Louisiana

Disclaimer

PLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction. This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.

At A Glance
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MEDICAID REIMBURSEMENT

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

PRIVATE PAYER LAW

  • Law Exists: Yes
  • Payment Parity: Yes

PROFESSIONAL REQUIREMENTS

  • Licensure Compacts: ASLP-IC, CC, EMS, IMLC, NLC, PTC
  • Consent Requirements: Yes

FQHCs

  • Originating sites explicitly allowed for Live Video:  No
  • Distant sites explicitly allowed for Live Video:  Yes
  • Store and forward explicitly reimbursed:  No
  • Audio-only explicitly reimbursed:  Yes
  • Allowed to collect PPS rate for telehealth:  Yes

STATE RESOURCES

  1. Medicaid Program: Louisiana Medicaid
  2. Administrator: Louisiana Dept. of Health and Hospitals
  3. Regional Telehealth Resource Center: TexLa Telehealth Resource Center
Disclaimer

PLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction. This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.

Last updated 11/03/2022

Audio Only Delivery

Medicaid: Overall Telehealth/Telemedicine Update

STATUS: Active

Medicaid: Outpatient SUD Treatment

STATUS: Active, until rescinded

Medicaid: Informational Bulletin on Telehealth Facilitation by Licensed Mental Health Practitioners

STATUS: Active, until rescinded

Medicaid: Information Bulletin on Telehealth Facilitation of Mental Health Rehabilitation Services

STATUS: Active, until rescinded

Medicaid: Response to COVID-19

STATUS: Active, until rescinded

Medicaid: Teledentistry

STATUS: Active

Medicaid 1915(c) Waiver: Appendix K – Communities Choices & Adult Day Health Care Waiver Combined

STATUS: Expired January 26, 2021; extended through Addendum

Medicaid 1915(c) Waiver: Appendix K Addendum – Communities Choices & Adult Day Health Care Waiver Combined

STATUS: Active, expires 6 months after the conclusion of the Public Health Emergency (PHE)

Medicaid 1915(c) Waiver: Appendix K – New Opportunities Waiver, Residential Options Waiver, Children’s Choice Waiver, Supports Waiver

STATUS: Expired January 26, 2021; extended through Addendum

Medicaid 1915(c) Waiver: Appendix K Extension – New Opportunities Waiver, Residential Options Waiver, Children’s Choice Waiver, Supports Waiver

STATUS: Active, expires 6 months after the conclusion of the Public Health Emergency (PHE)

Last updated 11/03/2022

Cross State Licensing

Previous COVID-19 waivers expired.

Last updated 11/03/2022

Easing Prescribing Requirements

Medicaid: Overall Telehealth/Telemedicine Update

STATUS: Active

Last updated 11/03/2022

Miscellaneous

Medicaid 1915(c) Waiver: Appendix K – Communities Choices & Adult Day Health Care Waiver Combined

STATUS: Expired January 26, 2021; extended through Addendum

Medicaid 1915(c) Waiver: Appendix K Addendum – Communities Choices & Adult Day Health Care Waiver Combined

STATUS: Active, expires 6 months after the conclusion of the Public Health Emergency (PHE)

Medicaid 1915(c) Waiver: Appendix K – New Opportunities Waiver, Residential Options Waiver, Children’s Choice Waiver, Supports Waiver

STATUS: Expired January 26, 2021; extended through Addendum

Medicaid 1915(c) Waiver: Appendix K Extension – New Opportunities Waiver, Residential Options Waiver, Children’s Choice Waiver, Supports Waiver

STATUS: Active, expires 6 months after the conclusion of the Public Health Emergency (PHE)

SB 29 Act No. 223: The Commissioner of Insurance Granted Certain Public Health Emergency Powers Related to Telehealth Access

STATUS: Permanent

Last updated 11/03/2022

Originating Site

Medicaid: Overall Telehealth/Telemedicine Update

STATUS: Active

Medicaid: Outpatient SUD Treatment

STATUS: Active, until rescinded

Medicaid: Informational Bulletin on Telehealth Facilitation by Licensed Mental Health Practitioners

STATUS: Active, until rescinded

Medicaid: Response to COVID-19

STATUS: Active, until rescinded

Medicaid: Information Bulletin on Telehealth Facilitation of Mental Health Rehabilitation Services

STATUS: Active, until rescinded

Medicaid: Teledentistry

STATUS: Active.

Medicaid: Home and Community-Based Services Waivers Community Choices Waiver (LAC 50:XXI.Subpart 7)

STATUS: Active during COVID-19 public health emergency (PHE).  Unclear if it’s referring to the federal or state PHE.

Last updated 11/03/2022

Private Payer

Senate Bill 29: Public Health Emergency Powers for Commissioner of Insurance 

STATUS: Permanent, effective August 1, 2021

Last updated 11/03/2022

Provider Type

Medicaid: Overall Telehealth/Telemedicine Update

STATUS: Active

Medicaid: Informational Bulletin on Telehealth Facilitation by Licensed Mental Health Practitioners

STATUS: Active, until rescinded

Medicaid: Information Bulletin on Telehealth Facilitation of Mental Health Rehabilitation Services

STATUS: Active, until rescinded

Medicaid: Response to COVID-19

STATUS: Active, until rescinded

Medicaid 1915(c) Waiver: Appendix K – Communities Choices & Adult Day Health Care Waiver Combined

STATUS: Expired January 26, 2021; extended through Addendum

Medicaid 1915(c) Waiver: Appendix K Addendum – Communities Choices & Adult Day Health Care Waiver Combined

STATUS: Active, expires 6 months after the conclusion of the Public Health Emergency (PHE)

Medicaid: Home and Community-Based Services Waivers Community Choices Waiver (LAC 50:XXI.Subpart 7)

STATUS: Active during COVID-19 public health emergency (PHE).  Unclear if it’s referring to the federal or state PHE.

Medicaid: Behavioral Health Services—Home and Community Based Services Waiver (LAC 50:XXXIII.Subpart 9)

STATUS: Active during COVID-19 public health emergency (PHE).  Unclear if it’s referring to the federal or state PHE.

Last updated 11/03/2022

Service Expansion

Medicaid: Overall Telehealth/Telemedicine Update

STATUS: Active

Medicaid: Outpatient SUD Treatment

STATUS: Active, until rescinded

Medicaid: Teledentistry

STATUS: Active

Medicaid: Response to COVID-19

STATUS: Active, until rescinded

Medicaid: Home and Community Based Services Waiver

STATUS: During COVID-19 public health emergency declaration

Medicaid: Hospice Recipient Eligibility-Waiver of Payment for Other Services

STATUS: During COVID-19 public health emergency declaration

Medicaid: Informational Bulletin on Telehealth Facilitation by Licensed Mental Health Practitioners

STATUS: Active, until rescinded

Medicaid: Information Bulletin on Telehealth Facilitation of Mental Health Rehabilitation Services

STATUS: Active, until rescinded

Medicaid: Home and Community-Based Services Waivers Community Choices Waiver (LAC 50:XXI.Subpart 7)

STATUS: Active during COVID-19 public health emergency (PHE).  Unclear if it’s referring to the federal or state PHE.

Last updated 11/08/2022

Definitions

“Telemedicine” shall have the same meaning as defined in R.S. 37:1262, may be provided as described in R.S. 37:1271(B)(4), and may include audio-only conversations as provided for in R.S. 37:1271(B)(4)(b).

