Delaware

CURRENT STATE LAWS & POLICY

AT A GLANCE

Medicaid Program

Delaware Medical Assistance Program (DMAP)

Administrator

Delaware Health and Social Services Dept., Division of Social Services

Regional Telehealth Resource Center

Mid-Atlantic Telehealth Resource Center

Medicaid Reimbursement

Live Video: Yes
Store-and-Forward: No
Remote Patient Monitoring: No

Private Payer

Law Exists: Yes
Payment Parity: Yes

Professional Requirements

Licensure Compacts: PTC, PSY, NLC, EMS
Consent Requirements: Yes

Last updated 02/28/2021

Audio Only Delivery

Medicaid:  Telehealth and COVID FAQs

STATUS: Active, until further notice

Medicaid: Changes to Telehealth Policy

STATUS: Active, until further notice

Medicaid: COVID-19 and Telehealth Fee Schedule

STATUS: Active

Medicaid 1915(c) Waiver: Appendix K DDDS Lifespan Waiver

STATUS: Expired January 26, 2021

Last updated 02/28/2021

Cross State Licensing

Office of the Governor: Declaration of Public Health Emergency

STATUS: Active

Department of Health and Social Services: Joint Order on COVID-19

STATUS: Active, until further notice, or end of DE public health emergency or state of emergency

Last updated 02/28/2021

Easing Prescribing Requirements

Medicaid:  Telehealth and COVID FAQs

STATUS: Active, until further notice

Medicaid: Changes to Telehealth Policy

STATUS: Active, until further notice

Division of Professional Regulation:  Letter to Pharmacists RE Telehealth

STATUS: Active

Last updated 02/28/2021

Miscellaneous

No Reference Found

Last updated 02/28/2021

Originating Site

Medicaid:  Telehealth and COVID FAQs

STATUS: Active, until further notice

HB 348:  Originating & Distant Sites

STATUS: Enacted  (Expires July 1, 2021)

Last updated 02/28/2021

Private Payer

Insurance Commissioner: Bulletin to Insurance Carriers on Telehealth

STATUS: Active, until withdrawn or superseded

Insurance Commissioner: Bulletin Additional Guidance on Telehealth

STATUS: Active, until withdrawn or superseded

Insurance Commissioner: Bulletin, Passage of Telemedicine Statute

STATUS: Active, expires July 1, 2021

Department of Insurance: Insurance Coverage for Telemedicine and Telehealth

STATUS: Active, expires July 1, 2021

Last updated 02/28/2021

Provider Type

Medicaid: Telehealth and COVID FAQs

STATUS: Active, until further notice

Medicaid: Changes to Telehealth Policy

STATUS: Active, until further notice

HB 348:  Originating & Distant Sites

STATUS: Enacted  (Expires July 1, 2021)

Last updated 02/28/2021

Service Expansion

Medicaid:  Telehealth and COVID FAQs

STATUS: Active, until further notice

Medicaid: Changes to Telehealth Policy

STATUS: Active, until further notice

Medicaid:  POS Telehealth and Codes

STATUS: Active

Medicaid: COVID-19 and Telehealth Fee Schedule

STATUS: Active

Office of the Governor: Declaration of Public Health Emergency

STATUS: Active

Last updated 02/28/2021

Definitions

Telemedicine is a cost-effective alternate to face-to-face encounters where access to care is compromised due to the lack of available service providers in the patient’s geographical location.  This definition is modeled on Medicare’s definition for telehealth services located at 42 CFR Sec. 410.78.  Note that the Federal Medicaid statute does not recognize telemedicine as a distinct service.

For purposes of DMAP, telemedicine is the use of medical or behavioral health information exchanged from one site to another site via an electronic interactive (two-way, real time) telecommunications system to improve a patient’s health.

SOURCE:  DE Medical Assistance Program.  Practitioner Provider Specific Manual, 2/21/20. Ch. 16 Telemedicine, 16.1 & 16.2 (Accessed Feb. 2021).

“Telemedicine is the use of medical or behavioral health information exchanged from one site to another via an electronic interactive telecommunications system to improve a patient’s health. Telemedicine services are provided with specialized equipment at each site including real-time streaming via the use of:

  • Video Camera
  • Audio Equipment
  • Monitor
  • The telecommunications must permit real-time encryption of the interactive audio and video exchanges with the consulting provider.”

SOURCE: DE Medical Assistance Program. Adult Behavioral Health Service Certification and Reimbursement.  Dec. 14, 2016.  Sec. 1.8. (Accessed Feb. 2021).

