparagraph (2), are not provided through audio-only interaction; or
- If the services:
- For counseling or treatment relating to a mental health condition or a substance use disorder, including, without limitation, when such counseling or treatment is provided through audio-only interaction; and
A provision prohibiting the State from:
- Requiring a person to obtain prior authorization that would not be required if a service were provided in person or through other means, establish a relationship with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to paying for services as described in paragraph (a) or (b). The State Plan for Medicaid may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or through other means.
- Requiring a provider of health care to demonstrate that it is necessary to provide services to a person through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to paying for services as described in paragraph (a) or (b).
- Refusing to pay for services as described in paragraph (a) or (b) because of:
- The distant site from which a provider of health care provides services through telehealth or the originating site at which a person who is covered by the State Plan for Medicaid receives services through telehealth; or
- The technology used to provide the services.
- Requiring services to be provided through telehealth as a condition to paying for such services.
- Categorizing a service provided through telehealth differently for purposes relating to coverage or reimbursement than if the service had been provided in person or through other means.
The provisions of this section do not:
- Require the Director to include in the State Plan for Medicaid coverage of any service that the Director is not otherwise required by law to include; or
- Require the State or any political subdivision thereof to:
- Ensure that covered services are available to a recipient of Medicaid through telehealth at a particular originating site; or
- Provide coverage for a service that is not included in the State Plan for Medicaid or provided by a provider of health care that does not participate in Medicaid.
SOURCE: NV Revised Statute 422.2721, Similar provisions also apply to Managed Care plans in Sec. 695G.162 (Accessed Mar. 2025).
Services provided via telehealth must be clinically appropriate and within the health care professional’s scope of practice as established by its licensing agency. Services provided via telehealth have parity with in-person health care services. Health care professionals must follow the appropriate Medicaid Services Manual (MSM) policy for the specific service they are providing.
- Photographs must be specific to the patient’s condition and adequate for rendering or confirming a diagnosis or a treatment plan. Dermatologic photographs (e.g., photographs of a skin lesion) may be considered to meet the requirement of a single media format under this instruction.
- Reimbursement for the DHCFP covered telehealth services must satisfy federal requirements of efficiency, economy, and quality of care.
- All participating providers must adhere to requirements of the Health Insurance Portability and Accountability Act (HIPAA). The DHCFP may not participate in any medium not deemed appropriate for protected health information by the DHCFP’s HIPAA Security Officer.
Telehealth services follow the same prior authorization requirements as services provided in person. Utilization of telehealth services does not require prior authorization, however, individual services delivered via telehealth may require prior authorization. It is the provider’s responsibility to refer to the individual medical coverage policies through the MSM for coverage requirements.
ESRD visits must include at least one in-person visit to examine the vascular access site by a provider; however, an interactive audio/video telecommunications system may be used for providing additional visits.
Telehealth may be used by any Nevada Medicaid and Nevada Check Up provider working within their scope of practice to provide services that can be appropriately provided via telehealth.
ELIGIBLE SERVICES/SPECIALTIES
Telehealth services are also covered by Nevada Medicaid. See MSM Chapter 3400, Telehealth Services for the complete coverage and limitations for Telehealth.
Medical Nutrition Therapy (MNT): May be provided through Telehealth services. See MSM Chapter 3400 for the Telehealth policy.
Podiatry: Telehealth services are covered when deemed medically necessary; refer to MSM Chapter 3400, Telehealth Services for services and prior authorization requirements.
Provider Office Services: Telehealth services are also covered by Nevada Medicaid. See MSM Chapter 3400, Telehealth Services for the complete coverage and limitations for Telehealth.
A licensed professional operating within the scope of their practice under state law may provide the following Telehealth services for Medicaid recipients:
- Annual wellness visits;
- Diabetic outpatient self-management;
- Documented psychiatric treatment in crisis intervention (e.g., threatened suicide); and
- Office or other outpatient visits
The following services must be provided in-person and are not considered appropriate services to be provided via telehealth:
- Personal care services provided by a Personal Care Attendant (PCA) as identified in provider qualifications found in MSM Chapter 2600, Intermediary Service Organization and MSM Chapter 3500, Personal Care Services;
- Home Health Services provided by a Registered Nurse (RN), Physical Therapist (PT), Occupational Therapist, Speech Therapist, Respiratory Therapist, Dietician or Home Health Aide as identified in provider qualifications found in MSM Chapter 1400, Home Health Agency (HHA); and
- Private Duty Nursing services provided by an RN as identified in provider qualifications found in MSM Chapter 900, Private Duty Nursing.3403.7
A health maintenance organization [or managed care organization] that provides medical services to recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Children’s Health Insurance Program pursuant to a contract with the Division of Health Care Financing and Policy of the Department of Health and Human Services shall provide referrals to providers of dental services who provide services through teledentistry.
