Last updated 02/16/2023
Consent Requirements
Effective Now Until June 30, 2024
Notwithstanding the provisions of section 19a-906 of the general statutes, as amended by this act, if a telehealth provider provides a telehealth service to a patient during the period beginning on May 10, 2021 and ending on June 30, 2024, the telehealth provider shall, at the time of the telehealth provider’s first telehealth interaction with a patient, inform the patient concerning the treatment methods and limitations of treatment using a telehealth platform, including, but not limited to, the limited duration of the relevant provisions of this section and sections 3 to 7, inclusive, of public act 21-9, as amended by this act, and, after providing the patient with such information, obtain the patient’s consent to provide telehealth services. The telehealth provider shall document such notice and consent in the patient’s health record. If a patient later revokes such consent, the telehealth provider shall document the revocation in the patient’s health record.
During the period beginning on May 10, 2021 and ending on June 30, 2024, each telehealth provider shall, at the time of the initial telehealth interaction, ask the patient whether the patient consents to the telehealth provider’s disclosure of records concerning the telehealth interaction to the patient’s primary care provider. If the patient consents to such disclosure, the telehealth provider shall provide records of all telehealth interactions during such period to the patient’s primary care provider, in a timely manner, in accordance with the provisions of sections 20-7b to 20-7e, inclusive, of the general statutes.
During the period beginning on May 10, 2021 and ending on June 30, 2024, any consent or revocation of consent under this section shall be obtained from or communicated by the patient, or the patient’s legal guardian, conservator or other authorized representative, as applicable.
SOURCE: HB 5596 (2021 Session), Sec. 1 & SB 2 (2022 Session), Sec. 32. (Accessed Feb. 2023).
Permanent Statute
At the time of the telehealth provider’s first telehealth interaction with a patient, the telehealth provider shall inform the patient concerning the treatment methods and limitations of treatment using a telehealth platform and, after providing the patient with such information, obtain the patient’s consent to provide telehealth services. The telehealth provider shall document such notice and consent in the patient’s health record. If a patient later revokes such consent, the telehealth provider shall document the revocation in the patient’s health record.
Consent must be obtained by the parent or the patient’s legal guardian as applicable.
SOURCE: CT Gen. Statutes Sec. 19a-906(b)(2)&(e). (Accessed Feb. 2023).
Providers must obtain informed consent in writing from each member before providing telehealth services and annually thereafter. The provider must ensure each patient is aware they can opt-out or refuse telehealth services at any time.
SOURCE: CT Medicaid Assistance Program Provider Bulletin 2020-09 (March 2020), p. 6. (Accessed Feb. 2023).
Last updated 02/16/2023
Definitions
Effective Now Until June 30, 2024
“Telehealth” means the mode of delivering health care or other health services via information and communication technologies to facilitate the diagnosis, consultation and treatment, education, care management and self-management of a patient’s physical, oral and mental health, and includes interaction between the patient at the originating site and the telehealth provider at a distant site, synchronous interactions, asynchronous store and forward transfers or remote patient monitoring, but does not include interaction through facsimile, texting or electronic mail.
SOURCE: SB 2 (2022 Session), Sec. 32. & HB 5596 (2021 Session), Sec. 1. (Accessed Feb. 2023).
Permanent Statute
“Telehealth” means the mode of delivering health care or other health services via information and communication technologies to facilitate the diagnosis, consultation and treatment, education, care management and self-management of a patient’s physical and mental health, and includes (A) interaction between the patient at the originating site and the telehealth provider at a distant site, and (B) synchronous interactions, asynchronous store and forward transfers or remote patient monitoring. Telehealth does not include the use of facsimile, texting or electronic mail.
SOURCE: CT General Statute 19a, Sec. 906. (Accessed Feb. 2023).
Synchronized telemedicine is defined as an audio and video telecommunication system with real-time communication between the patient and practitioner.
SOURCE: CT Policy – Provider Bulletin 2020-09. March 2020. (Accessed Feb. 2023).
Definition for Telemedicine Demonstration Program for FQHCs: “Telemedicine means the use of interactive audio, interactive video or interactive data communication in the delivery of medical advice, diagnosis, care or treatment and includes services described in subsection (d) of section 20-9 and 42 CFR 410.78(a)(3). Telemedicine does not include the use of facsimile or audio-only telephone.”
SOURCE: CT General Statute 17b, Sec. 245c. (Accessed Feb. 2023).
Last updated 02/16/2023
Email, Phone & Fax
Effective Now Until June 30, 2024
Notwithstanding the provisions of section 19a-906 of the general statutes, as amended by this act, and subdivision (1) of this subsection, a telehealth provider that is an in-network provider or a provider enrolled in the Connecticut medical assistance program that provides telehealth services to a Connecticut medical assistance program recipient, may, during the period beginning on May 10, 2021 and ending on June 30, 2024, use any information or communication technology in accordance with the directions, modifications or revisions, if any, made by the Office for Civil Rights of the United States Department of Health and Human Services to the provisions of the Health Insurance Portability and Accountability Act of 1996 P.L. 104-191, as amended from time to time, or the rules and regulations adopted thereunder.
Telehealth does not include facsimile, texting or electronic mail. The Commissioner of Social Services may, in the commissioner’s discretion and to the extent permissible under federal law, provide coverage under the Connecticut medical assistance program for audio-only telehealth services until June 30, 2023.
