New Hampshire

At A Glance
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MEDICAID REIMBURSEMENT

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

PRIVATE PAYER LAW

  • Law Exists: Yes
  • Payment Parity: No

PROFESSIONAL REQUIREMENTS

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

STATE RESOURCES

  1. Medicaid Program: New Hampshire Medicaid
  2. Administrator: Dept. of Health and Human Services
  3. Regional Telehealth Resource Center: Northeast Telehealth Resource Center

Last updated 08/18/2022

Audio-Only Delivery

Medicaid 1915(c) Waiver: Appendix K – In Home Support; Developmental Disabilities; Acquired Brain Disorder; Choices for Independence Waiver for Elderly and Chronically Ill Combined

STATUS: Active, expires no later than 6 months after the expiration of the PHE

Medicaid 1915(c) Waiver: Appendix K Addendum – In Home Support; Developmental Disabilities; Acquired Brain Disorder; Choices for Independence Waiver for Elderly and Chronically Ill Combined

STATUS: Active, expires no later than 6 months after the expiration of the PHE

Last updated 08/18/2022

Cross-State Licensing

No Reference Found

Last updated 08/18/2022

Easing Prescribing Requirements

No Reference Found

Last updated 08/18/2022

Miscellaneous

Medicaid 1915(c) Waiver: Appendix K – In Home Support; Developmental Disabilities; Acquired Brain Disorder; Choices for Independence Waiver for Elderly and Chronically Ill Combined

STATUS: Active, expires no later than 6 months after the expiration of the PHE

Medicaid 1915(c) Waiver: Appendix K Addendum – In Home Support; Developmental Disabilities; Acquired Brain Disorder; Choices for Independence Waiver for Elderly and Chronically Ill Combined

STATUS: Active, expires no later than 6 months after the expiration of the PHE

HB 1623: Permanently extends some policies

STATUS: Enacted

Last updated 08/18/2022

Originating Site

Medicaid 1915(c) Waiver: Appendix K – In Home Support; Developmental Disabilities; Acquired Brain Disorder; Choices for Independence Waiver for Elderly and Chronically Ill Combined

STATUS: Active, expires no later than 6 months after the expiration of the PHE

Medicaid 1915(c) Waiver: Appendix K Addendum – In Home Support; Developmental Disabilities; Acquired Brain Disorder; Choices for Independence Waiver for Elderly and Chronically Ill Combined

STATUS: Active, expires no later than 6 months after the expiration of the PHE

Last updated 08/18/2022

Private Payer

No Reference Found

Last updated 08/18/2022

Provider Type

Medicaid 1915(c) Waiver: Appendix K – In Home Support; Developmental Disabilities; Acquired Brain Disorder; Choices for Independence Waiver for Elderly and Chronically Ill Combined

STATUS: Active, expires no later than 6 months after the expiration of the PHE

Medicaid 1915(c) Waiver: Appendix K Addendum – In Home Support; Developmental Disabilities; Acquired Brain Disorder; Choices for Independence Waiver for Elderly and Chronically Ill Combined

STATUS: Active, expires no later than 6 months after the expiration of the PHE

Last updated 08/18/2022

Service Expansion

No Reference Found

Last updated 08/18/2022

Definitions

“Telemedicine,” as it pertains to the delivery of health care services, means the use of audio, video, or other electronic media for the purpose of diagnosis, consultation, or treatment. Telemedicine does not include the use of facsimile.

SOURCE: NH Revised Statutes Annotated, 415-J:2, (Accessed Aug. 2022).

Last updated 08/18/2022

Parity

SERVICE PARITY

Insurers may not deny coverage for services on the sole basis that the coverage is provided through telemedicine if the health care service would be covered if it were provided through in-person consultation between the covered person and a health care provider.  For the purposes of this chapter, covered services include remote patient monitoring and store and forward.

An insurer shall provide reimbursement for all modes of telehealth, including video and audio, audio-only, or other electronic media provided by medical providers to treat all members for all medically necessary services.