A managed care organization that provides dental services to recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Children’s Health Insurance Program pursuant to a contract with the Division of Health Care Financing and Policy of the Department of Health and Human Services shall:
- Maintain a list of providers of dental services included in the network of the managed care organization who offer services through teledentistry;
- At least quarterly, update the list and submit a copy of the updated list to the emergency department of each hospital located in this State;
- Allow such providers of dental services to include on claim forms codes for teledentistry services provided through both real-time interactions and asynchronous transmissions of medical and dental information.
SOURCE: NV Revised Statute Ch. 695G.162 and 695C.1708, [slight variations exist between sections] (Accessed Mar. 2025).
Mental Health and Alcohol/Substance Abuse Services
Nevada shall ensure that Mobile Crisis Response teams respond in person at the location in the community where a crisis arises or a family’s location of choice. For individuals 18 years of age and younger, responses in urban Clark and Washoe counties will be conducted face-to-face and in-person, with an average response time within one hour; average response times for these individuals in rural areas are within two hours. For adults, responses in urban areas shall be within one hour and within two hours in rural areas. Telehealth responses in these locations shall be initiated as soon as possible, within one hour, with face-to-face and in-person team members arriving within one hour in urban areas and within two hours in rural areas. Nevada identifies these Mobile Crisis Response teams that comply with ARPA and the US SSA as DMCT.
Reference Chapter 3400 related to telehealth modality. The use of telehealth shall be
- Dictated by client preference
- Utilized to include additional member(s) of the team not onsite
- Utilized to provide follow-up services to the individual following an initial encounter with the DMCT
- Utilized to include highly trained members of the team, such as psychiatrists, psychiatric nurse practitioners, or others who can prescribe and/or administer medications
Services not eligible for reimbursement when rendered by a DMCT under Nevada Medicaid include: …
- Crisis services delivered solely via telehealth without the availability of an in-person response to the individual in crisis
Supervisors review in-person or via telehealth the response to crisis episode with all involved QMHP-level Intern and QMHA-level staff, and shall appropriately document the time and content of that supervisory discussion.
All engaged DMCT staff shall receive training in the following areas prior to participating in a mobile response to a crisis episode: …
- Use of Telehealth equipment
HCBS State Plan Option Adult Day Health Care and Habilitation
Assessment: New Referral – If an applicant appears to meet program criteria, a face-to-face assessment or via telehealth under certain circumstances will be scheduled to determine needs-based eligibility using the Comprehensive SocialHealth Assessment (CSHA) tool. The DHCFP HCC will contact the applicant/representative within seven working days of the referral date to schedule a time to conduct an assessment.
Certified Community Behavioral Health Center Services
Initial services will not be denied to those who do not live in the CCBHC catchment area (where applicable), including the provision of crisis services and other services, and coordination and follow-up with providers in the recipient’s catchment area. Telehealth services may be provided.
Care coordination includes: Ensuring access to high-quality physical health care (both acute and chronic) and behavioral health care, as well as social services, housing, educational systems and employment opportunities as necessary to facilitate wellness and recovery of the whole person. This may include the use of telehealth services.
School Health Services
Only those services listed in MSM Sections 2803.3 – Preventive Health Screenings and Treatment through 2803.16 – Telehealth of this chapter are covered benefits.
SHS Covered Services include: …
- Telehealth services when clinically appropriate and within the health care professional’s scope of practice as established by its licensing agency. Refer to MSM Sections 2803.2L and 2803.16 of this chapter.
Services provided via telehealth must be clinically appropriate and within the health care professional’s scope of practice as established by its licensing agency.
SOURCE: Nevada Dept. of Health and Human Services, School Health Services, (11/28/23) (Accessed Mar. 2025).