SOURCE: HB 5596 (2021 Session), Sec. 1, 6. & SB 2 (2022 Session), Sec. 32. (Accessed Feb. 2023).
Permanent Policy/Statute
The department shall not pay for information or services provided to a client over the telephone except for case management behavioral health services for patients aged 18 and under.
SOURCE: CT Provider Manual. Clinic. Sec. 17b-262-823. Oct. 1, 2020. Ch. 7, pg. 20; Behavioral Health. Sec. 17b-262-918. Oct. 2020 Ch. 7, Pg. 6; CT Provider Manual. Physician and Psychiatrist. Sec. 17b-262-342 & 17b-262-456. Oct. 2020 Pg. 9 & 20; CT Provider Manual. Psychologist. Sec. 17b-262-472. Oct. 2020. Ch. 7, pg. 7; CT Provider Manual. Hospital Inpatient Services. Sec. 150.2(E)(III)(l). Oct. 2020. Ch. 7, pg. 44; CT Provider Manual. Chiropractic. Sec. 17b-262-540. Oct. 2020. Ch. 7, pg. 6; CT Provider Manual. Dental. Sec. 17b-262-698. Oct. 2020. Ch. 7, Pg. 44; CT Provider Manual. Home Health. Sec. 17b-262-729. Oct. 2020. Ch. 7, pg. 12; CT Provider Manual. Naturopath. Sec. 17b-262-552. Oct. 2020. Ch. 7, pg. 6; CT Provider Manual. Nurse Practitioner/Midwife. Sec. 17b-262-578. Oct. 2020. Ch. 7, pg. 7; CT Provider Manual. Podiatry. Sec. 17b-262-624. Oct. 2020. Ch. 7, pg. 6; CT Provider Manual. Vision Care. Sec. 17b-262-564. Oct. 2020. Ch. 7, pg. 4. (Accessed Feb. 2023).
The price for any supply listed in the fee schedule published by the department shall include and the department shall pay the lowest: … information furnished by the provider to the client over the telephone.
SOURCE: CT Provider Manual. Medical Services, Sec. 17b-262-720, p. 7. (Accessed Feb. 2023).
Telephonic consultations are not reimbursable under CMAP.
SOURCE: CT Policy Transmittal 2019-12. Effective Jan. 1, 2019. Released Mar. 1, 2019. (Accessed Feb. 2023).
Notwithstanding the provisions of section 17b-245c, 17b-245e or 19a-906 of the general statutes, as amended by this act, or any other section of the general statutes, regulation, rule, policy or procedure governing the Connecticut medical assistance program, the Commissioner of Social Services shall, to the extent permissible under federal law, provide coverage under the Connecticut medical assistance program for audio-only telehealth services when (1) clinically appropriate, as determined by the commissioner, (2) it is not possible to provide comparable covered audiovisual telehealth services, and (3) provided to individuals who are unable to use or access comparable, covered audiovisual telehealth services.
SOURCE: CT Statute Sec. 17b-245g, as added by CT HB 6470 (2021 Session). (Accessed Feb. 2023).
Last updated 02/16/2023
Live Video
POLICY
Effective Now Until June 30, 2024
During the period beginning on May 10, 2021 and ending on June 30, 2024, a telehealth provider may only provide a telehealth service to a patient when the telehealth provider:
- Is communicating through real-time, interactive, two-way communication technology or store and forward transfer technology;
- Has determined whether the patient has health coverage that is fully insured, not fully insured or provided through the Connecticut medical assistance program, and whether the patient’s health coverage, if any, provides coverage for the telehealth service;
- Has access to, or knowledge of, the patient’s medical history, as provided by the patient, and the patient’s health record, including the name and address of the patient’s primary care provider, if any;
- Conforms to the standard of care applicable to the telehealth provider’s profession and expected for in-person care as appropriate to the patient’s age and presenting condition, except when the standard of care requires the use of diagnostic testing and performance of a physical examination, such testing or examination may be carried out through the use of peripheral devices appropriate to the patient’s condition; and
- Provides the patient with the telehealth provider’s license number, if any, and contact information
A telehealth provider that is an in-network provider or a provider enrolled in the Connecticut medical assistance program that provides telehealth services to a Connecticut medical assistance program recipient, may, during the period beginning on May 10, 2021 and ending on June 30, 2024, use any information or communication technology in accordance with the directions, modifications or revisions, if any, made by the Office for Civil Rights of the United States Department of Health and Human Services to the provisions of the Health Insurance Portability and Accountability Act of 1996 P.L. 104-191, as amended from time to time, or the rules and regulations adopted thereunder.
No telehealth provider shall provide health care or health services to a patient through telehealth unless the telehealth provider has determined whether or not the patient has health coverage for such health care or health services.
A telehealth provider who provides health care or health services to a patient through telehealth during the period beginning on May 10, 2021 and ending on June 30, 2024, shall accept as full payment for such health care or health services:
- An amount that is equal to the amount that Medicare reimburses for such health care or health services if the telehealth provider determines that the patient does not have health coverage for such health care or health services; or
- The amount that the patient’s health coverage reimburses, and any coinsurance, copayment, deductible or other out-of-pocket expense imposed by the patient’s health coverage, for such health care or health services if the telehealth provider determines that the patient has health coverage for such health care or health services. If the patient’s health coverage uses a provider network, the amount of such reimbursement, and such coinsurance, copayment, deductible or other out-of-pocket expense, shall not exceed the in-network amount regardless of the network status of such telehealth provider.