An insurer offering a health plan in this state shall provide coverage and reimbursement for health care services provided through telemedicine on the same basis as the insurer provides coverage and reimbursement for health care services provided in person. An insurer shall not impose on coverage for health care services provided through telemedicine any additional benefit plan limitations to include annual or lifetime dollar maximums on coverage, deductibles, copayments, coinsurance, benefit limitation or maximum benefits that are not equally imposed upon similar services provided in-person. Nothing in this section shall be construed to allow an insurer to reimburse more for a health care service provided through telemedicine than would have been reimbursed if the health care service was provided in person.

If an insurer excludes a health care service from its in-person reimbursable service, then comparable services shall not be reimbursable as a telemedicine service.

SOURCE: NH Revised Statutes Annotated, 415-J:3, (Accessed Aug. 2022).


PAYMENT PARITY

An insurer offering a health plan in this state shall provide coverage and reimbursement for health care services provided through telemedicine on the same basis as the insurer provides coverage and reimbursement for health care services provided in person.

An insurer shall provide reasonable compensation to an originating site operated by a health care provider or a licensed health care facility if the health care provider or licensed health care facility is authorized to bill the insurer directly for health care services. In the event of a dispute between a provider and an insurance carrier relative to the reasonable compensation under this section, the insurance commissioner shall have exclusive jurisdiction under RSA 420-J:8-e to determine if the compensation is commercially reasonable. The provider and the insurance carrier shall each make best efforts to resolve any dispute prior to applying to the insurance commissioner for resolution, which shall include presenting to the other party evidence supporting its contention that the compensation level it is proposing is commercially reasonable.

The combined amount of reimbursement that a health benefit plan allows for the compensation to the distant site and the originating site shall be the same as the total amount allowed for health care services provided in person.

SOURCE: NH Revised Statutes Annotated, 415-J:3, (Accessed Aug. 2022).

Last updated 08/18/2022

Requirements

An insurer offering a health plan in this state may not deny coverage on the sole basis that the coverage is provided through telemedicine if the health care service would be covered if it were provided through in-person consultation between the covered person and a health care provider.

For the purposes of this chapter, covered services include remote patient monitoring and store and forward.

The following medical providers shall be allowed to perform health care services through the use of all modes of telehealth, including video and audio, audio-only, or other electronic media. Medical providers include, but are not limited to:

  • Physicians and physician assistants, under RSA 329 and RSA 328-D;
  • Advanced practice nurses, under RSA 326-B and registered nurses under RSA 326-B employed by home health care providers under RSA 151:2-b;
  • Midwives, under RSA 326-D;
  • Psychologists, under RSA 329-B;
  • Allied health professionals, under RSA 328-F;
  • Dentists, under RSA 317-A;
  • Mental health practitioners governed by RSA 330-A;
  • Community mental health providers employed by community mental health programs pursuant to RSA 135-C:7;
  • Alcohol and other drug use professionals, governed by RSA 330-C;
  • Dietitians, governed by RSA 326-H; and
  • Professionals certified by the national behavior analyst certification board or persons performing services under the supervision of a person certified by the national behavior analyst certification board as required by RSA 417-E:2.

An insurer shall provide reimbursement for all modes of telehealth, including video and audio, audio-only, or other electronic media provided by medical providers to treat all members for all medically necessary services. If an insurer excludes a health care service from its in-person reimbursable service, then comparable services shall not be reimbursable as a telemedicine service.  There shall be no restriction on eligible originating or distant sites for telehealth services. An originating site means the location of the member at the time the service is being furnished via a telecommunication system. A distant site means the location of the provider at the time the service is being furnished via a telecommunication system.

SOURCE: NH Revised Statutes Annotated, 415-J:3, (Accessed Aug. 2022).

Last updated 08/18/2022

Definitions

“Telehealth services” shall comply with 42 C.F.R. section 410.78, except for 42 C.F.R. section 410.78(b)(4). The use of the term “telemedicine” shall comply with the Centers for Medicare and Medicaid Services requirements governing the aforementioned telehealth services.

SOURCE: NH Revised Statutes 167:4-d (Accessed Aug. 2022).

Telehealth is the use of telecommunications technologies for remote delivery of medical services. Telehealth is used to facilitate live contact directly between an individual/individual’s family and a provider.