Applied Behavioral Health
Effective with dates of service on or after September 23, 2024, claim details billed by provider types (PT) 34 (Therapy) or 85 (Applied Behavior Analysis) for the procedure codes listed below (see announcement) will deny with error code 679 (This service is not covered under telehealth) when billed with Place of Service (POS) code 10.
Doula Services
For services rendered via telehealth, refer to MSM Chapter 3400 – Telehealth Services. Please refer to the Telehealth Billing Instructions for additional information.
Crisis Stabilization
Inclusive Services
- Telehealth Services (in accordance with MSM Chapter 3400)
SOURCE: Crisis Services: Certified Community Behavioral Health Center (CCBHC) Delivering Mobile Crisis Response as a Designated Mobile Crisis Team (DMCT) Attached to a CCBHC, (9/3/24), Crisis Services: Mobile Crisis Response Delivered By A Designated Mobile Crisis Team (DMCT), 9/3/24, (Accessed Mar. 2025).
Non-Covered Service
- A crisis intervention/stabilization service delivered solely via telehealth without an in-person response
SOURCE: Nevada Dept. of Health and Human Services, Crisis Services: Crisis Stabilization Center, Billing Guidelines (9/3/24), Crisis Services: Certified Community Behavioral Health Center (CCBHC) Delivering Mobile Crisis Response as a Designated Mobile Crisis Team (DMCT) Attached to a CCBHC, (9/3/24), Crisis Services: Mobile Crisis Response Delivered By A Designated Mobile Crisis Team (DMCT), 9/3/24, (Accessed Mar. 2025).
ELIGIBLE PROVIDERS
Telehealth may be used by any Nevada Medicaid and Nevada Check Up provider working within their scope of practice to provide services that can be appropriately provided via telehealth.
The distant site is the site where the provider delivering services is located at the time the service is provided via a telecommunications system. The provider at the distant site must use the appropriate Place of Service (POS) code in addition to the appropriate modifier when billing for services provided via telehealth. Note that for distant site services billed under Critical Access Hospital (CAH) method II on institutional claims and billed by outpatient providers on institutional claims, the GT modifier (telehealth service rendered via interactive audio and video telecommunications system) is required.
Note: The distant site may not also be the originating site.
Indian Health Services and Tribal Clinics must follow guidelines set forth in MSM Chapter 3400 (Telehealth Services)
Distant site: Use encounter code T1015. Distant site Telehealth services may be reimbursable as encounters (see Encounters below).
Providers must follow guidelines set forth in Medicaid Services Manual (MSM) Chapter 3400, Telehealth Services. Telehealth may be used by a licensed professional operating within the scope of their practice under state law.
Use the appropriate procedure code for the service provided in addition to the appropriate Place of Service (POS) code and modifier.
Please review the Telehealth Billing Instructions for additional information, including a list of POS codes and modifiers.
The distant site is defined as the location where a provider of health care is providing telehealth services to a patient located at an originating site. The distant site provider must be an enrolled Medicaid provider.
Facilities that are eligible for encounter reimbursement (e.g. Indian Health (IH) programs, Federally Qualified Health Centers (FQHCs), Rural Health Centers (RHCs)) may bill for an encounter in lieu of an originating site facility fee, if the distant site is for ancillary services (i.e. consult with specialist). If the originating site and distant site are two different encounter sites, the originating site may only bill the telehealth facility fee, and the distant encounter site may bill the encounter code.
A provider is not eligible for payment as both the originating and distant site for the same patient, same date of service.
The distant site is the site where the provider delivering services is located at the time the service is provided via a telecommunications system. The provider at the distant site must use Place of Service (POS) Code 02 when billing for services provided via telehealth. Use of the POS code certifies the service meets telehealth requirements. Note that for distant site services billed under Critical Access Hospital (CAH) method II on institutional claims, the GT modifier (telehealth service rendered via interactive audio and video telecommunications system) is required.
An FQHC may bill for an encounter in lieu of an originating site facility fee, if the distant site is for ancillary services (i.e. consult with specialist). If, for example, the originating site and distant site are two different encounter sites, the originating encounter site must bill the telehealth originating Healthcare Common Procedural Coding System (HCPCS) code and the distant encounter site may bill the encounter code. Refer to MSM Chapter 3400 – Telehealth Services.