If a telehealth provider determines that a patient is unable to pay for any health care or health services described in subdivisions (1) and (2) of this subsection, the provider shall offer to the patient financial assistance, if such provider is otherwise required to offer to the patient such financial assistance, under any applicable state or federal law.
A telehealth provider may provide telehealth services pursuant to the provisions of this section from any location.
The Commissioner of Social Services may, in the commissioner’s discretion and to the extent permissible under federal law, provide coverage under the Connecticut medical assistance program for audio-only telehealth services until June 30, 2023.
SOURCE: HB 5596 (2021 Session), Sec. 1, 6. & SB 2 (2022 Session), Sec. 32. (Accessed Feb. 2023).
Permanent Statute
CT Medicaid is required to provide coverage for telehealth services for categories of health care services that the commissioner determines are clinically appropriate to be provided through telehealth, cost effective for the state and likely to expand access to medically necessary services where there is a clinical need for those services to be provided by telehealth or for Medicaid recipients whom accessing healthcare poses an undue hardship.
The commissioner may provide coverage of telehealth services pursuant to this section notwithstanding any provision of the regulations of Connecticut state agencies that would otherwise prohibit coverage of telehealth services. The commissioner may implement policies and procedures as necessary to carry out the provisions of this section while in the process of adopting the policies and procedures as regulations.
SOURCE: CT General Statute 17b, Sec. 245e. (Accessed Feb. 2023).
In accordance with section 17b- 245e of the 2020 supplement to the Connecticut General Statutes, the Department of Social Services (DSS or Department) will implement full coverage of specified synchronized telemedicine, which is defined as an audio and video telecommunication system with real-time communication between the patient and practitioner. The coverage of specified synchronized telemedicine services will be covered under both Connecticut’s Medicaid Program and Children’s Health Insurance Program (CHIP) when they:
- Are medically necessary, in accordance with the statutory definition of medical necessity
- Are rendered via a HIPAA-compliant, real time audio and video communication system (but note that certain popular video chatting software programs are not HIPAA-compliant); and
- Comply with all CMAP requirements that would otherwise apply to the same service performed face-to-face (in-person), including, but not limited to, enrollment, scope of practice, licensure, documentation, and other applicable requirements.
SOURCE: CT Policy – Provider Bulletin 2020-09. March 2020. (Accessed Feb. 2023).
Connecticut’s Medical Assistance Program will not pay for information or services provided to a client by a provider electronically or over the telephone. However, there is an exception for case management behavioral health services for clients age eighteen and under.
SOURCE: CT Provider Manual. Physicians and Psychiatrists. Sec. 17b-262-342. Pg. 9, Oct. 2020; CT Provider Manual. Psychologists. Sec. 17b-262-472. Oct. 2020. Pg. 7; & CT Provider Manual. Behavioral Health. Sec. 17b-262-918. Oct. 2020. Pg. 6. (Accessed Feb. 2023).
A telehealth provider shall only provide telehealth services to a patient when the telehealth provider: (A) Is communicating through real-time, interactive, two-way communication technology or store and forward technologies; (B) has access to, or knowledge of, the patient’s medical history, as provided by the patient, and the patient’s health record, including the name and address of the patient’s primary care provider, if any; (C) conforms to the standard of care applicable to the telehealth provider’s profession and expected for in-person care as appropriate to the patient’s age and presenting condition, except when the standard of care requires the use of diagnostic testing and performance of a physical examination, such testing or examination may be carried out through the use of peripheral devices appropriate to the patient’s condition; and (D) provides the patient with the telehealth’s provider license number and contact information.
SOURCE: CA Gen. Statutes Sec. 19a-906(b)(1). (Accessed Feb. 2023).
ELIGIBLE SERVICES/SPECIALTIES
See bulletin for the behavioral health services that may be rendered via telemedicine.
SOURCE: CT Policy – Provider Bulletin 2020-09. March 2020. (Accessed Feb. 2023).
Opioid Treatment Programs are required to perform a complete, fully documented physical evaluation prior to admission. The program physician may render the physical evaluation component of MAT services via telemedicine only when all of the following are met:
- The CMAP member’s originating site is another CMAP-enrolled Opioid Treatment Program (Methadone Maintenance Clinic) that is part of the same billing entity as the originating site;
- The originating site is providing all the other required components of MAT services including the intake and psychiatric evaluation;
- As required by 42 CFR 8.12(f), an authorized healthcare professional under the supervision of a program physician is present with the member at the originating site; and
- The distant site provider must be located at a different service location/address than the originating site.
Induction services must always be rendered face-to-face (in-person) and only after the physical and psychiatric evaluation has been performed. Once a CMAP member has been inducted, routine psychotherapy services may be rendered via telemedicine.
MAT services that may be rendered via telemedicine include medication management and psychotherapy services.
SOURCE: CT Policy – Provider Bulletin 2020-09. March 2020. (Accessed Feb. 2023).