“Telemedicine is the practice of health care delivery, diagnosis, consultation, treatment, and transfer of medical data using interactive telecommunication technology that enables a health care practitioner and a patient at two locations separated by distance to interact via two-way video and audio transmissions simultaneously. Neither a telephone conversation nor an electronic mail message between a health care practitioner and patient, or a true consultation as may be defined by rules promulgated by the board pursuant to the Administrative Procedure Act, constitutes telemedicine.”

“Telehealth” shall have the same meaning as defined in R.S. 40:1223.3 and may include audio-only conversations as provided for in R.S. 40:1223.3(5).

“Telehealth” means healthcare services, including behavioral health services, provided by a healthcare provider, as defined in this Section, to a person through the use of electronic communications, information technology, asynchronous store-and-forward transfer technology, or synchronous interaction between a provider at a distant site and a patient at an originating site, including but not limited to assessment of, diagnosis of, consultation with, treatment of, and remote monitoring of a patient, and transfer of medical data. The term “telehealth” shall not include any of the following:

  • Electronic mail messages and text messages that are not compliant with applicable requirements of the Health Insurance Portability and Accountability Act of 1996, as amended (42 U.S.C. 1320d et seq.).
  • Facsimile transmissions.

SOURCE: LA Revised Statute Sec. 22: 1841; Sec. 37: 1262  and 40:1223.3, (Accessed Nov. 2022).

Last updated 11/08/2022

Parity

SERVICE PARITY

No Reference Found


PAYMENT PARITY

The payment, benefit, or reimbursement to such a licensed physician at the originating facility or terminus shall not be less than seventy-five percent of the reasonable and customary amount of payment, benefit, or reimbursement which that licensed physician receives for an intermediate office visit.

SOURCE: LA Revised Statutes 22:1821(F). (Accessed Nov. 2022).

Physical Therapy

A health coverage plan shall pay for covered physical therapy services provided via telehealth to an insured person. Telehealth coverage and payment shall be equivalent to the coverage and payment for the same service provided in person unless the telehealth provider and the health coverage plan contractually agree to an alternative payment rate for telehealth services.

SOURCE: LA House Bill 304, & LA Revised Statute 22:1845.1, (Accessed Nov. 2022).

Last updated 11/08/2022

Requirements

When the governor declares a state of emergency or a public health emergency, the commissioner may issue emergency rules or regulations that may remove restraints to telehealth and telemedicine, as well as other things. See statute for full details.

SOURCE: LA Revised Statute 22:11(C) (Accessed Nov. 2022).

Health insurance issuers shall waive any coverage limitations restricting telemedicine access to providers included within a plan’s telemedicine network.

Health insurance issuers shall waive any requirement that the patient and provider have a prior relationship in order to have services delivered through telemedicine.

Health insurance issuers shall cover mental health services provided by telemedicine consultation to the same extent the services would be covered if provided through an in-person consultation. This shall not be interpreted to require coverage of telemedicine services that cannot be appropriately provided remotely.

Health insurance issuers shall waive any requirement limiting coverage to provider-to-provider consultations only and shall cover telemedicine consultations between a patient and a provider to the extent the same services would be covered if provided in person.

SOURCE: LA Admin Code, Sec. 37:XIII.1747, (Accessed Nov. 2022).

Each issuer of a health coverage plan shall display in a conspicuous manner on the health coverage plan issuer’s website information regarding how to receive covered telemedicine medical services, telehealth healthcare services, and remote patient monitoring services.

A link clearly identified on the health coverage plan’s issuer’s website to the information shall be sufficient to meet the requirements.

SOURCE: LA Revised Statute Sec. 22: 1842, (Accessed Nov. 2022).

Certain requirements apply in order to receive reimbursement for remote patient monitoring.  See text of statute.

 SOURCE: LA Revised Statute Sec. Sec. 22: 1843. (Accessed Nov. 2022).

Payment, benefit, or reimbursement under such policy or contract shall not be denied to a licensed physician conducting or participating in the transmission at the originating health care facility or terminus who is physically present with the individual who is the subject of such electronic imaging transmission and is contemporaneously communicating and interacting with a licensed physician at the receiving terminus of the transmission.   The payment, benefit, or reimbursement to such a licensed physician at the originating facility or terminus shall not be less than seventy-five percent of the reasonable and customary amount of payment, benefit, or reimbursement which that licensed physician receives for an intermediate office visit.

No reference found for distant-site physician reimbursement.

SOURCE: LA Revised Statutes 22:1821(F). (Accessed Nov. 2022).

Physical Therapy

A health coverage plan shall pay for covered physical therapy services provided via telehealth to an insured person.

A health coverage plan shall require a healthcare professional to be licensed or otherwise authorized to practice physical therapy in this state to be eligible to receive payment for telehealth services.

A health coverage plan shall not do any of the following:

  • Require a previously established in-person relationship or the provider to be physically present with a patient or client, unless the provider determines that it is necessary to perform that service in person.
  • Require prior authorization, medical review, or administrative clearance for telehealth that would not be required if that service were provided in person.
  • Require demonstration that it is necessary to provide services to a patient or client as telehealth.
  • Require a provider to be employed by another provider or agency in order to provide telehealth services that would not be required if that service were provided in person.
  • Restrict or deny coverage based solely on the communication technology or application used to provide the telehealth service; however, a health coverage plan may restrict physical therapy services via telehealth when the services are being provided solely by telephone.
  • Impose specific requirements or limitations on the technologies used to provide telehealth services; however, a health coverage plan may require the provider to demonstrate that the technology used to provide telehealth services is both safe and secure.
  • Impose additional certification, location, or training requirements as a condition of payment for telehealth services; however, this Paragraph does not prohibit a health coverage plan from providing additional reimbursement incentives  to providers with an enhanced certification, training, or accreditation.
  • Require a provider to be part of a telehealth network.

A health coverage plan is not required to provide coverage or reimbursement for any of the following procedures or services provided via telehealth:

  • A modality that is a type of electrical, thermal, or mechanical energy.
  • Manual therapy, massage, dry needling, or other invasive procedures

SOURCE: LA House Bill 304, & LA Revised Statute 22:1845.1, (Accessed Nov. 2022).

Last updated 11/08/2022

Definitions

“Telehealth” means healthcare services, including behavioral health services, provided by a healthcare provider, as defined in this Section, to a person through the use of electronic communications, information technology, asynchronous store-and-forward transfer technology, or synchronous interaction between a provider at a distant site and a patient at an originating site, including but not limited to assessment of, diagnosis of, consultation with, treatment of, and remote monitoring of a patient, and transfer of medical data. The term “telehealth” shall not include any of the following:

  • Electronic mail messages and text messages that are not compliant with applicable requirements of the Health Insurance Portability and Accountability Act of 1996, as amended, 42 U.S.C. 1320d et seq.
  • Facsimile transmissions

SOURCE: LA Revised Statutes 40:1223.3, (Accessed Nov. 2022).

“Telemedicine/telehealth is the use of a telecommunications system to render healthcare services when a physician or other licensed practitioner and a beneficiary are not in the same location. The telecommunications system shall include, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the beneficiary at the originating site and the physician or other licensed practitioner at the distant site. The telecommunications system must be secure, ensure patient confidentiality, and be compliant with the requirements of the Health Insurance Portability and Accountability Act.”