A licensed professional operating within the scope of their practice under state law may provide Telehealth services. Providers must follow guidelines set forth in MSM Chapter 3400 (Telehealth Services).
- Originating Site: The FQHC may bill an encounter rate in lieu of the originating site fee, if the distant site (provider) is providing ancillary services. The originating site code, Q3014, must be used when billing in lieu of an encounter code.
- Distant Site: FQHCs providing services for a recipient from a distant site may bill the appropriate encounter rate with Place of Service (POS) Code 02. Use of the POS code certifies the service meets telehealth requirements.
Crisis Stabilization
The CSC provider must be staffed at all times (24/7/365) with a multidisciplinary team capable of meeting the needs of individuals experiencing all levels of crisis in the community; including:
- Psychiatrists or psychiatric nurse practitioners (telehealth may be used if audio and visual are utilized)
ELIGIBLE SITES
In order to receive coverage for a telehealth facility fee, the originating site must be an enrolled Medicaid provider.
A provider is not eligible for payment as both the originating and distant site for the same patient, same date of service.
If a patient is receiving telehealth services at an originating site not enrolled in Medicaid, the originating site is not eligible for a facility fee from the DHCFP. Examples of this include, but are not limited to, cellular devices, home computers, kiosks and tablets.
Facilities that are eligible for encounter reimbursement (e.g., Indian Health (IH) programs, Federally Qualified Health Centers (FQHCs), Rural Health Centers (RHCs)) may bill for an encounter in lieu of an originating site facility fee, if the distant site is for ancillary services (i.e. consult with specialist). If, for example, the originating site and distant site are two different encounter sites, the originating site may only bill the telehealth facility fee, and the distant encounter site may bill the encounter code.
Eligible sites:
- Office of provider
- Critical Access Hospital (CAH)
- Rural Health Clinic (RHC)
- Federally Qualified Health Center (FQHC)
- Hospital
- End Stage Renal Disease (ESRD) Facility
- Skilled Nursing Facility (SNF)
- Community Mental Health Centers (CMHC)
- Indian Health Services/Tribal Organization/Urban Indian Organization
- School-Based Health Centers
- Schools
- Family Planning Clinics
- Public Health Clinics
- ·Comprehensive Outpatient Rehabilitation Facilities
- Community Health Clinics (State Health Division)
- Special Children’s Clinics
- Human Immunodeficiency Virus (HIV) Clinics
- Therapy offices
- Chiropractic offices
- Emergency Medical Services (EMS) performing Community Paramedic Services
- Recipient’s smart phone (no facility fee)
- Recipient’s home computer (no facility fee)
- Recipient’s home (no facility fee)
Originating site: Use procedure code Q3014. Originating site Telehealth services are not reimbursable as encounters.
The following services can be provided within a community paramedicine provider’s scope of practice as part of a community paramedicine visit when requested in plan of care: …
- Telehealth originating site
The originating site is the location where an eligible Medicaid/Nevada Check Up recipient is at the time the service is provided via a telecommunications system.
An FQHC may bill for an encounter in lieu of an originating site facility fee, if the distant site is for ancillary services (i.e. consult with specialist). If, for example, the originating site and distant site are two different encounter sites, the originating encounter site must bill the telehealth originating Healthcare Common Procedural Coding System (HCPCS) code and the distant encounter site may bill the encounter code. Refer to MSM Chapter 3400 – Telehealth Services.
A licensed professional operating within the scope of their practice under state law may provide Telehealth services. Providers must follow guidelines set forth in MSM Chapter 3400 (Telehealth Services).
- Originating Site: The FQHC may bill an encounter rate in lieu of the originating site fee, if the distant site (provider) is providing ancillary services. The originating site code, Q3014, must be used when billing in lieu of an encounter code.
- Distant Site: FQHCs providing services for a recipient from a distant site may bill the appropriate encounter rate with Place of Service (POS) Code 02. Use of the POS code certifies the service meets telehealth requirements.