CT does not pay for information or services furnished by a licensed behavioral health clinician to the client electronically or over the telephone, except for case management behavioral health services for clients age eighteen and under.
SOURCE: CT Provider Manual. Behavioral Health. Sec. 17b-262-918. Oct. 2020. Pg. 6. (Accessed Feb. 2023).
ELIGIBLE PROVIDERS
Effective Now Until June 30, 2024
A telehealth provider may provide telehealth services from any location.
Telehealth providers include the following who are providing health care or other health services through the use of telehealth within such person’s scope of practice and in accordance with the standard of care applicable to the profession:
- Any physician licensed under chapter 370
- Physical therapist or physical therapist assistant licensed under chapter 376
- Chiropractor licensed under chapter 372
- Naturopath licensed under chapter 373
- Podiatrist licensed under chapter 375
- Occupational therapist or occupational therapy assistant licensed under chapter 376a
- Optometrist licensed under 380
- Registered nurse or advanced practice registered nurse licensed under chapter 378
- Physician assistant licensed under chapter 370
- Psychologist licensed under chapter 383
- Marital and family therapist licensed under chapter 383a
- Clinical social worker or master social worker licensed under chapter 383b
- Alcohol and drug counselor licensed under chapter 376b
- Professional counselor licensed under chapter 383c
- Dietitian-nutritionist licensed under chapter 384b
- Speech and language pathologist licensed under chapter 399
- Respiratory care practitioner licensed under chapter 381a
- Audiologist licensed under chapter 397a
- Pharmacist licensed under chapter 400j
- Paramedic licensed under chapter 384d
- Nurse-midwife licensed under chapter 377
- Dentist licensed under chapter 379
- Behavior analyst licensed under chapter 382a
- Genetic counselor licensed under chapter 383d
- Music therapist certified in the manner described in chapter 383f
- Art therapist licensed in the manner described in chapter 383g
- Athletic trainer licensed under chapter 375a
A telehealth provider may also be an appropriately licensed, certified or registered provider as listed below, that is in another state or territory of the United States or the District of Columbia and that provides telehealth services pursuant to his or her authority under any relevant order issued by the Commissioner of Public Health and maintains professional liability insurance, or other indemnity against liability for professional malpractice, in an amount that is equal to or greater than that required for similarly licensed, certified or registered Connecticut health care providers:
- physician
- physician assistant
- physical therapist
- physical therapist assistant
- chiropractor
- naturopath
- podiatrist
- occupational therapist
- occupational therapy assistant
- optometrist
- registered nurse
- advanced practice registered nurse
- psychologist
- marital and family therapist
- clinical social worker
- master social worker
- alcohol and drug counselor
- professional counselor
- dietitian
- nutritionist
- speech and language pathologist
- respiratory care practitioner
- audiologist
- pharmacist
- paramedic
- nurse-midwife
- dentist
- behavior analyst
- genetic counselor
- music therapist
- art therapist
- athletic trainer
SOURCE: HB 5596 (2021 Session), Sec. 1, & SB 2 (2022 Session), Sec. 32. (Accessed Feb. 2023).
Permanent Policy
Only the following categories of CMAP-enrolled providers may provide and bill for such psychotherapy services or psychiatric diagnostic evaluations within their scope of practice via telemedicine:
- Physician
- Physician Assistant
- Advanced Practice Registered Nurses
- Licensed Behavioral Health Clinicians (defined below and which includes only the following: Licensed Psychologists, Licensed Clinical Social Workers, Licensed Marital and Family Therapists, Licensed Professional Counselors, and Licensed Alcohol and Drug Counselors)
- Behavioral Health Clinics – including Enhanced Care Clinics (ECCs)
- Behavioral Health Federally Qualified Health Centers (FQHCs)
- Medical Clinics – excluding School Based Health Centers (SBHCs)
- Rehabilitation Clinics
- Outpatient Hospital Behavioral Health (BH) Clinics
- Outpatient Psychiatric Hospitals
- Outpatient Chronic Disease Hospitals (CDHs)
Modifiers GT is used when the member’s originating site is located in a healthcare facility or office; or modifier 95 Is used when the member is located at home.
SOURCE: CT Policy – Provider Bulletin 2020-09. March 2020. (Accessed Feb. 2023).
Medication Assisted Treatment
Eligible providers:
- Physician
- APRNs
- PAs
- Behavioral Health Clinics
Medication Management
Eligible Providers:
- Physicians
- PAs
- APRNs
- Medical Clinics – excluding SBHCs
- Behavioral Health Clinics – including ECCs
- Behavioral Health FQHCs
- Outpatient Hospital BH Clinics
- Outpatient Chronic Disease Hospitals
Eligible providers for out of state surgery and homebound patients include:
- Physicians
- PAs
- APRNs
- CNMs
- Podiatrists
Eligible providers to determine if patient to be homebound and/or provide and bill for such service:
- Physicians
- PAs
- APRNs
- CNMs
- Podiatrists
For homebound patients, provider must document the reason the member is being determined homebound.
Documentation must be maintained by both the originating site provider and the distant site provider to substantiate the services provided. Originating site documentation must indicate the member received or has been referred for telehealth services.
SOURCE: CT Policy – Provider Bulletin 2020-09. March 2020. (Accessed Feb. 2023).