SOURCE: NH Department of Health and Human Services, Medicaid to Schools Program Medicaid to Schools Technical Assistance Guide pg. 91, (May 3, 2022), (Accessed Aug. 2022).

Last updated 08/18/2022

Email, Phone & Fax

“Telehealth services” shall comply with 42 C.F.R. section 410.78, except for 42 C.F.R. section 410.78(b)(4).

SOURCE: NH Revised Statutes 167:4-d & 42 CFR Sec. 410.78(a)(3). (Accessed Aug. 2022).

The Medicaid program shall provide reimbursement for all modes of telehealth, including video and audio, audio-only, or other electronic media provided by medical providers to treat all members for all medically necessary services. Eligible medical providers shall be allowed to perform health care services through the use of all modes of telehealth, including video and audio, audio-only, or other electronic media.

SOURCE: NH Revised Statutes Annotated, 167:4-d, (Accessed Aug. 2022).

Effective as of 4/1/2022, FQ modifier identifying the service was furnished using audio-only communication technology has been added to MMIS.

SOURCE: NH Medicaid Provider Bulletin, New Modifiers and Teleheath POS (Mar. 25, 2022), (Accessed Aug. 2022).

Last updated 08/18/2022

Live Video

POLICY

The Medicaid program shall provide coverage and reimbursement for health care services provided through telemedicine on the same basis as the Medicaid program provides coverage and reimbursement for health care services provided in person.

The Medicaid program shall provide reimbursement for all modes of telehealth, including video and audio, audio-only, or other electronic media provided by medical providers to treat all members for all medically necessary services.

NH Medicaid is required by statute to cover Medicaid-covered services provided within the scope of practice of a physician or other health care provider as a method of delivery of medical care. The appropriate application of telehealth services provided by physicians and other health care providers is determined by the department based on the Centers for Medicare and Medicaid Services regulations, and also includes persons providing psychotherapeutic services.

NH Medicaid is not prohibited from providing coverage for only those services that are medically necessary and subject to all other terms and conditions of the coverage.

Telemedicine services for primary care, remote patient monitoring and substance use disorder services are covered only when the patient has established care at an originating site via face-to-face in-person service.  Exceptions include:

  • The provider is a Department of Veteran Affairs (VA) practitioner or VA-contracted practitioner not required to obtain a special registration pursuant to 21 U.S.C. section 831(h);
  • The patient is being treated by, and is physically located in a correctional facility administered by the state of New Hampshire or a New Hampshire county;
  • The patient is being treated by, and is physically located in a doorway as defined in RSA 167:4-d, II(c);
  • The patient is being treated by and is physically located in a state designated community mental health center pursuant to RSA 135; or
  • The patient is being treated by, and physically located in, a hospital or clinic registered in a manner fully consistent with 21 U.S.C. section 823(f)

SOURCE: NH Revised Statutes 167:4-d (Accessed Aug. 2022).


ELIGIBLE SERVICES/SPECIALTIES

“Telehealth services” shall comply with 42 C.F.R. section 410.78, except for 42 C.F.R. section 410.78(b)(4).  This section limits telehealth services to specific CPT/HCPCS codes.

New Hampshire Medicaid is required by statute to provide coverage for Medicaid-covered services provided within the scope of practice of a physician or other health care provider.  It must be an appropriate application of telehealth services, as determined by the department based on CMS regulations and also includes psychotherapeutic services.

Coverage under this section shall include the use of telehealth or telemedicine for Medicaid-covered services provided within the scope of practice of a physician or other health care provider as a method of delivery of medical care:

(1) Which is an appropriate application of telehealth services provided by physicians and other health care providers, as determined by the department based on the Centers for Medicare and Medicaid Services regulations, and also including persons providing psychotherapeutic services as provided in He-M 426.08 and 426.09;

(2) Primary care, remote patient monitoring & substance use disorder shall only be covered in the event that the patient has already established care at an originating site via face-to-face in-person service.  Exceptions include:

  • The provider is a Department of Veteran Affairs (VA) practitioner or VA-contracted practitioner not required to obtain a special registration pursuant to 21 U.S.C. section 831(h);
  • The patient is being treated by, and is physically located in a correctional facility administered by the state of New Hampshire or a New Hampshire county;
  • The patient is being treated by, and is physically located in a doorway as defined in RSA 167:4-d, II(c);
  • The patient is being treated by and is physically located in a state designated community mental health center pursuant to RSA 135; or
  • The patient is being treated by, and physically located in, a hospital or clinic registered in a manner fully consistent with 21 U.S.C. section 823(f); and

(3) By which an individual shall receive medical services from a physician or other health care provider who is an enrolled Medicaid provider without in-person contact with that provider.

