Store and Forward
POLICY
The Michigan Department of Health and Human Services (MDHHS) covers both synchronous (real-time interactions) and asynchronous (over separate periods of time) telemedicine services. MDHHS requires that all telemedicine policy provisions within this policy and other current policy are established and maintained within all telemedicine services.
Asynchronous telemedicine services include the transmission of a beneficiary’s medical or other personally identifiable information through a secure, Health Insurance Portability and Accountability Act (HIPAA)-compliant, electronic communications system to a provider, often a specialist, at a distant site without the beneficiary present. Such communications, including store and forward services, interprofessional telephone/Internet/electronic health record consultations, and RPM services, involve contact between two parties (beneficiary to provider or provider to provider) in a way that does not require real-time interaction. Services must be medically necessary or essential for behavioral health and part of a provider-directed treatment plan.
Asynchronous telemedicine services must be performed under the general or direct supervision of a Medicaid-enrolled physician or practitioner who has an active role in the management of the beneficiary’s physical and/or behavioral health. The analysis and interpretation of the beneficiary’s data must contribute to the development and/or monitoring of the beneficiary’s treatment plan. Asynchronous telemedicine services do not include telephone calls, images transmitted via facsimile machines, and text messages without visualization of the beneficiary. Photographs visualized by a telecommunications system must be specific to the beneficiary’s physical and/or behavioral health condition and adequate for furnishing or confirming a diagnosis and/or treatment plan.
Asynchronous telemedicine services generally may not be separately reported on the same day the beneficiary presents for an evaluation and management (E/M) or other related service to the same provider. These services are typically considered part of the E/M or other related service and are not separately reimbursed. Activities performed in the facility setting under the general or direct supervision of the provider are bundled with the facility services on the UB-04 claim form and cannot be reported on the CMS 1500 claim form or billed under the provider’s National Provider Identifier (NPI).
Store and forward services are asynchronous electronic transmissions of physical and/or behavioral health information from the beneficiary to a Medicaid-enrolled physician or practitioner at the distant site when video or face-to-face contact is not necessary. Information transmitted to the provider is analyzed and used in the diagnosis, development, or maintenance of an individualized treatment plan. Information may include, but is not limited to, digital images, documents, video clips, still images, x-rays, magnetic resonance images (MRIs), electrocardiograms (EKGs) and electroencephalograms (EEGs), and audio clips.
Store and forward services include interpretation and follow-up with the beneficiary. Services must not originate from or result in a related E/M service.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 2232 & 2237-2238, Jan. 1, 2026. (Accessed Jan. 2026).
Asynchronous telemedicine service codes are listed on the corresponding provider specific fee schedules. Additional program-specific coverage will be represented on individual program fee schedules and will be indicated in the program-specific sections below as indicated.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 2240 Jan. 1, 2026, (Accessed Jan. 2026).
In accordance with Section 16284 of Public Act No. 359 of 2016, telemedicine services, including asynchronous telemedicine, must be provided only with direct or indirect beneficiary consent and this consent must be properly documented in the beneficiary’s medical record in accordance with applicable standards of practice.
Interprofessional consultations (including e-Consults), are defined as a type of asynchronous telemedicine service in which the beneficiary’s Medicaid-enrolled treating provider (e.g., attending or primary) requests the opinion and/or treatment advice of a Medicaid-enrolled consulting provider with the specialty expertise to assist in the diagnosis and/or management of the beneficiary’s condition without beneficiary face-to-face contact with the consulting provider. The service must be for the direct benefit of the beneficiary, directly relevant to the individual beneficiary’s original evaluation, diagnosis, and/or treatment, and must conclude with a written report from the consulting provider to the treating provider, when applicable.
The beneficiary for whom the service is requested may be either a new or established patient to the consulting provider. Service time is based on the total review and interprofessional communication time. The review of beneficiary information, including but not limited to medical records, laboratory studies, imaging studies, medications, and pathology reports, is included in the service and should not be separately reported. The written or verbal request for the consultation must be documented in the beneficiary’s medical record by the treating provider. Additional documentation requirements (within the medical record of the beneficiary) include date of service; name of provider agency or person providing the service; nature, extent, or units of service; and the place of service, along with all record keeping requirements as outlined in the MDHHS Medicaid Provider Manual.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 2238, Jan. 1, 2026 (Accessed Jan. 2026).
ELIGIBLE SERVICES/SPECIALTIES
Telemedicine must only be utilized when there is a clinical benefit to the beneficiary. Examples of clinical benefit include:
- Ability to diagnose a medical condition in a patient population without access to clinically appropriate in-person diagnostic services.
- Treatment option for a beneficiary population without access to clinically appropriate in-person treatment options.
- Decreased rate of subsequent diagnostic or therapeutic interventions (for example, due to reduced rate of recurrence of the disease process).
- Decreased number of future hospitalizations or physician visits.
- More rapid beneficial resolution of the disease process treatment.
- Decreased pain, bleeding, or another quantifiable symptom.