Telehealth providers includes the following who are providing health care or other health services through the use of telehealth within such person’s scope of practice and in accordance with the standard of care applicable to the profession:
- Any physician licensed under chapter 370
- Physical therapist licensed under chapter 376
- Chiropractor licensed under chapter 372
- Naturopath licensed under chapter 373
- Podiatrist licensed under chapter 375
- Occupational therapist or licensed under chapter 376a
- Optometrist licensed under 380
- Registered nurse or advanced practice registered nurse licensed under chapter 378
- Physician assistant licensed under chapter 370
- Psychologist licensed under chapter 383
- Marital and family therapist licensed under chapter 383a
- Clinical social worker or master social worker licensed under chapter 383b
- Alcohol and drug counselor licensed under chapter 376b
- Professional counselor licensed under chapter 383c
- Dietitian-nutritionist licensed under chapter 384b
- Speech and language pathologist licensed under chapter 399
- Respiratory care practitioner licensed under chapter 381a
- Audiologist licensed under chapter 397a
- Pharmacist licensed under chapter 400j
- Paramedic licensed under chapter 384d
- Nurse-Midwife licensed under chapter 377
- Behavior Analyst licensed under chapter 382a
SOURCE: CT Gen. Statutes Sec. 19a-906(a)(12). (Accessed Feb. 2023).
Medication Assisted Treatment – Opioid Treatment Program
The distant site provider cannot bill for the physical evaluation component rendered via telemedicine.
SOURCE: CT Policy – Provider Bulletin 2020-09. March 2020. (Accessed Feb. 2023).
Medical and Behavioral Health Federally Qualified Health Centers (FQHCs) are eligible to bill their encounter rate when an approved, medically necessary telemedicine service is rendered.
SOURCE: CT Policy – Provider Bulletin 2020-09. March 2020. (Accessed Feb. 2023).
Effective July 1, 2024
A telehealth provider also is to include an appropriately licensed, certified or registered provider as listed below in another state or territory of the United States or the District of Columbia, who (i) provides telehealth services under any relevant order issued pursuant to section 33 of this act, (ii) provides mental or behavioral health care through the use of telehealth within such person’s scope of practice and in accordance with the standard of care applicable to the profession, and (iii) maintains professional liability insurance, or other indemnity against liability for professional malpractice, in an amount that is equal to or greater than that required for similarly licensed, certified or registered Connecticut mental or behavioral health care providers:
- physician
- naturopath
- registered nurse
- advanced practice registered nurse
- physician assistant
- psychologist
- marital and family therapist
- clinical social worker
- master social worker
- alcohol and drug counselor
- professional counselor
- dietitian-nutritionist
- nurse-midwife
- behavior analyst
- music therapist
- art therapist
SOURCE: SB 2 (2022 Session), Sec. 30. (Accessed Feb. 2023).
ELIGIBLE SITES
There is no limitation on the originating site for a member receiving individual therapy, family therapy or psychotherapy with medication management.
Psychiatric diagnostic evaluations may be rendered via telemedicine only if the member is located at a CMAP-enrolled originating site.
Modifiers GT is used when the member’s originating site is located in a healthcare facility or office; or modifier 95 Is used when the member is located at home.
Documentation must be maintained by both the originating site provider and the distant site provider to substantiate the services provided. Originating site documentation must indicate the member received or has been referred for telehealth services.
SOURCE: CT Policy – Provider Bulletin 2020-09. March 2020, (Accessed Feb. 2023).
Medication Assisted Treatment
Due to Opioid Treatment Programs (Methadone Maintenance Clinics) receiving a daily payment rate for all MAT services provided, the daily payment rate will continue to be paid to the originating site only. The distant site provider must be located at a different service location/address than the originating site.
SOURCE: CT Policy – Provider Bulletin 2020-09. March 2020. (Accessed Feb. 2023).
GEOGRAPHIC LIMITS
No Reference Found
FACILITY/TRANSMISSION FEE
Effective Now Until June 30, 2024
No telehealth provider shall charge a facility fee for a telehealth service provided during the period beginning on May 10, 2021 and ending on June 30, 2024.
SOURCE: HB 5596 (2021 Session), Sec. 1. & SB 2 (2022 Session), Sec. 32. (Accessed Feb. 2023).
Permanent Statute
No telehealth provider shall charge a facility fee for telehealth services.
SOURCE: CT Gen. Statutes Sec. 19a-906(h). (Accessed Feb. 2023).
No telehealth provider or hospital shall charge a facility fee for telehealth services. Such prohibition shall apply to hospital telehealth services whether provided on campus or otherwise. For purposes of this subsection, “hospital” has the same meaning as provided in section 19a490 and “campus” has the same meaning as provided in section 19a508c.
SOURCE: CT Gen. Statutes Sec. 19a-906(h), as proposed to be amended by SB 2 (2022 Session), Sec. 31. (Accessed Feb. 2023).