The Medicaid program shall provide reimbursement for all modes of telehealth, including video and audio, audio-only, or other electronic media provided by medical providers to treat all members for all medically necessary services.  The combined amount of reimbursement that the Medicaid program allows for the compensation to the distant site and the originating site shall not be less that the total amount allowed for health care services provided in person.

With written consent of the patient receiving medication assisted treatment through telehealth services provided under this section, the health care provider shall provide notification of the patient’s medication assisted treatment to the doorway.

The department shall adopt rules to carry out this section.

SOURCE: NH Revised Statutes 167:4-d (Accessed Aug. 2022).

Medicaid to Schools Program

Medical services delivered via telehealth including those services in a school setting are reimbursable pursuant to RSA 167:4-D. Claims should be submitted with the appropriate procedure code and TM modifier along with modifier GT and place of service (02 for telehealth).

SOURCE: NH Medicaid to Schools Billing Guidelines and Billable Procedure Codes Companion to the Technical Assistance Guide, pg. 2 ( Mar. 1, 2022), ( Accessed Aug. 2022). 

Any direct service that would have previously been rendered and Medicaid covered as face-to-face may now be rendered via telehealth. This includes both medical services as well as behavioral health services. Follow up with students on home activities that normally would have been done face-to-face would be considered direct services. Work that Rehabilitation Assistants are doing remotely in support of students such as sensory exercises, teaching communication skills or other such medically related activities in support of the student’s plan of care would be billable. Notification to NH Medicaid to transition an individual from face- to- face direct treatment to telehealth visits is not required.

NH Medicaid pays the same rate as if the service was provided face-to-face. Billing for the service delivered should identify the CPT codes typically used for in-person visits with the addition of the GT modifier and place of service 02 (telehealth) to the claim form. The use of the GT modifier and the 02 place of service are for all Medicaid to Schools covered procedure codes both medical and behavioral health. Medicaid is not adopting a different set of procedure codes specific to telehealth.

SOURCE: NH Department of Health and Human Services, Medicaid to Schools Program Medicaid to Schools Technical Assistance Guide pgs. 91 & 92, (May 2, 2022), (Accessed Aug. 2022).

The following new modifiers listed below have been added to MMIS:

  • FQ – the service was furnished using audio-only communication technology
  • FR – the supervising practitioner was present through two-way, audio/video communication technology
  • FS – split (or shared) Evaluation and Management service
  • FT- unrelated Evaluation and Management (E/M) visit during a postoperative period, or on the same day as a procedure or another E/M visit

These modifiers are effective 4/1/2022 and are informational only.

SOURCE: NH Medicaid Provider Bulletin, New Modifiers and Telehealth POS (Mar. 25, 2022), (Accessed Aug. 2022).


ELIGIBLE PROVIDERS

“Telehealth services” shall comply with 42 C.F.R. section 410.78, except for 42 C.F.R. section 410.78(b)(4).  This sections limits providers that can be reimbursed for telehealth to the following:

  • Physician
  • Physician assistant
  • Nurse practitioner
  • Clinical nurse specialist
  • Nurse-midwife
  • Clinical psychologist and clinical social worker (may not seek payment for medical evaluation and management services)
  • Registered dietician or nutrition professional
  • Certified registered nurse anesthetist

Medical providers below shall be allowed to perform health care services through the use of all modes of telehealth, including video and audio, audio-only, or other electronic media. Medical providers include, but are not limited to, the following:

  • Physicians and physician assistants, governed by RSA 329 and RSA 328- D;
  • Advanced practice nurses, governed by RSA 326-B and registered nurses under RSA 326-B employed by home health care providers
  • Midwives
  • Psychologists
  • Allied Health Professionals
  • Dentist
  • Mental health practitioners
  • Community mental health providers employed by community mental health programs
  • Alcohol and other drug use professionals
  • Dietitians
  • Professionals certified by the national behavior analyst certification board or persons performing services under the supervision of a person certified by the national behavior analyst certification board.