Last updated 02/28/2021

Email, Phone & Fax

Telephone, chart review, electronic mail messages, facsimile transmissions or internet services for online medical evaluations are not considered telemedicine.

SOURCE:  DE Medical Assistance Program.  Practitioner Provider Specific Manual, 2/21/20. Ch. 16.8.1, Telemedicine, pg. 82, (Accessed Feb. 2021). 

Last updated 02/28/2021

Live Video

POLICY

DE Medicaid reimburses for live video telemedicine services for up to three different consulting providers for separately identifiable telemedicine services provided to a member per date of service.

SOURCE:  DE Medical Assistance Program.  Practitioner Provider Specific Manual, 2/21/20. Ch. 16 Telemedicine, Sec. 16..2, pg. 82 & Adult Behavioral Health Service Certification and Reimbursement.  Dec. 14, 2016.  Sec. 1.8, p. 14.  (Accessed Feb. 2021).

The GT modifier (which indicates the service occurred via interactive audio and video telecommunication system) can be used for Early and Periodic Screening, Diagnostic and Treatment Services through the School Based Health Services program in  Group Physical Therapy treatment utilizing code 97150 + the GT modifier.

SOURCE: DE School Based Health Services Specific Policy Manual, pg. 53 & 57 (8/20/18). (Accessed Feb. 2021).

The referring provider is not required to be present at the originating site, however the recipient of the services must be present.

Reimbursement to the referring provider will only occur when providing a separately identifiable covered service.

SOURCE:  DE Medical Assistance Program.  Practitioner Provider Specific Manual, 2/21/20. Ch. 16.2.6.1.1, 16.2.6.1.2,& 16.5.1 Telemedicine, pg. 79-80 (Accessed Feb. 2021). 

The recipient:

  • must be able to verbally communicate, either directly or through a representative, with the originating and distant site providers,
  • must be able to receive services via telemedicine, and
  • must have provided consent for the use of telemedicine.

SOURCE:  DE Medical Assistance Program.  Practitioner Provider Specific Manual, 2/21/20. Ch. 16.5.5 Telemedicine, pg. 81 (Accessed Feb. 2021).


ELIGIBLE SERVICES/SPECIALTIES

The service must be medically necessary, written in the patient’s treatment plan and, follow generally accepted standards of care. The service provided by the distant provider must be a service covered by DMAP.

SOURCE:  DE Medical Assistance Program.  Practitioner Provider Specific Manual, 2/21/20. Ch. 16 Telemedicine, Sec. 16.5.2, pg. 80-81. (Accessed Feb. 2021).

Interactive audio and video telecommunications can be used for group physical therapy in the Early and Periodic Screening, Diagnostic and Treatment Services through the School Based Health Services program for group physical therapy treatment.

SOURCE: DE School Based Health Services Specific Policy Manual, pg. 53 & 57 (8/20/18). (Accessed Feb. 2021).

Tele-Dentistry

Synchronous real-time tele-dentistry services must be provided in accordance with the recommendations provided by the American Dental Association.  The evaluation is limited to a specific oral health problem or complaint.

SOURCE: DE Medical Assistance Program. Adult Dental Program Services Provider Specific Manual. Nov. 7, 2020.  Sec. 4.2. p. 8 (Accessed Feb. 2021).

Rate Methodologies for the CPT codes under the telemedicine section of the State Plan for Adult Behavioral Health Services are paid at a lower rate and provided in the manual.

SOURCE: DE Medical Assistance Program. Adult Behavioral Health Service Certification and Reimbursement.  Dec. 14, 2016.  Sec. 1.8. p. 14 (Accessed Feb. 2021).


ELIGIBLE PROVIDERS

To receive payment for services delivered through telemedicine technology from DMAP or MCOs, healthcare practitioners must:

  • Act within their scope of practice;
  • Be licensed (in Delaware, or the State in which the provider is located if exempted
  • under Delaware State law to provide telemedicine services without a Delaware (license) for the service for which they bill DMAP;
  • Be enrolled with DMAP/MCOs;
  • Be located within the continental United States;
  • Be credentialed by DMMA-contracted MCOs, when needed;
  • Submit a DMMA Disclosure Form.

SOURCE:  Adult Behavioral Health Service Certification and Reimbursement.  Dec. 14, 2016.  Sec. 1.8. Pg. 11 (Accessed Feb. 2021).