Last updated 02/16/2023
Miscellaneous
Effective Now Until June 30, 2024
A telehealth provider may only provide a telehealth service to a patient when the telehealth provider:
- Is communicating through real-time, interactive, two-way communication technology or store and forward transfer technology;
- Has determined whether the patient has health coverage that is fully insured, not fully insured or provided through Medicaid or the Children’s Health Insurance Program, and whether the patient’s health coverage, if any, provides coverage for the telehealth service;
- Has access to, or knowledge of, the patient’s medical history, as provided by the patient, and the patient’s health record, including the name and address of the patient’s primary care provider, if any;
- Conforms to the standard of care applicable to the telehealth provider’s profession and expected for in-person care as appropriate to the patient’s age and presenting condition, except when the standard of care requires the use of diagnostic testing and performance of a physical examination, such testing or examination may be carried out through the use of peripheral devices appropriate to the patient’s condition; and
- Provides the patient with the telehealth provider’s license number, if any, and contact information.
Nothing prevents a health care provider from:
- Providing on-call coverage pursuant to an agreement with another health care provider or such health care provider’s professional entity or employer;
- consulting with another health care provider concerning a patient’s care;
- ordering care for hospital outpatients or inpatients; or
- using telehealth for a hospital inpatient, including for the purpose of ordering medication or treatment for such patient in accordance with the Ryan Haight Online Pharmacy Consumer Protection Act, 21 USC 829(e), as amended from time to time.
“Health care provider” means a person or entity licensed or certified pursuant to chapter 370, 372, 373, 375, 376 to 376b, inclusive, 378, 379, 380, 381a, 383 to 383c, inclusive, 384b, 397a, 399 or 400j of the general statutes or licensed or certified pursuant to chapter 368d or 384d of the general statutes.
A telehealth provider who provides health care or health services to a patient through telehealth until June 30, 2024, shall:
(A) Accept as full payment for such health care or health services:
(i) An amount that is equal to the amount that Medicare reimburses for such health care or health services if the telehealth provider determines that the patient does not have health coverage for such health care or health services; or
(ii) The amount that the patient’s health coverage reimburses, and any coinsurance, copayment, deductible or other out-of-pocket expense imposed by the patient’s health coverage, for such health care or health services if the telehealth provider determines that the patient has health coverage for such health care or health services. If the patient’s health coverage uses a provider network, the amount of such reimbursement, and such coinsurance, copayment, deductible or other out-of-pocket expense, shall not exceed the in-network amount regardless of the network status of such telehealth provider.
(3) If a telehealth provider determines that a patient is unable to pay for any health care or health services described in subdivisions (1) and (2) of this subsection, the provider shall offer to the patient financial assistance, if such provider is otherwise required to offer to the patient such financial assistance, under any applicable state or federal law.
SOURCE: HB 5596 (2021 Session) & SB 2 (2022 Session). (Accessed Feb. 2023).
Permanent Statute/Policy
The Commissioner is required to submit a report by Aug. 1, 2020 to the joint standing committees of the General Assembly on the categories of health care services in which the department is utilizing telehealth services, in what cities or regions of the state such services are being offered and any cost savings realized by the state by providing telehealth services.
SOURCE: CT General Statute 17b, Sec. 245e. (Accessed Feb. 2023).
Effective for dates of service January 1, 2021 and forward, telemedicine claims should no longer be billed with POS 02.
SOURCE: CT Department of Social Services, Medical Assistance Program, Provider Bulletin 2020-100, Dec. 2020. (Accessed Feb. 2023).
Audio-Only Telephone Remote Early Intervention Services is permissible only in accordance with the following:
- Developmental Evaluations
- Assessments
- IFSP Planning
- Early Intervention Treatment Services (EITS)
SOURCE: Medicaid Provider Bulletin on Remote Early Intervention Treatment Services, Provider Bulletin 2020-16, p. 3 (Accessed Feb. 2023).
The executive director of the Office of Health Strategy, established under section 19a-754a of the general statutes, shall conduct a study regarding the provision of, and coverage for, telehealth services in this state. Such study shall include, but need not be limited to, an examination of (1) the feasibility and impact of expanding access to telehealth services, telehealth providers and coverage for telehealth services in this state beginning on July 1, 2024, and (2) any means available to reduce or eliminate obstacles to patient access to telehealth services, telehealth providers and coverage for telehealth services in this state, including, but not limited to, any means available to reduce patient costs for telehealth services and coverage for telehealth services in this state. Not later than January 1, 2023, the executive director shall submit a report on the findings of such study, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committees of the General Assembly having cognizance of matters relating to public health, human services and insurance.
SOURCE: SB 2 (2022 Session), sec. 41. (Accessed Feb. 2023).
Last updated 02/16/2023
Out of State Providers
Effective Now Until June 30, 2023
The following providers in another state or territory of the United States or the District of Columbia, that provide telehealth services pursuant to his or her authority under any relevant order issued by the Commissioner of Public Health, and maintains professional liability insurance or other indemnity against liability for professional malpractice in an amount that is equal to or greater than that required for similarly licensed, certified or registered Connecticut health care providers, are considered a telehealth provider:
- Physician
- Physician assistant
- Physical therapist or physical therapist assistant
- Chiropractor
- Naturopath
- Podiatrist
- Occupational therapist or occupational therapy assistant
- Optometrist
- Registered nurse or advanced practice registered nurse
- Psychologist
- Marital and family therapist
- Clinical social worker
- Master social worker
- Alcohol and drug counselor
- Professional counselor
- Dietitian-nutritionist
- Speech and language pathologist
- Respiratory care practitioner
- Audiologist
- Pharmacist
- Paramedic
- Nurse-midwife
- Dentist
- Behavior analyst
- Genetic counselor
- Music therapist
- Art therapist
- Athletic trainer
Effective Now Until June 30, 2024
Ending on June 30, 2024, any Connecticut entity, institution or health care provider that engages or contracts with a telehealth provider that is licensed, certified or registered in another state or territory of the United States or the District of Columbia to provide health care or other health services shall verify the credentials of such provider in the state in which he or she is licensed, certified or registered, ensure that such a provider is in good standing in such state, and confirm that such provider maintains professional liability insurance or other indemnity against liability for professional malpractice in an amount that is equal to or greater than that required for similarly licensed, certified or registered Connecticut health care providers.