SOURCE: NH Revised Statutes 167:4-d & 42 CFR Sec. 410.78(b)(2), (Accessed Aug. 2022).

Medicaid to Schools Program

All services provided via telehealth must be within the provider’s professional scope of practice and He-W 589.04. The following provider types are eligible to provide telehealth services:

  • Occupational Therapists (OTs)
  • Physical Therapists (PTs)
  • Speech and Language Pathologists (SLPs)
  • Rehabilitation Assistants
  • Psychologists
  • Board Certified Behavior Analysts (BCBAs)
  • School Physicians
  • Psychiatrists
  • Advanced Registered Nurse Practitioners (APRNs) and Registered Nurses (RNs)
  • Licensed alcohol and drug counselors (LADC) and master licensed alcohol and drug counselors (MLADC) per He-W 513
  • Psychotherapists and Mental Health Practitioners

SOURCE: NH Department of Health and Human Services, Medicaid to Schools Program Medicaid to Schools Technical Assistance Guide pg. 91, (May 3, 2022), (Accessed Aug. 2022).


ELIGIBLE SITES

There shall be no restriction on eligible originating or distant sites for telehealth services. An originating site means the location of the member at the time the service is being furnished via a telecommunication system. A distant site means the location of the provider at the time the service is being furnished via a telecommunication system.

SOURCE: NH Revised Statutes Annotated, 167:4-d, (Accessed Aug. 2022).

“Originating site” means the location of the patient, whether or not accompanied by a health care provider, at the time services are provided by a health care provider through telemedicine, including, but not limited to, a health care provider’s office, a hospital, or a health care facility, or the patient’s home or another nonmedical environment such as a school-based health center, a university-based health center, or the patient’s workplace.

SOURCE: NH Revised Statutes 167:4-d (Accessed Aug. 2022).

Effective as of 4/1/2022 place of service 10, telehealth provided in a patient’s home has been added to MMIS.

SOURCE: NH Medicaid Provider Bulletin, New Modifiers and Telehealth POS (Mar. 25, 2022), (Accessed Aug. 2022).

Medicaid to Schools Program

Medical services delivered via telehealth including those services in a school setting are reimbursable pursuant to RSA 167:4-D. Claims should be submitted with the appropriate procedure code and TM modifier along with modifier GT and place of service (02 for telehealth).

SOURCE: NH Medicaid to Schools Billing Guidelines and Billable Procedure Codes Companion to the Technical Assistance Guide, pg. 2 ( Mar. 1, 2022), ( Accessed Aug. 2022). 


GEOGRAPHIC LIMITS

New Hampshire Medicaid does not follow 42 CFR 410.78(b)(4), listing geographic and site restrictions on originating sites.

SOURCE: NH Revised Statutes 167:4-d (Accessed Aug. 2022).


FACILITY/TRANSMISSION FEE

New Hampshire Medicaid complies with the Centers for Medicare and Medicaid Service requirements for telehealth. Based on the Medicare requirements, originating sites are eligible for a facility fee.

SOURCE: NH Revised Statutes 167:4-d, (Accessed Aug. 2022).

Last updated 08/18/2022

Miscellaneous

No reference found

Last updated 08/18/2022

Out of State Providers

No Reference Found

Last updated 08/18/2022

Overview

New Hampshire Medicaid follows the Center for Medicare and Medicaid Services requirements and Federal regulations for the use of telehealth and telemedicine. Reimbursement is available for live video under some circumstances. New Hampshire statute has a definition for store-and-forward and remote patient monitoring, and states that the Medicaid program shall provide reimbursement for all modes of telehealth, including video and audio, audio-only, or other electronic media provided by medical providers to treat all members for all medically necessary services.  It states that primary care, remote patient monitoring and substance use disorder services shall only be covered in the event that the patient has already established care at an originating site via face-to-face in-person service, with a few exceptions.  Statute does not prohibit the Medicaid program from providing coverage for only those services that are medically necessary and subject to all other terms and conditions of the coverage.