SOURCE: LA Dept. of Health and Hospitals, Professional Svcs. Provider Manual, Chapter Five of the Medicaid Svcs. Manual, Section 5.1, p. 165. (As revised 9/3/20), & MCO Manual (revised 10/7/22), pg. 148-149, (Accessed Nov. 2022).

Telecare is a delivery of care services to recipients in their home by means of telecommunications and/or computerized devices to improve outcomes and quality of life, increase independence and access to health care, and reduce health care costs. Telecare services include:

  • Activity and sensor monitoring;
  • Health status monitoring; and
  • Medication dispensing and monitoring.

SOURCE: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, Section 7.1, p. 25-26 (As revised on Oct. 14 2021). (Accessed Aug. 2022). 

Last updated 11/08/2022

Email, Phone & Fax

Hospices may report some social worker calls as a visit. Hospices may not report any other types of phone calls.

SOURCE: LA Medicaid, Chapter 24: Hospice, Sec. 24.9, Medicaid Svcs. Manual, p. 62, (As issued on Feb. 7, 2022), (Accessed Nov. 2022).

Rural health clinics (RHC) and federally qualified health clinics (FQHC) are required to indicate the appropriate place of service, either 02 (other than home) or 10 (home), based on the beneficiary’s location at the time of and append modifier 95 for the billing of telemedicine/telehealth services. Services delivered via an audio/video system and via an audio-only system are to be coded the same way.

SOURCE: LA Dept. of Health, Informational Bulletin 20-1. (May 20, 2022). (Accessed Nov. 2022). 

Early and Periodic Screening, Diagnostics and Treatment Health Services (EPSDT)

  • All services eligible for telemedicine/telehealth may be delivered via an interactive audio/video telecommunications system;
  • A secure, HIPAA-compliant platform is preferred, if available. However, for the duration of the COVID-19 event, if a HIPAA-compliant system is not immediately available at the time it is needed, providers may use everyday communications technologies such as cellular phones with widely available audio/video communication platforms;
  • Providers should follow guidance from the Office for Civil Rights at the Department of Health and Human Services for software deemed appropriate for use during this event;
  • For the duration of the COVID-19 event, in cases where an interactive audio/video system is not immediately available at the time it is needed, an interactive audio-only system (e.g., telephone) without the requirement of video may be employed, unless noted otherwise;
  • For use of an audio-only system, the same standard of care must be met, and the need and rationale for employing an audio-only system must be documented in the clinical record; and
  • Please note, some telemedicine/telehealth services require delivery through an audio/video system due to the clinical nature of these services. Where applicable, this requirement is noted explicitly.

SOURCE: LA Dept. of Health and Hospitals, EPSDT Health and IDEA Related Services, Ch. 20, Sec. 20.1, (As issued on Sept. 22, 2021), (Accessed Nov. 2022).

Last updated 11/08/2022

Live Video

POLICY

Louisiana Medicaid only reimburses the distant site for services provided via telemedicine. Reimbursement for services provided by telemedicine/telehealth is at the same level as services provided in person.

The beneficiary’s clinical record must include documentation that the service was provided through the use of telemedicine/telehealth. NOTE: The distant site provider must be enrolled as a Louisiana Medicaid provider to receive reimbursement for covered services rendered to Louisiana Medicaid beneficiaries.

Medicaid covered services provided using telemedicine must be identified on claim submissions by appending the modifier “95” to the applicable procedure code and indicating the correct place of service, either POS 02 (other than home) or 10 (home). Both the correct POS and the -95 modifier must be present on the claim to receive reimbursement

SOURCE: LA Dept. of Health and Hospitals, Professional Svcs. Provider Manual, Chapter Five of the Medicaid Svcs. Manual, Section 5.1, p. 165-166 (Sept. 3, 2020). (Accessed Nov. 2022).

Telemedicine/telehealth is the use of an interactive audio and video telecommunications system to permit real time communication between a distant site health care practitioner and the beneficiary. There is no restriction on the originating site (i.e., where the beneficiary is located) and it can include, but is not limited to, a healthcare facility,  school, or the beneficiary’s home.

Medicaid covered services provided via telehealth/telemedicine shall be identified on claim submissions by appending the Health Insurance Portability and Accountability Act (HIPAA) of 1996 compliant place of service (POS) or modifier to the appropriate procedure code, in line with current policy

SOURCE: LA Admin. Code 50: Sec. 501 & 503, p. 34 (Accessed Nov. 2022).

The MCO shall reimburse the distant site provider for services provided via telemedicine/telehealth. Reimbursement for services provided by telemedicine/telehealth is at the same level as services provided in person. The MCO shall require the provider to include in the enrollee’s clinical record documentation that the service was provided through the use of telemedicine/telehealth. The distant site provider must be enrolled as a Louisiana Medicaid provider to receive reimbursement for covered
services rendered to Louisiana Medicaid enrollees.

SOURCE: MCO Manual (revised 10/7/22), pg. 149, (Accessed Nov. 2022).


ELIGIBLE SERVICES/SPECIALTIES

The department shall periodically review policies regarding Medicaid reimbursement for telehealth services to identify variations between permissible reimbursement under that program and reimbursement available to healthcare providers under the Medicare program.

The department may modify its administrative rules, policies, and procedures applicable to Medicaid reimbursement for telehealth services as necessary to provide for a reimbursement system that is comparable to that of the Medicare program for those services.

SOURCE:  LA Statute RS 40:1255.2 (Accessed Nov. 2022). 

When otherwise covered, services located in the Telemedicine appendix of the CPT manual, or its successor, may be reimbursed when provided by telemedicine/telehealth. In addition, other specified services may be reimbursed when provided by telemedicine/telehealth and these services are explicitly noted in this manual.

SOURCE: LA Dept. of Health and Hospitals, Professional Svcs. Provider Manual, Chapter Five of the Medicaid Svcs. Manual, Section 5.1, p. 165. (Sept. 3, 2020). (Accessed Nov. 2022).

In the event that the federal or state government declares an emergency or disaster, the Medicaid Program may temporarily cover services provided through the use of an interactive audio telecommunications system, without the requirement of video, if such action is deemed necessary to ensure sufficient services are available to meet beneficiaries’ needs.

SOURCE: LA Admin Code, Sec. 50:I.505, (Accessed Nov. 2022).

When otherwise covered, the MCO shall cover services located in the Telemedicine appendix of the CPT manual, or its successor, when provided by telemedicine/telehealth. In addition, the MCO shall cover other services provided by telemedicine/telehealth when indicated as covered via telemedicine/telehealth in Medicaid program policy. Physicians and other licensed practitioners must continue to adhere to all existing clinical policy for all services rendered. Providing services through telemedicine/telehealth does not remove or add any medical necessity requirements.

SOURCE: MCO Manual (revised 10/7/22), pg. 149, (Accessed Nov. 2022).

Behavioral Health Services

Assessments, evaluations, individual psychotherapy, family psychotherapy, and medication management services may be reimbursed when provided via telecommunication technology. The LMHP is responsible for acting within the telehealth scope of practice as decided by their licensing board. The provider must bill the procedure code (CPT codes) with modifier “95”, as well as the correct place of service, either POS 02 (other than home) or 10 (home). Reimbursement will be at the same rate as a face-to-face service.

SOURCE: LA Dept. of Health and Hospitals, Behavioral Health Services, Chapter Two of the Medicaid Svcs. Manual, Section 2.3, p. 101-102 (As issued on Feb. 25, 2022). (Accessed Nov. 2022).