Ending on June 30, 2024, the Commissioner of Public Health may temporarily waive, modify or suspend any regulatory requirements adopted by the Commissioner of Public Health or any boards or commissions as the Commissioner of Public Health deems necessary to reduce the spread of COVID-19 and to protect the public health for the purpose of providing residents of this state with telehealth services from out-of-state practitioners.
SOURCE: HB 5596 (2021 Session) & SB 2 (2022 Session). (Accessed Feb. 2023).
*See COVID-19 Licensing Section in regard to any effective temporary orders.
Effective July 1, 2022
The Commissioner of Public Health may issue an order authorizing telehealth providers who are not licensed, certified or registered to practice in this state to provide telehealth services to patients in this state. Such order may be of limited duration and limited to one or more types of providers described in subdivision (13) of subsection (a) of section 1 of public act 21-9, as amended by this act, or subdivision (12) of subsection (a) of section 19a906 of the general statutes, as amended by this act. The commissioner may impose conditions including, but not limited to, a requirement that any telehealth provider providing telehealth services to patients in this state pursuant to such order shall submit an application for licensure, certification or registration, as applicable. The commissioner may suspend or revoke any authorization provided pursuant to this section to a telehealth provider who violates any condition imposed by the commissioner or applicable requirements for the provision of telehealth services under the law. Any such order issued pursuant to this section shall not constitute a regulation, as defined in section 4-166 of the general statutes.
SOURCE: SB 2 (2022 Session), Sec. 33 (Accessed Feb. 2023).
Out-of-State Surgery
Physicians rendering inpatient surgical services for a CMAP member must ensure the hospital has submitted and obtained an approved prior authorization for the inpatient surgery. Once the hospital has an approved authorization on file for the CMAP member, the member is eligible to receive their pre- and/or post-surgical consultations via telemedicine. Any telemedicine service related to the surgery must be rendered by the Out-of-State (OOS) provider who will be performing the surgery. All telemedicine services must be clinically appropriate and medically necessary. Pre/Post surgery instructions are not eligible for reimbursement via telemedicine.
SOURCE: CT Medical Assistance Program, Provider Bulletin 2020-09 (March 2020), p. 4. (Accessed Feb. 2023).
Border Hospital Reimbursement
The Department of Social Services (DSS) is notifying border and out-of-state (OOS) hospitals that the rates and parameters for reimbursement of inpatient and outpatient hospital services, provided to Connecticut Medicaid members, have been updated effective for dates of discharges on or after January 1, 2023.
SOURCE: CT Medical Assistance Program, Provider Bulletin 2022-95 (Dec. 20220), p. 1. (Accessed Feb. 2023).
The Commissioner of Public Health, in consultation with the Commissioner of Early Childhood, shall develop and implement a plan to establish licensure by reciprocity or endorsement of a person who (1) is (A) a speech and language pathologist licensed or certified to provide speech and language pathology services, or entitled to provide speech and language pathology services under a different designation, in another state having requirements for practicing in such capacity that are substantially similar to or higher than the requirements in force in this state, or (B) an occupational therapist licensed or certified to provide occupational therapy services, or entitled to provide occupational therapy services under a different designation, in another state having requirements for practicing in such capacity that are substantially similar to or higher than the requirements in force in this state, (2) has no disciplinary action or unresolved complaint pending against such person, and (3) intends to provide early intervention services under the employment of an early intervention service program participating in the birth-to-three program established pursuant to section 17a-248b of the general statutes.
When developing and implementing such plan, the Commissioner of Public Health shall consider eliminating barriers to the expedient licensure of such persons in order to immediately address the needs of children receiving early intervention services under the birthto-three program. The provisions of any interstate licensure compact regarding a speech and language pathologist or occupational therapist adopted by the state shall supersede any program of licensure by reciprocity or endorsement implemented under this section for such speech and language pathologist or occupational therapist.
On or before January 1, 2023, the Commissioner of Public Health shall (1) implement the plan to establish licensure by reciprocity or endorsement, and (2) report, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committees of the General Assembly having cognizance of matters relating to public health and children regarding such plan and recommendations for any necessary legislative changes related to such plan.
SOURCE: SB 2 (2022 Session), Sec. 26. (Accessed Feb. 2023).