Eligible distant site providers include:

  • Inpatient/outpatient hospitals (including ER)
  • Physicians (or PAs under the physician’s supervision)
  • Certified Nurse Practitioners
  • Nurse Midwives
  • Licensed Psychologists
  • Licensed Clinical Social Workers
  • Licensed Professional Counselors of Mental Health
  • Speech Language Therapists
  • Audiologists
  • Other providers as approved by the DMAP

SOURCE:  DE Medical Assistance Program.  Practitioner Provider Specific Manual, 2/21/20. Ch. 16.2.4.3 Telemedicine, pg. 77-78, & Adult Behavioral Health Service Certification and Reimbursement.  Dec. 14, 2016.  Sec. 1.8. Pg. 12 (Accessed Feb. 2021).


ELIGIBLE SITES

An originating site refers to the facility in which the Medicaid patient is located at the time the telemedicine service is being furnished. An approved originating site may include the DMAP member’s place of residence, day program, or alternate location in which the member is physically present and telemedicine can be effectively utilized.

Medical Facility Sites:

  • Outpatient Hospitals
  • Inpatient Hospitals
  • Federally Qualified Health Centers
  • Rural Health Centers
  • Renal Dialysis Centers
  • Skilled Nursing Facilities
  • Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)
  • Intermediate Care Facilities/Institutions for Mental Diseases (ICF/IMDs)
  • Outpatient Mental Health/Substance Abuse Centers/Clinics
  • Community Mental Health Centers/Clinics
  • Public Health Clinics
  • PACE Centers
  • Assisted Living Facilities
  • School-Based Wellness Centers
  • Patient’s Home (must comply with HIPAA, privacy, secure communications, etc., and does not warrant an originating site fee)
  • Other Sites as approved by the DMAP

 

Medical Professional Sites:

  • Physicians (or Physicians Assistants under the supervision of a physician)
  • Certified Nurse Practitioners
  • Medical and Behavioral Health Therapists

SOURCE:  DE Medical Assistance Program.  Practitioner Provider Specific Manual, 2/21/20. Ch. 16.2.5.4.1 & 16.2.5.4.2 Telemedicine, pg. 78, & 79 & Adult Behavioral Health Service Certification and Reimbursement.  Dec. 14, 2016.  Sec. 1. 8. pg. 11 & 12 (Accessed Feb. 2021).


GEOGRAPHIC LIMITS

There are no geographical limitations within Delaware regarding the location of an originating site provider.

SOURCE:  DE Adult Behavioral Health Service Certification and Reimbursement.  Dec. 14, 2016.  Sec. 1.8, p. 12. (Accessed Feb. 2021).


FACILITY/TRANSMISSION FEE

A facility fee is covered for originating sites.

Facility fees for the distant site are not covered.

Only one facility fee is permitted per date, per member.

SOURCE:  DE Medical Assistance Program.  Practitioner Provider Specific Manual, 2/21/20. Ch. 16 Telemedicine, Sec. 16.2 & 16.8.3, pg. 77-82 (Accessed Feb. 2021).

Last updated 02/28/2021

Miscellaneous

The face-to-face encounter for home health services used to evaluate a patient’s condition and recertify services may take place via telehealth.

SOURCE:  DE Medical Assistance Program.  Home Health Provider Specific Manual, 2/21/20. Sec. 5.2.8,  p. 18. (Accessed Feb. 2021).

Provider manual lays out three different models for prescribing:

  1. First Model:  The distant provider consults with the referring healthcare practitioner (if present during the telemedicine session or by other means) about appropriate medications. The referring provider then executes the prescription locally for the patient.
  2. Second Model:  The consulting provider works with a medical professional at the originating site to provide front line care, including writing prescriptions. This method is common at mental health centers. The medical professional must be available on site to write the prescription exactly as described by the consulting healthcare practitioner.
  3. Third Model:  The consulting healthcare practitioner directly prescribes and sends/calls-in the initial prescription or refill to the patient’s pharmacy.

For stimulants, narcotics and refills, hard copy prescriptions can be written and sent via delivery service to the referring site for the consumer to pick up a couple days after the appointment (see manual for more details).

SOURCE:  DE Medical Assistance Program.  Practitioner Provider Specific Manual, 2/21/20. Ch. 16 Telemedicine, Sec. 16.11 p. 83 & Adult Behavioral Health Service Certification and Reimbursement.  Dec. 14, 2016.  Sec. 1.8, p. 13.  (Accessed Feb. 2021). 