Ambulance Providers – Managed Care Organizations

Physician directed treatment-in-place service is the facilitation of a telehealth visit by an ambulance provider.  Each paid treatment-in-place ambulance claim must have a separate and corresponding paid treatment-in-place telehealth claim, and each paid treatment-in-place telehealth claim must have a separate and corresponding paid treatment-in-place ambulance claim or a separate and corresponding paid ambulance transportation claim. The MCO may not reimburse for both an emergency transport to a hospital and an ambulance treatment-in-place service for the same incident.

SOURCE: LA Medicaid Managed Care Organization (MCO) Manual, p. 68 (As revised 10/17/22), (Accessed Nov. 2022).

Early and Periodic Screening, Diagnostics and Treatment Health Services (EPSDT)

Telemedicine/telehealth is not a covered service, but is a service delivery method. Louisiana Medicaid encourages the use of this delivery method, when appropriate, for any and all healthcare services (i.e., not just those related to COVID-19 symptoms). Louisiana Medicaid allows for the telemedicine/telehealth mode of delivery for many common healthcare services.

All services eligible for telemedicine/telehealth may be delivered via an interactive audio/video telecommunications system.

Reimbursement for services delivered through telemedicine/telehealth is at the same level as reimbursement for in-person services.

SOURCE: LA Dept. of Health and Hospitals, EPSDT Health and IDEA Related Services, Ch. 20, Sec. 20.1, (As issued on Sept. 22, 2021), (Accessed Nov. 2022).

The department shall include in its Medicaid policies and procedures all of the following information relating to telehealth:

  • An exhaustive listing of the covered healthcare services which may be furnished through telehealth.
  • Processes by which providers may submit claims for reimbursement for healthcare services furnished through telehealth.
  • The conditions under which a managed care organization may reimburse a provider or facility that is not physically located in this state for healthcare services furnished to an enrollee through telehealth.

ELIGIBLE PROVIDERS

The distant site provider must be enrolled as a Louisiana Medicaid provider to receive reimbursement for covered services.

SOURCE: LA Dept. of Health and Hospitals, Professional Svcs. Provider Manual, Chapter Five of the Medicaid Svcs. Manual, Section 5.1, p. 165 (As issued on Sept. 3, 2020). (Accessed Nov. 2022).

Rural health clinics (RHC) and federally qualified health clinics (FQHC): Reimbursement for these services will be at the all-inclusive prospective payment rate on file for the date of service (DOS).

SOURCE: LA Dept. of Health, Informational Bulletin 20-1. (May 20, 2022). (Accessed Nov. 2022). 

FQHC manual refers to provider manual for billing instructions for telemedicine services.

SOURCE: LA Dept. of Health and Hospitals, Federally Qualified Health Centers Provider Manual, Chapter 22, Sec. 22.4, pg. 33, (As issued on Jun. 30, 2022) & Rural Health Clinic Manual, Chapter 40, Sec. 40.4, pg. 33 (As issued on Jun. 30, 2022). (Accessed Nov. 2022).


ELIGIBLE SITES

Originating site means the location of the Medicaid beneficiary at the time the services are provided. There is no restriction on the originating site and it can include, but is not limited to, a healthcare facility, school, or the beneficiary’s home.

SOURCE: LA Dept. of Health and Hospitals, Professional Svcs. Provider Manual, Chapter Five of the Medicaid Svcs. Manual, Section 5.1, p. 165. (As revised 9/3/20), & MCO Manual (revised 10/7/22), pg. 149, (Accessed Nov. 2022).

The Centers for Medicare and Medicaid Services (CMS) added a new place of service (POS) for telehealth services provided in the patient’s home effective for dates of service on and after January 1, 2022. Providers are required to use the appropriate POS, either 02 (other than home) or 10 (home) with modifier 95 for the billing of telemedicine/telehealth services based on the beneficiary’s location at the time of service.

SOURCE: LA Dept. of Health, Informational Bulletin 19-11. (May 18, 2022). (Accessed Nov. 2022). 

Rural health clinics (RHC) and federally qualified health clinics (FQHC) are required to indicate the appropriate place of service, either 02 (other than home) or 10 (home), based on the beneficiary’s location at the time of and append modifier 95 for the billing of telemedicine/telehealth services. Services delivered via an audio/video system and via an audio-only system are to be coded the same way.

SOURCE: LA Dept. of Health, Informational Bulletin 20-1. (May 20, 2022). (Accessed Nov. 2022). 


GEOGRAPHIC LIMITS

A BHS provider may not provide telehealth services outside of its geographic service area.

SOURCE: LA Admin Code 48:I Sec. 5606, (Accessed Nov. 2022).


FACILITY/TRANSMISSION FEE

Louisiana Medicaid only reimburses the distant site provider.

SOURCE: LA Dept. of Health and Hospitals, Professional Svcs. Provider Manual, Chapter Five of the Medicaid Svcs. Manual, Section 5.1, p. 165 (As issued on Sept. 3, 2020). (Accessed Nov. 2022).

Last updated 10/11/2022

Miscellaneous

The department shall include in its Medicaid policies and procedures all of the following information relating to telehealth:

  1. An exhaustive listing of the covered healthcare services which may be furnished through telehealth.
  2. Processes by which providers may submit claims for reimbursement for healthcare services furnished through telehealth.
  3. The conditions under which a managed care organization may reimburse a provider or facility that is not physically located in this state for healthcare services furnished to an enrollee through telehealth.

SOURCE: LA Statute Sec. 46:460.54. (Accessed Nov. 2022).

The beneficiary’s clinical record must include documentation that the service was provided through the use of telemedicine/telehealth.

SOURCE: LA Dept. of Health and Hospitals, Professional Svcs. Provider Manual, Chapter Five of the Medicaid Svcs. Manual, p. 165, (As issued on Sept. 3, 2020), (Accessed Nov. 2022).

Last updated 11/08/2022

Out of State Providers

No Reference Found

Last updated 11/08/2022

Overview

Live video telemedicine is covered for distant site providers enrolled in Louisiana Medicaid.  There is no reimbursement for the originating site.  Activity and sensor monitoring, health status monitoring and medication dispensing and monitoring are forms of remote patient monitoring that are covered by Louisiana Medicaid.  There is no reference to store-and-forward.

Last updated 11/08/2022

Remote Patient Monitoring

POLICY

Under the Community Choices Waiver, Louisiana Medicaid will reimburse for telecare, including:

  • Activity and Sensor Monitoring,
  • Health status monitoring, and
  • Medication dispensing and monitoring.

Monthly telecare services consist of:

  • Delivering, furnishing, maintaining and repairing/replacing equipment on an ongoing basis. This may be done remotely as long as all routine requests are resolved within three business days;
  • Monitoring of recipient-specific service activities by qualified staff;
  • Training the recipient and/or the recipient’s responsible representative in the use of the equipment;
  • Cleaning and storing equipment;
  • Providing remote teaching and coaching as necessary to the recipient and/or caregiver(s); and
  • Analyzing data, developing and documenting interventions by qualified staff based on information/data reported.

Personal Emergency Response System (PERS) is also reimbursed under Community Choices Waiver, which sends alerts when emergency services are needed by the recipient.