GEOGRAPHIC LIMITS
A Medicaid Managed Care Organization shall not refuse to provide the coverage described in subsection 1 or the reimbursement described in subsection 2 because of:
- The distant site from which a provider of health care provides services through telehealth or the originating site at which an insured receives services through telehealth; or
- The technology used to provide the services
SOURCE: NV Revised Statute Sec. 695G.162. (Accessed Mar. 2025).
FACILITY/TRANSMISSION FEE
In order to receive coverage for a telehealth facility fee, the originating site must be an enrolled Medicaid provider.
A provider is not eligible for payment as both the originating and distant site for the same patient, same date of service.
If a patient is receiving telehealth services at an originating site not enrolled in Medicaid, the originating site is not eligible for a facility fee from the DHCFP. Examples of this include, but are not limited to, cellular devices, home computers, kiosks and tablets.
Facilities that are eligible for encounter reimbursement (e.g. Indian Health (IH) programs, Federally Qualified Health Centers (FQHCs), Rural Health Centers (RHCs)) may bill for an encounter in lieu of an originating site facility fee, if the distant site is for ancillary services (i.e. consult with specialist). If the originating site and distant site are two different encounter sites, the originating site may only bill the telehealth facility fee, and the distant encounter site may bill the encounter code.
Q3014 – Telehealth originating site facility fee.
In order to bill the Q3014 facility fee, an originating site must be enrolled as a Nevada Medicaid provider. Eligible sites include:
- Office of provider
- Critical Access Hospital (CAH)
- Rural Health Clinic (RHC)
- Federally Qualified Health Center (FQHC)
- Hospital
- End Stage Renal Disease (ESRD) Facility
- Skilled Nursing Facility (SNF)
- Community Mental Health Centers (CMHC)
- Indian Health Services/Tribal Organization/Urban Indian Organization
- School-Based Health Centers
- Schools
- Family Planning Clinics
- Public Health Clinics
- Comprehensive Outpatient Rehabilitation Facilities
- Community Health Clinics (State Health Division)
- Special Children’s Clinics
- Human Immunodeficiency Virus (HIV) Clinics
- Therapy offices
- Chiropractic offices
- Emergency Medical Services (EMS) performing Community Paramedicine Services
Originating sites that cannot bill the facility fee (Q3014):
- Recipient smart phones
- Recipient home computers
- Recipient’s home
Providers that bill per diem or encounter rates may bill an encounter rate in lieu of the originating site fee. Per diem or encounter-based providers would not bill HCPCS code Q3014 and an encounter code, as the facility fee is already included in the per diem/encounter rates. If the telecommunication system used is a recipient’s smart phone or home computer, the facility fee may not be billed.
Some provider types that may bill for an originating site facility fee include:
- Some Special Clinic provider types
- Some Applied Behavior Analysis provider types
- Therapists
- Chiropractors
- Providers at End-Stage Renal Disease Facilities
SOURCE: NV Dept. of Health and Human Svcs. Announcement 1048 & 1202. (Accessed Mar. 2025).
If the originating site is enrolled as a Nevada Medicaid provider, they may bill HCPCS code Q3014. If the telecommunication system used is a recipient’s smart phone or home computer, the facility fee may not be billed.
Q3014 is listed as an allowable service for FQHC/CCBHC and CCBHC.
SOURCE: NV Medicaid, CCBHC Allowable Services and FQHC/CCBHC Allowable Services, (Accessed Mar. 2025).
An FQHC may bill for an encounter in lieu of an originating site facility fee, if the distant site is for ancillary services (i.e. consult with specialist). If, for example, the originating site and distant site are two different encounter sites, the originating encounter site must bill the telehealth originating Healthcare Common Procedural Coding System (HCPCS) code and the distant encounter site may bill the encounter code. Refer to MSM Chapter 3400 – Telehealth Services.
Q3014 Telehealth Services is listed as an eligible CPT service for registered dietitians, community paramedics, community health workers, residential substance use treatment in an institution for mental disease, substance use treatment clinic and opioid treatment program.
SOURCE: Nevada Dept. of Health and Human Services Billing Guidelines Registered Dietitians Billing Instructions, (12/19/2019), Community Paramedics, Billing Instructions, (11/4/2019), Community Health Workers Billing Guide, (2/19/2025), substance use treatment clinic (2/19/25), opioid treatment program (2/19/25). (Accessed Mar. 2025).
< BACK TO RESOURCES