Confidentiality, privacy and electronic security standards for telemedicine as well as a contingency plan required of telemedicine sites is listed in the DE Behavioral Health Service Certification and Reimbursement manual.

SOURCE:  DE Medical Assistance Program.  Adult Behavioral Health Service Certification and Reimbursement.  Dec. 14, 2016.  Sec. 1.8. p. 10 (Accessed Feb. 2021).

Last updated 02/28/2021

Out of State Providers

The Distant site provider must be located within the continental US and enrolled in the DE Medicaid program or in a DE Medicaid Managed Care Organization to be reimbursed for services.

SOURCE:  DE Medical Assistance Program.  Practitioner Provider Specific Manual, 2/21/20. Ch. 16.2.4.1 & 16.5.7 Telemedicine pg. 77 & 81. (Accessed Feb. 2021).

Last updated 02/28/2021

Overview

Delaware Medical Assistance Program (DMAP) reimburses for medically necessary telemedicine services delivered via live video for certain providers and for patients at specific sites.  DMAP does not reimburse for store-and-forward and makes no reference to remote patent monitoring.

Last updated 02/28/2021

Remote Patient Monitoring

POLICY

No Reference Found


CONDITIONS

No Reference Found


PROVIDER LIMITATIONS

No Reference Found


OTHER RESTRICTIONS

No Reference Found

Last updated 02/28/2021

Store and Forward

POLICY

Asynchronous or “store-and-forward” applications do not meet the DMAP definition of telemedicine.

SOURCE:  DE Medical Assistance Program.  Practitioner Provider Specific Manual, 2/21/20. Ch. 16.3.4.1 Telemedicine, pg. 80 & Adult Behavioral Health Service Certification and Reimbursement.  Dec. 14, 2016.  Sec. 1.8. p. 10 (Accessed Feb. 2021).


ELIGIBLE SERVICES/SPECIALTIES

No Reference Found


GEOGRAPHIC LIMITS

No Reference Found


TRANSMISSION FEE

No Reference Found

Last updated 02/28/2021

Definitions

Group and Blanket Insurance, & Health Insurance Contracts

Also applies to:  Physicians, Podiatry, Optometry, Chiropractic, Nursing, Occupational Therapy, Mental Health, Psychology, Dietetic and Nutrition Therapy, Pharmacy, and Clinical Social Work

Telehealth means the use of information and communications technologies consisting of telephone, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

SOURCE: Title 18, Sec. 3370; & Title 18, Sec. 3571R; DE Code Title 24, Sec. 1702, Sec. 502, Sec. 701, Sec. 1902, Sec. 2002, Sec. 2101, Sec. 2502, Sec. 3002, Sec. 3502, Sec. 3802 & Sec. 3902. 18 DE Administrative Code 1409. (Accessed Feb. 2021).

“Telemedicine” means a form of telehealth which is the delivery of clinical health-care services by means of real time 2-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support health-care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care by a health-care provider practicing within his or her scope of practice as would be practiced in-person with a patient, and legally allowed to practice in the State,  while such patient is at an originating site and the health-care provider is at a distant site.

SOURCE: 18 DE Administrative Code 1409 (Accessed Feb. 2021).

Board of Dentistry

“Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

SOURCE: DE Code Title 24, Sec. 1101.  (Accessed Feb. 2021).

Telehealth is the use of electronic communications to provide and deliver a host of health-related information and health-care services, including dentistry and dental hygiene-related information and services, over large and small distances. Telehealth encompasses a variety of health care and health promotion activities, including education, advice, reminders, interventions, and monitoring of interventions.

SOURCE: DE Code Title 24, Sec. 1100.  (Accessed Feb. 2021).

Group and Blanket Insurance, & Health Insurance Contracts

Telemedicine means a form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual or other telecommunications or electronic communications, including the application of secure video conferencing or store-and-forward transfer technology to provide or support healthcare delivery which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care by a health care provider practicing within his or her scope of practice as would be practiced in-person with a patient, and legally allowed to practice in the state, while such patient is at an originating site and the health care provider is at a distant site.

SOURCE: Title 18, Sec. 3370; & Title 18, Sec. 3571R. (Accessed Feb. 2021).

Last updated 02/28/2021

Parity

SERVICE PARITY

A payer must reimburse the provider for the diagnosis, consultation, or treatment of the patient on the same basis as in-person services for telemedicine.