Activity and Sensor Monitoring

This service is a computerized system that monitors the recipient’s in-home movement and activity for health, welfare and safety purposes.  At a minimum the system must:

  • Monitor the home’s points of egress;
  • Detect falls;
  • Detect movement or lack of movement;
  • Detect whether doors are opened or closed; and
  • Provide a push button emergency alert system.

Some systems also monitor the home’s temperature.

Health Status Monitoring

This service collects health-related data to assist the health care provider in assessing the recipient’s health condition and in providing recipient education and consultation. Could be beneficial for patient with chronic conditions for monitoring weight, oxygen saturation measurements and vital signs.

Medication Dispensing and Monitoring

A remote monitoring system that is individually pre-programmed to dispense and monitor the recipient’s compliance with medication therapy.  The provider or caregiver is notified when there are missed doses or non-compliance with medication therapy.

SOURCE: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, Section 7.1, p. 23-25 (as issued on Oct. 14, 2021). (Accessed Nov. 2022).

Standards

Assistive Devices and Medical Supplies Provided by a Durable Medical Equipment (DME) provider that:

  • Is enrolled to provide DME; and
  • Has enrolled in Medicaid as an Assistive Devices and Medical Supplies CCW provider (Provider Type 17);

OR

Provided by a home health agency provider that:

  • Is licensed to provide home health services;
  • Is Medicare certified; and
  • Has enrolled in Medicaid as an OAAS – Community Choices Waiver assistive devices provider (Provider Type 17).

For personal emergency response systems (PERS), these services are provided by a provider that:

  • Is enrolled in Medicaid as a PERS provider; and
  • Has furnished verification (copy of letter from the manufacturer written on the manufacturer’s letterhead stationary) that the provider is an authorized dealer, supplier or manufacturer of a PERS product.

The PERS provider must install and support PERS equipment in compliance with all of the applicable federal, state, parish and local laws and regulations, as well as meet manufacturer’s specifications, response requirements, maintenance records, and recipient education.

SOURCE: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, Section 7.6, p. 74 and 84 (As replaced on July 16, 2021). (Accessed Nov. 2022).


CONDITIONS

Health status monitoring:

May be beneficial to individuals with congestive heart failure, diabetes or pulmonary disease.

Services must be based on a verified need of the beneficiary and the service must have a direct or remedial benefit with specific goals and outcomes.

SOURCE: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, Section 7.1, p. 35 (as replaced on Oct. 14, 2021). (Accessed Nov. 2022).


PROVIDER LIMITATIONS

Telecare providers must meet the following requirements:

  • Be UL listed/certified or have 501(k) clearance;
  • Be web-based;
  • Be compliant with the requirements of the Health Insurance Portability and Accountability Act (HIPAA);
  • Have beneficiary specific reporting capabilities for tracking and trending;
  • Have a professional call center for technical support based in the United States; and
  • Have on-going provision of web-based data collection for each beneficiary, as appropriate. This includes response to beneficiary

SOURCE: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, Section 7.6, p. 84 (As replaced on July 16, 2021). (Accessed Nov. 2022). 


OTHER RESTRICTIONS

Limitations

  • Services must be based on verified need and have a direct or remedial benefit with specific goals and outcomes.
  • Benefit must be determined by an independent assessment on any item that costs over $500 and on all communication devices, mobility devices, and environmental controls.
  • Independent assessments must be performed by individuals who have no fiduciary relationship with the manufacturer, supplier, or vendor of the item.
  • All items must reduce reliance on other Medicaid State Plan or waiver services
  • All items must meet applicable standards of manufacture, design and installation
  • The items must be on the Plan of Care developed by the support coordinator and are subject to approval by OAAS Regional Office or its designee.
  • A beneficiary will not be able to simultaneously receive telecare activity and sensor monitoring services and traditional PERS services.

Where applicable, beneficiaries must use Medicaid state plan services, Medicare, or other available payers first. The beneficiary’s preference for a certain brand or supplier is not grounds for declining another payer in order to access waiver services.

SOURCE: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, Section 7.1, p. 35 & 32 (As replaced on Oct. 14, 2021). (Accessed Nov. 2022).

Last updated 11/08/2022

Store and Forward

POLICY

Louisiana Medicaid will not provide reimbursement for store-and-forward based upon the definition of “telemedicine/telehealth” which describes telemedicine as including “audio and video equipment permitting two-way, real time interactive communication” therefore excluding store-and-forward.

SOURCE: LA Dept. of Health and Hospitals, Professional Svcs. Provider Manual, Chapter Five of the Medicaid Svcs. Manual, Section 5.1, p. 165 (As issued on Sept. 3, 2020). (Accessed Nov. 2022). 


ELIGIBLE SERVICES/SPECIALTIES

No Reference Found


GEOGRAPHIC LIMITS

No Reference Found


TRANSMISSION FEE

No Reference Found

Last updated 11/08/2022

Cross State Licensing

Requirement for Permit/Qualifications. A physician who does not possess a Louisiana medical license shall not engage in the practice of medicine in this state via telemedicine, as defined in Chapter 75 of these rules, unless he or she holds a telemedicine permit issued by the board. A telemedicine permit is a limited license that provides lawful authority to a physician who does not hold a current, unrestricted Louisiana medical license to practice telemedicine with respect to patients located in this state. To be eligible for a telemedicine permit an applicant shall:

  • Possess the qualifications for licensing prescribed by § 311. of these rules;
  • Possess an unrestricted license to practice medicine issued by the medical licensing authority of a state other than Louisiana (whether allopathic or osteopathic);
  • Have completed a board-approved application and satisfied the applicable fee.

The board shall issue a telemedicine license to allow the practice of medicine across state lines to an applicant who holds a full and unrestricted license to practice medicine in another state or territory of the United States.

The board shall establish by rule in accordance with the Administrative Procedure Act the requirements for licensure including not opening an office in Louisiana, not meeting with patients in Louisiana, and not receiving calls in Louisiana from patients. The physician, when examining a patient by telemedicine, shall establish a bona fide physician-patient relationship by:

  • Conducting an appropriate examination of the patient as determined by the board.
  • Establishing a diagnosis through the use of accepted medical practices including but not limited to patient history, mental status, and appropriate diagnostic and laboratory testing.
  • Discussing with the patient any diagnosis as well as the risks and benefits of various treatment options.
  • Ensuring the availability for appropriate follow-up care.
  • Fulfilling any other requirements as deemed appropriate and necessary by the board.

SOURCE: LA Revised Statutes 37:1276.1. (Accessed Nov. 2022).

A physician who practices telemedicine by virtue of a telemedicine permit issued by the board shall not:

  • Open an office in this state;
  • Meet with patients in this state;
  • Receive telephone calls in this state from patients; or
  • Engage in the practice of medicine in this state beyond the limited authority conferred by his or her telemedicine permit.

No physician shall supervise, collaborate or consult with an allied health care provider located in this state via telemedicine unless he or she possesses a full and unrestricted license to practice medicine in this state and satisfies and complies with the prerequisites and requirements specified by all applicable laws and rules.

No physician shall utilize telemedicine to provide care to a patient who is physically located outside of this state, unless the physician possesses lawful authority to do so by the licensing authority of the state in which the patient is located.

SOURCE: LA Admin. Code 46: XLV. 7513. , p. 227 (Accessed Nov. 2022).

LA state agencies and professional boards can regulate the use of telehealth including licensing of out-of-state healthcare providers.  See rule for requirements.

SOURCE: LA Revised Statutes 40:1223.4 (Accessed Nov. 2022).