Effective July 1, 2024
A telehealth provider also is to include an appropriately licensed, certified or registered provider as listed below in another state or territory of the United States or the District of Columbia, who (i) provides telehealth services under any relevant order issued pursuant to section 33 of this act, (ii) provides mental or behavioral health care through the use of telehealth within such person’s scope of practice and in accordance with the standard of care applicable to the profession, and (iii) maintains professional liability insurance, or other indemnity against liability for professional malpractice, in an amount that is equal to or greater than that required for similarly licensed, certified or registered Connecticut mental or behavioral health care providers:
- physician
- naturopath
- registered nurse
- advanced practice registered nurse
- physician assistant
- psychologist
- marital and family therapist
- clinical social worker
- master social worker
- alcohol and drug counselor
- professional counselor
- dietitian-nutritionist
- nurse-midwife
- behavior analyst
- music therapist
- art therapist
SOURCE: SB 2 (2022 Session), Sec. 30. (Accessed Feb. 2023).
Last updated 02/16/2023
Overview
CT has enacted temporary laws relative to telehealth, active until June 30, 2024, that require reimbursement of synchronous interactions, asynchronous store and forward transfers or remote patient monitoring. After the law expires the law will revert back to what is CT’s ‘permanent statute’ section, unless new legislation is passed before that time that further amends the law.
Based on a previous law and permanent statute, Connecticut Medicaid is also required to cover telemedicine services for categories of health care that the commissioner determines are appropriate, cost effective and likely to expand access to medically necessary services where there is a clinical need for those services to be provided by telehealth or for Medicaid recipients for whom accessing appropriate health care services poses an undue hardship. The CT Medicaid Program manuals do not mention reimbursement for telemedicine though provider bulletins do indicate coverage and reimbursement for some services. For audio-only services, while permanent policy does not provide reimbursement for behavioral health services provided electronically or over the phone, there is an exception for case management behavioral health services for clients age eighteen and under. There is no reference to remote patient monitoring.
SOURCE: HB 5596 (2021 Session) & SB 2 (2022 Session), CT Statute 17b-245e, (Accessed Feb. 2023).
An additional new law requires reimbursement of audio-only telehealth under certain circumstances and reimbursement for services provided by means of telehealth to the same extent as if the service was provided in person.
Last updated 02/16/2023
Remote Patient Monitoring
POLICY
Effective Now Until June 30, 2024
Notwithstanding the provisions of section 19a-906 of the general statutes and subdivision (1) of this subsection, a telehealth provider that is an in-network provider or a provider enrolled in the Connecticut medical assistance program that provides telehealth services to a Connecticut medical assistance program recipient, may, during the period beginning on May 10, 2021 and ending on June 30, 2024, use any information or communication technology in accordance with the directions, modifications or revisions, if any, made by the Office for Civil Rights of the United States Department of Health and Human Services to the provisions of the Health Insurance Portability and Accountability Act of 1996 P.L. 104-191, as amended from time to time, or the rules and regulations adopted thereunder.
SOURCE: HB 5596 (2021 Session), Sec. 1 & SB 2 (2022 Session), Sec. 32. (Accessed Feb. 2023).
“Remote patient monitoring” means the personal health and medical data collection from a patient in one location via electronic communication technologies that is then transmitted to a telehealth provider located at a distant site for the purpose of health care monitoring to assist the effective management of the patient’s treatment, care and related support.
SOURCE: CT Statute 19a-906(a)(8). (Accessed Feb. 2023).
TRANSMISSION FEE
No Reference Found
CONDITIONS
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PROVIDER LIMITATIONS
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OTHER RESTRICTIONS
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Last updated 02/16/2023
Store and Forward
POLICY
Effective Now Until June 30, 2024
Notwithstanding the provisions of section 19a-906 of the general statutes, as amended by this act, and subdivision (1) of this subsection, a telehealth provider that is an in-network provider or a provider enrolled in the Connecticut medical assistance program that provides telehealth services to a Connecticut medical assistance program recipient, may, during the period beginning on May 10, 2021 and ending on June 30, 2024, use any information or communication technology in accordance with the directions, modifications or revisions, if any, made by the Office for Civil Rights of the United States Department of Health and Human Services to the provisions of the Health Insurance Portability and Accountability Act of 1996 P.L. 104-191, as amended from time to time, or the rules and regulations adopted thereunder.
SOURCE: HB 5596 (2021 Session), Sec. 1 & SB 2 (2022 Session), Sec. 32. (Accessed Feb. 2023).
Permanent Policy
Although CT Medicaid previously covered electronic consultations, as of January 1, 2020 and forward, the codes used to bill for electronic consultations are no longer payable under the CT Medical Assistance Program. This is due to guidance received by the Centers for Medicare and Medicaid Services (CMS), that reimbursement for electronic consultations does not meet the federal requirements.
SOURCE: CT Policy – Provider Bulletin 2019-75. Dec. 2019, (Accessed Feb. 2023).
“Asynchronous” means any transmission to another site for review at a later time that uses a camera or other technology to capture images or data to be recorded.
SOURCE: CT Statute Sec. 19a-906(a)(1). (Accessed Feb. 2023).
“Store and forward transfer” means the asynchronous transmission of a patient’s medical information from an originating site to the telehealth provider at a distant site.
SOURCE: CT Statute Sec. 19a-906(a)(9). (Accessed Feb. 2023).
ELIGIBLE SERVICES/SPECIALTIES
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GEOGRAPHIC LIMITS
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TRANSMISSION FEE
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