SOURCE: Title 18, Sec. 3370; & Title 18, Sec. 3571R. (Accessed Feb. 2021).


PAYMENT PARITY

An insurer, health service corporation, or health maintenance organization shall reimburse the treating provider or the consulting provider for the diagnosis, consultation, or treatment of the insured delivered through telemedicine services on the same basis and at least at the rate that the insurer, health service corporation, or health maintenance organization is responsible for coverage for the provision of the same service through in-person consultation or contact. Payment for telemedicine interactions shall include reasonable compensation to the originating or distant site for the transmission cost incurred during the delivery of health-care services.

SOURCE: Title 18, Sec. 3370; & Title 18, Sec. 3571R.(Accessed Feb. 2021).

Last updated 02/28/2021

Requirements

Private payers must provide coverage for the cost of health care services provided through telemedicine, and telehealth as directed through regulations by the Department.  Insurers must pay for telemedicine services at the same rate as in-person.  Payment for telemedicine must include reasonable compensation to the originating or distant site for the transmission cost.

Private payers may not impose an annual or lifetime dollar maximum on coverage for telemedicine services other than what would apply in the aggregate to all items and services covered under the policy. Additionally, no copayment, coinsurance, or deductible amounts, or any policy year, calendar year, lifetime, or other durational benefit limitation or maximum for benefits or services may be imposed unless equally imposed on all terms and services under the policy.

SOURCE: Title 18, Sec. 3370; & Title 18, Sec. 3571R.(Accessed Feb. 2021).

No insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; health service corporation providing individual or group accident and sickness subscription contracts; or managed care organization or health maintenance organization providing a health care plan for health care services shall impose any limitation on the ability of an insured to seek medical care through the use of telehealth service solely because the health care service is being provided through telehealth. Such prohibited limitations shall include, but not be limited to, preauthorization, medical necessity, homebound requirements.

SOURCE: 18 DE Administrative Code 1409 (Accessed Feb. 2021).

Last updated 02/28/2021

Cross State Licensing

No Reference Found

Last updated 02/28/2021

Definitions

Applies to: Physical Therapy “Telehealth, as set forth in the Board’s rules and regulations, means the use of electronic communications to provide and deliver a host of health-related information and healthcare services, including physical therapy and athletic training related information and services, over large and small distances.  Telehealth encompasses a variety of healthcare and health promotion activities, including education, advice, reminders, interventions, and monitoring of intervention.”

SOURCE: DE Code. Title 24, Sec. 2602 & 24 DE Administrative Code 2600.(Accessed Feb. 2021).

Applies to: Physicians, Podiatry, Optometry, Chiropractic, Dentistry, Nursing, Occupational Therapy, Mental Health, Psychology, Dietetic and Nutrition Therapy, Pharmacy, and Clinical Social Work

“Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

SOURCE: DE Code. Title 24, Sec. 2002. (Accessed: Feb. 2021)

Applies to: Physicians, Podiatry, Optometry, Chiropractic, Dentistry, Nursing, Occupational Therapy, Mental Health, Chemical Dependency Professionals, Psychology, Dietetic and Nutrition Therapy, Clinical Social Work, and Professional Art Therapists

Telemedicine means a form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual or other telecommunications or electronic communications, including the application of secure video conferencing or store-and-forward transfer technology to provide or support healthcare delivery which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care by a licensee practicing within his or her scope of practice as would be practiced in-person with a patient and with other restrictions as defined in regulation.

SOURCE: DE Code Title 24, Sec. 1702, Sec. 502, Sec. 701, Sec. 1101, Sec. 1902, Sec. 2002, Sec. 2101, Sec. 2502, Sec. 3002, Sec. 3060, Sec. 3502, Sec. 3802, & Sec. 3902. (Accessed Feb. 2021)& DE Code Title 24, Chapter 30, Sec. 3002. (Accessed Feb. 2021).

Applies to: Mental Health and Chemical Dependency Professionals

“Telemedicine” means a form of telehealth which is the delivery of clinical health-care services by means of real time 2-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support health-care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care by a licensee practicing within his or her scope of practice as would be practiced in-person with a patient and with other restrictions as defined in regulation.

SOURCE: DE Code Title 24, Chapter 30, Sec. 3002. (Accessed Feb. 2021).

NOTE: DE Professional Boards each have a different definition of telehealth/telepractice/telemedicine.  See Miscellaneous section for references.

Last updated 02/28/2021

Licensure Compacts

Member of enhanced Nurse Licensure (NLC) Compact.