 A physician may practice in the state with a full license, or hold a telemedicine permit.

SOURCE: LA Admin. Code 46: XLV.7507. p. 226 (Accessed Nov. 2022).

Licensed Professional Counselors

Licensees shall provide services consistent with the jurisdictional licensing laws and rules in both the jurisdiction in which licensee is physically located and where the client is physically located. Licensees providing teletherapy services to clients outside of Louisiana must comply with the regulations in the state in which the client is located at the time of service. The licensee shall contact the licensing board in the state where the client is located and document all relevant regulations regarding teletherapy. A nonresident of Louisiana who wishes to provide teletherapy health services in Louisiana must be licensed by the board. Teletherapy is a specialty area and requires board approval. Licensees who may provide teletherapy must meet the following requirements:

  1. The licensee must be licensed in Louisiana.
  2. The licensee must be licensed in the state where the client is located if licensing is required.
  3. The licensee must complete: a. professional training with a minimum of 3 asynchronous or synchronous clock hours in teletherapy. The training shall meet continuing education standards established by the board.  See rule for list of requirements.

SOUCE: LA Admin. Code 46: LX.505., p. 7 (Accessed Nov. 2022).

Teledentistry

  1. Treatment or diagnosis via teledentistry may be provided to patients in Louisiana only by a dentist who holds a license issued by the Board of Dentistry. The Louisiana licensed dentist need not be in Louisiana while providing the teledentistry
  2. An exception to the requirement that the provider of teledentistry services to a patient in Louisiana hold a Louisiana license is when a Louisiana licensed dentist with an in-person relationship with a patient consults an expert with a valid dental license in another United States jurisdiction for advice regarding the patient’s treatment or diagnosis; in this case the expert consulted need not have a Louisiana license.
  3. The standard of care applicable to a provider of teledentistry services, including obtaining informed consent and record documentation, is no different from the standard of care required in traditional dentistry.

SOURCE: Department of Health Board of Dentistry amendment to LAC 46:XXXIII.203 p. 12 (Accessed Nov. 2022)

Requirements listed under Title 37, Chapter 15, Part 1 do not apply  to a consultation without limitation between a practicing physician licensed in this state and a practicing physician licensed in another state or jurisdiction.

SOURCE: LA Revised Statute 37:1291 (Accessed Aug. 2022).

Speech-Language Pathology and Audiology

The use of telehealth in the delivery of speech-language pathology or audiology services, regardless of where the services are rendered or delivered, constitutes the practice of speech-language pathology or audiology and shall require Louisiana licensure for in-state practitioners and telehealth registration for out-of-state practitioners.

SOURCE: LA Revised Statute Title 37, Sec. 2660.1, (Accessed Nov. 2022).

Board of Optometry

The practice of optometry is deemed to occur both where the patient is located and where the optometrist providing professional services is located and is hereby declared to affect the public health, safety and welfare, and is subject to regulation and control in the public interest. It is further declared to be a matter of public interest and concern that the practice of optometry, as defined in this chapter, rendered to a person located in Louisiana or by an optometrist located in Louisiana be limited to qualified persons licensed to practice optometry in the state of Louisiana and registered as a telemedicine provider with the board.

An optometric telemedicine provider must hold an active Louisiana optometric license in good standing. Any optometric telemedicine license shall be renewed on an annual basis provided the licensee is in good standing and shall have the same renewal due dates as the basic optometric license.

SOURCE: LA Admin Code LAC 46:LI.509, (Accessed Nov. 2022).

Last updated 11/08/2022

Definitions

“Telemedicine is the practice of health care delivery, diagnosis, consultation, treatment, and transfer of medical data by a physician using technology that enables the physician and a patient at two locations separated by distance to interact. Such technology may include electronic communications, information technology, asynchronous store-and-forward transfer technology, or technology that facilitates synchronous interaction between a physician at a distant site and a patient at an originating site. The term “telemedicine” shall not include any of the following:

  • Electronic mail messages
  • Text messages
  • Facsimile transmissions

SOURCE: LA Revised Statute 37:1262(4) (Accessed Nov. 2022). 

“Telehealth” means healthcare services, including behavioral health services, provided by a healthcare provider, as defined in this Section, to a person through the use of electronic communications, information technology, asynchronous store-and-forward transfer technology, or synchronous interaction between a provider at a distant site and a patient at an originating site, including but not limited to assessment of, diagnosis of, consultation with, treatment of, and remote monitoring of a patient, and transfer of medical data. The term “telehealth” shall not include any of the following:

  • Electronic mail messages and text messages that are not compliant with applicable requirements of the Health Insurance Portability and Accountability Act of 1996, as amended (42 U.S.C. 1320d et seq.).
  • Facsimile transmissions.

SOURCE: LA Revised Statute 40:1223.3 (Accessed Nov. 2022).

Speech-Language Pathology & Audiology

Telehealth is a mode of delivering audiology and speech-language pathology services that utilizes information and communication technologies to enable the diagnosis, consultation, treatment, education care management, and self-management of clients at a distance from the audiologist or speech-language pathologist provider services to be accessed when providers are in a distant site and patients are in the originating site. Telehealth facilitates self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.

SOURCE: LA Admin. Code 46: LXXV.103., p. 3-4 (Accessed Nov. 2021).

Physician’s Use of Telemedicine in Practice

Telemedicine – the practice of health care delivery, diagnosis, consultation, treatment, and transfer of medical data by a physician using interactive telecommunication technology that enables a physician and a patient at two locations separated by distance to interact via two-way video and audio transmissions simultaneously. Neither an electronic mail message between a physician and a patient, or a true consultation constitutes telemedicine for the purposes of this Part. A physician practicing by telemedicine may utilize interactive audio without the requirement of video if, after access and review of the patient’s medical records, the physician determines that he or she is able to meet the same standard of care as if the healthcare services were provided in-person.

SOURCE: LA Admin. Code 46: XLV.7503., p. 225 (Accessed Nov. 2022).

Board of Optometry

Optometric Telemedicine — a health service interaction that is delivered by a licensed optometrist acting within the scope of his or her license between an optometrist in one physical location and a patient located in any different physical location, accomplished via audio-visual link, imaging, telephone, or other appropriate forms of electronic communication and/or technology used to allow or assist the optometrist in providing care to the patient and may require the use of advanced telecommunications technology, otdoa.la.gov/media/japawb11/46v45.pdfher than facsimile technology, including all of the following:

  • Compressed digital interactive video, audio, or data transmission;
  • Clinical data transmission using computer imaging by way of still image capture and store and forward;
  • Another technology that facilitates access to health care services or optometric specialty expertise.

SOURCE: LA Admin Code LAC 46:LI.509, (Accessed Nov. 2022).

 

 

Last updated 11/08/2022

Licensure Compacts

Member of Physical Therapy Compact.

SOURCE:  PT Compact. Compact Map. (Accessed Nov. 2022).

Member of Nurse Licensure Compact.

SOURCE:  Nurse Licensure Compact.  Current NLC States and Status.  NCSBN.  (Accessed Nov. 2022).

Member of Audiology and Speech-Language Pathology Interstate Compact

SOURCE: ASLP, ASLP-IC Map, (Accessed Nov. 2022).

Member of Interstate Medical Licensure Compact

SOURCE: Interstate Medical Licensure Compact. U.S. State Participation in the Compact, (Accessed Nov. 2022).