Furthermore, telemedicine must only be utilized when the beneficiary’s goals for the visit can be adequately accomplished, there exists reasonable certainty of the beneficiary’s ability to effectively utilize the technology, and the beneficiary’s comfort with the nature of the visit is ensured. Telemedicine must be used as appropriate regarding the best interests/preferences of the beneficiary and not merely for provider ease. Appropriate guidance must be provided to the beneficiary to ensure they are prepared and understand all steps to effectively utilize the technology prior to the first visit. Beneficiary consent must be obtained prior to service provision (see policy for “Consent for Telemedicine Services” in MSA 20-09 for further information).
In-person visits remain the preferred method of service delivery for most healthcare services; however, in cases where this option is not available or in-person services are not ideal or are challenging for the beneficiary, telemedicine may be used as a complement to in-person services. Applicable beneficiary records must contain documentation regarding the reason for the use of telemedicine and the steps taken to ensure the beneficiary was provided utilization guidance in an appropriate manner.
In special situations, depending upon the needs of the beneficiary, providers may opt to deliver the majority of or all services for a specific condition via telemedicine. If this situation occurs, it must be documented in the beneficiary’s record or in their individual plan of service (IPOS). This situation should be the exception, not the norm. (Refer to the program-specific subsections of this policy for specific guidance regarding this benefit.)
All services provided via telemedicine must meet all the quality and specifications as would be if performed in-person. Furthermore, if while participating in the visit the desired goals of the beneficiary and/or the provider are not being accomplished, either party must be provided the opportunity to stop the visit and schedule an in-person visit instead (refer to the “Contingency Plan” section of bulletin MSA 20-09 for such instances). This follow-up visit must be provided within a reasonable time and be as easy as possible to schedule.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 2234-2235, Jan. 1, 2026 (Accessed Jan. 2026).
Allowable telemedicine services for synchronous telemedicine are listed on the telemedicine fee schedules which can be accessed on the MDHHS website. Asynchronous telemedicine service codes are listed on the corresponding provider specific fee schedules. Additional program-specific coverage will be represented on individual program fee schedules and will be indicated in the program-specific sections below as indicated.
Covered asynchronous telemedicine services must be billed with applicable POS and modifiers as standard practice.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 2240 & 2241, Jan. 1, 2026 (Accessed Jan. 2026).
Interprofessional Consultations
The beneficiary for whom the service is requested may be either a new or established patient to the consulting provider. Service time is based on the total review and interprofessional communication time. The review of beneficiary information, including but not limited to medical records, laboratory studies, imaging studies, medications, and pathology reports, is included in the service and should not be separately reported. The written or verbal request for the consultation must be documented in the beneficiary’s medical record by the treating provider. Additional documentation requirements (within the medical record of the beneficiary) include date of service; name of provider agency or person providing the service; nature, extent, or units of service; and the place of service, along with all record keeping requirements as outlined in the MDHHS Medicaid Provider Manual. Providers must also consult with the American Medical Association (AMA) coding guidelines to ensure appropriate reporting of these services. Providers should not report interprofessional telephone/Internet/electronic health record consultations when the sole purpose of the communication is to arrange a transfer of care or other face-to-face service. In consultations that cross state lines, consulting providers must be an enrolled Medicaid provider in the state in which the beneficiary resides, though they need only be licensed/credentialed in the state in which they are practicing. Interprofessional consultations that occur across state lines require prior authorization. Refer to the General Information for Providers chapter for further information regarding out-of-state/beyond borderland providers and the prior authorization process.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 2238-2239, Jan. 1, 2026 (Accessed Jan. 2026).
Diabetes Prevention Program (MiDPP)
Sessions may take place in the following modalities and make-up sessions are encouraged:
- In-person
- Distance Learning (synchronous audio-visual or audio-only telemedicine): Lifestyle coaches deliver sessions where the coach is present in one location and participants are participating from another location. Claims for an audio-only session must include the appropriate procedure code, place of service code and modifier 93 and claims for an audio-visual session must include the appropriate procedure code, place of service code and modifier 95.
- Online: An asynchronous mode of delivery where participants log into course sessions via a computer, tablet, or smart phone. Per CDC requirements, MiDPP lifestyle coach interaction (in person or via synchronous telemedicine) is required and must be no less than once per week during the first six months and once per month during the second six months.
When billing for a telemedicine session, synchronous or asynchronous, MiDPP providers are expected to adhere to current MDHHS telemedicine policy and modifiers. Refer to the Michigan Medicaid Telemedicine Fee schedule for the list of current codes acceptable for MiDPP telemedicine claims. Claims for an asynchronous session must include the appropriate procedure code and the following remark: “Service provided via an asynchronous telemedicine platform”.
The Michigan Diabetes Prevention Program (MiDPP) will align with recently added HCPCS code G9871 (Behavioral counseling for diabetes prevention, online, 60 min) for asynchronous online delivery. MiDPP providers and lifestyle coaches are required to follow the Diabetes Prevention Recognition Program (DPRP) standards and operating procedures, as well as Michigan Medicaid telemedicine policy as outlined in the MDHHS Medicaid Provider Manual.
SOURCE: MI Dept. of Health and Human Services., Bulletin 26-03, Code Updates, Jan. 22, 2026. (Accessed Jan. 2026).
GEOGRAPHIC LIMITS
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TRANSMISSION FEE
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