SOURCE: Nurse Licensure Compact. Current NLC States and Status. (Accessed Feb. 2021). & NCBSN. Enhanced Nurse Licensure Compact (eNLC) Interstate Commission Sets Jan. 19, 2018, as Implementation Date for eNLC. (Accessed Feb. 2021).

Member of Physical Therapy Licensure Compact. (Enacted Legislation – Not yet issuing or accepting compact privileges)

SOURCE: PT Compact.  Member States.  (Accessed Feb. 2021). 

Member of Psychology Interjurisdictional Compact.

SOURCE: PSYPACT. PSYPACT Map.  (Accessed Feb. 2021).

Last updated 02/28/2021

Miscellaneous

No Reference Found

Last updated 02/28/2021

Online Prescribing

Pharmacists are prohibited from dispensing prescription drug orders through an Internet pharmacy if the pharmacist knows that the prescription order was issued solely on the basis of an Internet consultation or questionnaire, or medical history form submitted to an Internet pharmacy through an Internet site.

SOURCE: DE Code, Title 16 Sec. 4744(d)(1)(a). (Accessed Feb. 2021)

APRNs and Physicians

Establishing a proper provider-patient relationship includes:

  • Verifying the location of and to the extent possible, the identity of the requesting patient;
  • Disclosing the provider’s identity and credentials;
  • Obtaining consent;
  • Establishing a diagnosis through acceptable medical practices, including a physical exam;
  • Discuss with patient the diagnosis;
  • Ensure availability of distant site provider or coverage of patient for follow up care; and
  • Provide written visit summary to patient.

Without a prior patient-provider relationship, providers are prohibited from issuing prescriptions based on internet questionnaire, internet consult or a telephone consult.

Prescriptions through telemedicine and under a physician-patient relationship may include controlled substances, subject to limitations set by the Board.

SOURCE: Title 24, Sec. 1769D(b) & DE Code Title 24, Sec. 1933(b)(4)(g). (Accessed Feb. 2021).

Physicians

Prior to a diagnosis and treatment, a physician using telemedicine must either provide:

  • An appropriate in-person exam;
  • Have another DE licensed practitioner at the originating site with the patient at the time of diagnosis;
  • Diagnosis must be based using both audio and visual communication; or
  • The service meets standards of establishing a patient-physician relationship included as part of evidenced-based clinical practice guidelines in telemedicine developed by major medical specialty societies.

After a relationship has been established, subsequent treatment of the same patient with the same physician need not satisfy the limitations of this section.

This section shall not limit the practice of radiology or pathology.

SOURCE: Title 24, Sec. 1769D(h)(i)(j). (Accessed Feb. 2021). 

A remote, audio-only examination is not an “appropriate in-person examination”.

No opioid prescribing is permitted via telemedicine with the exception of addiction treatment programs offering medication assisted treatment that have received a Division of Substance Abuse and Mental Health (DSAMH) waiver to use telemedicine through DSAMH’s licensure or renewal process. All other controlled substance prescribing utilizing telemedicine is held to the same standards of care and requisite practice as prescribing for in-person visits.

For formation of the physician-patient relationship using audio and visual communications, the audio and visual communications must be live, real-time communications.

SOURCE: DE Admin Code. Sec. 1700.  Sec. 19. (Accessed Feb. 2021).

Last updated 02/28/2021

Professional Board Standards

Physical Therapists and Athletic Trainers

SOURCE: DE Statute Title 24, Sec. 2602 (Accessed Jan. 2021).

Board of Mental Health and Chemical Dependency Professionals

SOURCE: DE Admin. Code Title 24, Sec. 3002 (Accessed Feb. 2021).

Board of Clinical Social Work Examiners

SOURCE: 24 DAC 3902 & 3920. (Accessed Feb. 2021).

Respiratory Care Practice Advisory Council

SOURCE: 24 DAC 1769D. (Accessed Feb. 2021).

Board of Examiners in Optometry

SOURCE: 24 DAC 2101. (Accessed Feb. 2021).

Board of Occupational Therapy Practice

SOURCE: 24 DAC 2002. (Accessed Feb. 2021).

Board of Dietetics/Nutrition

SOURCE: 24 DAC 3802 (Accessed Feb. 2021).

Board of Dentistry and Dental Hygiene

SOURCE: 24 DAC 1100 (Accessed Feb. 2021).

Pharmacy

SOURCE: 24 DAC 2500 (Accessed Feb. 2021).