Member of Emergency Medical Services (EMS) Compact.

SOURCE: Interstate Commission for EMS Personnel Practice, Compact Governance (Accessed Nov. 2022).

Member of Counseling Compact

SOURCE: Counseling Compact, Compact Map, (Accessed Nov. 2022).

* See Compact websites for implementation and license issuing status and other related requirements.

Last updated 11/08/2022

Miscellaneous

Louisiana has specific standards for its telemedicine physicians.

SOURCE: LA Statute Sec. 37:1271 (Accessed Nov. 2022). 

Requires licensing standards be developed by the Department of Health on the delivery of behavioral health services through telehealth.

SOURCE: LA Revised Statute 40:2156 (Accessed Nov. 2022).

Teledentistry

A dental hygienist licensed in Louisiana may perform radiographs, oral prophylaxis, place sealants and place fluoride varnish without a Louisiana licensed dentist being physically present in the clinic if all of the following conditions are met:

A Louisiana licensed dentist is providing direct supervision via teledentistry and reviews exams being done by the hygienist and images of the patient’s oral cavity via the teledentistry connection. Unless restricted by bandwidth considerations, the teledentistry must be contemporaneous (synchronist). If bandwidth prohibits contemporaneous viewing by the dentist, non-contemporaneous (asynchronous) viewing of the patient may be employed, but the dentist must review the exam before the patient is dismissed from the clinic on the day of treatment.

See rule for complete requirements.

SOURCE: Louisiana Admin Code XXXIII, Ch. 7, Sec. 701, (Accessed Nov. 2022).

Venue in any suit filed involving care rendered via telehealth pursuant to the provisions of this Part or telemedicine pursuant to the provisions of R.S. 37:1271(B) shall be proper and instituted before the district court of the judicial district in which the patient resides or in the district court having jurisdiction in the parish where the patient was physically located during the provision of the telehealth or telemedicine service. The patient is considered physically located at the originating site as defined in R.S. 40:1223.3.

SOURCE: LA Statute Sec. 40, Sec. 1223.5, (Accessed Nov. 2022).

Last updated 11/08/2022

Online Prescribing

Physicians utilizing telemedicine shall establish a proper physician-patient relationship by:

  • Verify the identity of the patient.  Appropriate contact and identifying information shall be made part of the medical record;
  • Conduct an appropriate exam. The examination does not require an in-person visit if the technology is sufficient to provide the physician the pertinent clinical information reasonably necessary to practice at an acceptable level of skill and safety;
  • Establish a proper diagnosis through the use of accepted medical practices; e.g., history, mental status, appropriate diagnostic and laboratory testing;
  • Discuss the diagnosis and risks and benefits of various treatment options;
  • ·Ensure the availability of appropriate follow up care;
  • Create and/or maintain a medical record.

SOURCE: LA Admin. Code 46: XLV.7503. p. 249 (Accessed Nov. 2022). 

Telemedicine, including the issuance of any prescription via electronic means, shall be held to the same prevailing and usually accepted standards of medical practice as those in traditional, face-to-face settings.

An online, electronic or written mail message, or a telephonic evaluation by questionnaire or otherwise, does not satisfy the standards of appropriate care.

No physician shall utilize telemedicine:

  1. for the treatment of non-cancer related chronic or intractable pain, as set forth in §§6915-6923 of the board’s rules;
  2. for the treatment of obesity, as set forth in §§6901-6913 of the board’s rules;
  3. to authorize or order the prescription, dispensation or administration of any controlled substance unless;
    1. the physician has had at least one in-person visit with the patient within the past year; provided, however, the requirement for an in-person visit shall not apply to a physician who holds an unrestricted license to practice medicine in LA and who practices telemedicine upon any patient being treated at a healthcare facility that is required to be licensed pursuant to the laws of LA and which holds a current registration with the U.S. Drug Enforcement Administration;
    2. the prescription is issued for a legitimate medical purpose;
    3. the prescription is in conformity with the standard of care applicable to an in-person visit; and
    4. the prescription is permitted by and in conformity with all applicable state and federal laws and regulations.

The Board may grant an exception if the physician submits a written application.

SOURCE: LA Admin. Code 46: XLV.7503,7505 & 7513. p. 251 (Accessed Nov. 2022).

All of the following restrictions and authorizations apply to a physician who holds an unrestricted license to practice medicine from the board and who practices telemedicine upon any patient who is being treated at a healthcare facility that is required to be licensed pursuant to the laws of this state and which holds a current registration with the United States Drug Enforcement Administration:

  • The physician shall use the same standard of care as if the healthcare services were provided in person.
  • The physician shall be authorized to prescribe any controlled dangerous substance without necessity of conducting an appropriate in-person patient history or physical examination of the patient as otherwise would be required by R.S. 37:1271(B)(2).
  • The physician shall not be subject to any regulatory prohibition or restriction on the practice of telemedicine, including prohibitions or restrictions related to prescribing controlled dangerous substances, which are in any manner more restrictive than the prohibitions and restrictions that are otherwise applicable to the entire practice of medicine.

SOURCE: LA Statute Sec. 37:1271.1. (Accessed Nov 2022). 

No physician practicing telemedicine can prescribe a controlled dangerous substance prior to conducting an appropriate in-person patient history or physical examination of the patient as determined by the Board.

SOURCE: LA Revised Statutes 37:1271(B)(3). (Accessed Nov. 2022).

Teledentistry

Controlled substances may not be prescribed via teledentistry except in emergency situations where the dentist determines:

  • That immediate administration of the controlled substance is necessary for proper treatment of the intended ultimate user, and
  • That no appropriate alternate treatment is available, including administration of a drug that is not a controlled substance.

In an emergency situation the prescription for a controlled substance must be limited to the amount adequate to treat the patient during the emergency period.

SOURCE: LA Admin. Code LAC 46:XXXIII.203 (Accessed Nov. 2022)

Board of Optometry

Evaluation, treatment, and consultation recommendations made in an optometric telemedicine setting, including issuing a prescription via electronic means, shall be held to the same standards of appropriate practice as those in traditional in-person clinical settings.

SOURCE: LA Admin Code LAC 46:LI.509, (Accessed Nov. 2022).

Last updated 11/08/2022

Professional Boards Standards

Louisiana Medical Board

SOUCE: LA Admin. Code 46: XLV.75 p. 225 (Accessed Nov. 2022).

Speech Language Pathology and Audiology

SOUCE: LA Admin. Code 46: LXXV.135. p. 18 (Accessed Nov. 2022).

Licensed Professional Counselors

SOUCE: LA Admin. Code 46: LX.505., p. 6-7 (Accessed Nov. 2022).

Physical Therapy Board

SOUCE: LA Admin. Code 46: LIV.319. p. 24-25 (Accessed Nov. 2022).

Registered Dietitians/Nutritionists

SOUCE: LA Admin. Code 46: LXIX.101. p. 4-5 (Accessed Nov. 2022).

Board of Dentistry

SOURCE: LA Admin. Code LAC 46:XXXIII.203 p. 8 (Accessed Nov. 2022)

Board of Optometry

SOURCE: LA Admin Code LAC 46:LI.509, (Accessed Nov. 2022).

Hearing Aid Dealers – The Louisiana Board for Hearing Aid Dealers have the power to promulgate rules for the provision of telehealth services by licensed hearing aid dealers that, at a minimum, comply with the Louisiana Telehealth Access Act, R.S. 40:1223.1 et seq.

SOURCE: LA Revised Statute 37:2457(11) (Accessed Nov. 2022).

Each state agency or professional or occupational licensing board or commission that regulates the practice of a healthcare provider, as defined in this Part, may promulgate, in accordance with the Administrative Procedure Act, any rules necessary to provide for, promote, and regulate the use of telehealth in the delivery of healthcare services within the scope of practice regulated by the licensing entity. However, any rules and regulations shall be consistent with and no more restrictive than the provisions contained in this Section.  See rule for requirements

SOURCE: LA Revised Statute Sec. 40:1223.4, (Accessed Nov. 2022).

Last updated 11/08/2022

Definition of a Visit

Encounter – A face-to-face visit with a physician, physician assistant, nurse practitioner, nurse midwife, visiting nurse, clinical psychologist, clinical social worker, or any other State plan approved ambulatory provider during which an FQHC core or other ambulatory service is rendered. Multiple medical encounters with more than one health care practitioner or with the same health care practitioner, which take place on the same day at a single location, constitute a single visit, except for cases in which the beneficiary, subsequent to the first encounter, suffers illness or injury requiring additional diagnosis or treatment.

SOURCE: LA Dept. of Health and Hospitals, Federally Qualified Health Centers Provider Manual, Chapter 22, Glossary C, pg. 42, (As issued on Mar. 10, 2022) (Accessed Nov. 2022).

Medical (inclusive of DSMT services) encounters are defined as face-to-face visits with a physician, physician assistant, nurse practitioner, certified nurse mid-wife, or visiting nurse during which a FQHC service is rendered. Behavioral health encounters are defined as face-to-face visits with a physician with a psychiatric specialty, nurse practitioner with a psychiatric specialty, clinical nurse specialist with a psychiatric specialty, licensed clinical psychologist, licensed clinical social worker, licensed professional counselor, licensed marriage and family therapist, respectively, during which behavioral health service is rendered. A behavioral health specific service must be rendered in order to bill a behavioral health encounter.

A dental encounter is defined as a face-to-face visit with a dentist where dental services are rendered.

SOURCE: LA Dept. of Health and Hospitals, Federally Qualified Health Centers Provider Manual, Chapter 22, Sec. 22.1, pg. 15, (As replaced on Mar. 10, 2022) (Accessed Nov. 2022).

Last updated 11/08/2022

Eligible Distant Site

Reimbursement for service codes appropriate to telemedicine/telehealth will be at the all-inclusive prospective payment rate on file for the date of service (DOS).

SOURCE: LA Dept. of Health, Informational Bulletin 20-1. (May 20, 2022). (Accessed Nov. 2022).

See: LA Medicaid Live Video Eligible Providers

Last updated 11/08/2022

Eligible Originating Site

LA Medicaid does not have an explicit list of eligible originating sites. They only state that a site should be coded either with POS 02 (places other than the home) or POS 10 (beneficiary’s home).  Note that they do not reimburse an originating site fee.

SOURCE: LA Dept. of Health, Informational Bulletin 20-1. (May 20, 2022). (Accessed Nov. 2022).

See: LA Medicaid Live Video Eligible Sites

Last updated 11/08/2022

Home Eligible

Medicaid allows FQHCs to bill with POS code 10 indicating the patient is at their home.

SOURCE: LA Dept. of Health, Informational Bulletin 20-1. (May 20, 2022). (Accessed Nov. 2022).

Last updated 11/08/2022

Modalities Allowed

Live Video

If a covered service is provided via an interactive audio and video telecommunications system (telemedicine), providers must refer to Chapter 5 of the Professional Services Provider Manual on www.lamedicaid.com for specific billing instructions.

SOURCE: LA Dept. of Health and Hospitals, Federally Qualified Health Centers Provider Manual, Chapter 22, Sec. 22.4, pg. 33, (As replaced on Mar. 10, 2022) (Accessed Nov. 2022).

LA Medicaid reimburses for service codes that are appropriate for telemedicine/telehealth via live video, including for FQHCs.

SOURCE: LA Dept. of Health, Informational Bulletin 20-1. (May 20, 2022). (Accessed Nov. 2022).

See: LA Medicaid Live Video


Store and Forward

Store-and-forward is not included in definition of telemedicine for LA Medicaid.  See: LA Medicaid Store and Forward


Remote Patient Monitoring

LA Medicaid provides reimbursement for ‘telecare’ which includes remote monitoring activities in the Community Choice Waiver program. However, there is no reference to whether or not FQHCs could be reimbursed for RPM.  See: LA Medicaid Remote Patient Monitoring


Audio-Only

Services delivered via an audio/video system and via an audio-only system are to be coded the same way (with the 02 or 10 POS and 95 modifier.

SOURCE: LA Dept. of Health, Informational Bulletin 20-1. (May 20, 2022). (Accessed Nov. 2022). 

See: LA Medicaid Email, Phone and Fax

Last updated 11/08/2022

Patient-Provider Relationship

No reference found.

Last updated 11/08/2022

PPS Rate

Reimbursement for service codes appropriate to telemedicine/telehealth will be at the all-inclusive prospective payment rate on file for the date of service (DOS).

SOURCE: LA Dept. of Health, Informational Bulletin 20-1. (May 20, 2022). (Accessed Nov. 2022). 

Last updated 11/08/2022

Same Day Encounters

Multiple medical and/or behavioral health encounters, however, with more than one health care practitioner or with the same health care practitioner, which take place on the same day at a single location, constitute a single visit, except for cases in which the beneficiary, subsequent to the first encounter, suffers illness or injury requiring additional diagnosis or treatment. When the beneficiary suffers illness or injury requiring additional diagnosis or treatment unrelated to the initial encounter visit an additional medical and/or behavioral health encounter may be billed.

Multiple dental encounters with more than one health care practitioner or with the same health care practitioner, which take place on the same day at a single location, constitute a single visit except for cases in which the beneficiary, subsequent to the first encounter, suffers illness or injury requiring additional diagnosis or treatment.

Only one medical encounter (inclusive DSMT encounters) per day per beneficiary, one behavioral health encounter per day per beneficiary, and one dental encounter per day per beneficiary may be billed except in cases in which the beneficiary, subsequent to the first encounter, suffers illness or injury requiring additional diagnosis or treatment. Services shall not be arbitrarily delayed or split in order to bill additional encounters.

SOURCE: LA Dept. of Health and Hospitals, Federally Qualified Health Centers Provider Manual, Chapter 22, Sec. 22.1, pg. 15, (As replaced on Mar. 10, 2022) (Accessed Nov. 2022).

An FQHC provider can be reimbursed for only one medical, one behavioral health, and one dental encounter per day. Core service encounters with more than one health professional, and multiple encounters with the same health profession, that take place on the same date of service, at a single location, constitute a single visit, and are limited to one encounter per day except when one of the following conditions exists:

  1. After the first encounter, the beneficiary suffers illness or injury requiring additional diagnosis or treatment; and
  2. The beneficiary has a medical visit or dental visit on the same day. Behavioral health benefits are subject to the requirements outlined in Section 22:1 Covered Services, of this provider manual chapter.

SOURCE: LA Dept. of Health and Hospitals, Federally Qualified Health Centers Provider Manual, Chapter 22, Sec. 22.4, pg. 30-31, (As replaced on Mar. 10, 2022) (Accessed Nov. 2022).