SOURCE: NH Revised Statutes 167:4-d (Accessed Aug. 2022).

Last updated 08/18/2022

Remote Patient Monitoring

POLICY

“Remote patient monitoring” means the use of electronic technology to remotely monitor a patient’s health status through the collection and interpretation of clinical data while the patient remains at an originating site. Remote patient monitoring may or may not take place in real time. Remote patient monitoring shall include assessment, observation, education and virtual visits provided by all covered providers including licensed home health care providers.

Coverage under this section shall include the use of telehealth or telemedicine for Medicaid-covered services provided within the scope of practice of a physician or other health care provider as a method of delivery of medical care:

(1) Which is an appropriate application of telehealth services provided by physicians and other health care providers, as determined by the department based on the Centers for Medicare and Medicaid Services regulations, and also including persons providing psychotherapeutic services as provided in He-M 426.08 and 426.09;

(2) By which telemedicine services for primary care, remote patient monitoring, and substance use disorder services shall only be covered in the event that the patient has already established care at an originating site via face-to-face in-person service. A provider shall not be required to establish care via face-to-face in-person service when:

  • The provider is a Department of Veteran Affairs (VA) practitioner or VA-contracted practitioner not required to obtain a special registration pursuant to 21 U.S.C. section 831(h);
  • The patient is being treated by, and is physically located in a correctional facility administered by the state of New Hampshire or a New Hampshire county;
  • The patient is being treated by, and is physically located in a doorway as defined in RSA 167:4-d, II(c);
  • The patient is being treated by and is physically located in a state designated community mental health center pursuant to RSA 135; or
  • The patient is being treated by, and physically located in, a hospital or clinic registered in a manner fully consistent with 21 U.S.C. section 823(f); and

(3) By which an individual shall receive medical services from a physician or other health care provider who is an enrolled Medicaid provider without in-person contact with that provider.

SOURCE: NH Revised Statutes 167:4-d (Accessed Aug. 2022).


CONDITIONS

No Reference Found


PROVIDER LIMITATIONS

No Reference Found


OTHER RESTRICTIONS

No Reference Found

Last updated 08/18/2022

Store and Forward

POLICY

New Hampshire statute addressing Medicaid has a definition for store-and-forward as it pertains to telemedicine and as an exception to 42 CFR 410.78.

Store-and-forward means the use of asynchronous electronic communications between a patient at an originating site and a health care service provider at a distant site for the purpose of diagnostic and therapeutic assistance in the care of patients. This includes the forwarding and/or transfer of stored medical data from the originating site to the distant site through the use of any electronic device that records data in its own storage and forwards its data to the distant site via telecommunication for the purpose of diagnostic and therapeutic assistance.

The Medicaid program shall provide reimbursement for all modes of telehealth, including video and audio, audio-only, or other electronic media provided by medical providers to treat all members for all medically necessary services.

SOURCE: NH Revised Statutes 167:4-d (Accessed Aug. 2022).


ELIGIBLE SERVICES/SPECIALTIES

No Reference Found


GEOGRAPHIC LIMITS

No Reference Found


TRANSMISSION FEE

No Reference Found

Last updated 08/18/2022

Cross State Licensing

Recently Passed Legislation (Effective August 6, 2022)

Unless otherwise prescribed by statute, an out-of-state healthcare professional providing services by means of telemedicine or telehealth shall be required to be licensed, certified, or registered by the appropriate New Hampshire licensing body if the patient is physically located in New Hampshire at the time of service.. This paragraph shall not apply to out-of-state physicians who provide consultation services.

SOURCE: NH Revised Statutes Annotated Sec. 310-A:1-g, as amended by SB 382 (2022 Session), (Accessed Aug. 2022).

Recently Passed Legislation (Effective August 6, 2022)

Physician and Physician Assistant Licensure Pursuant to Reciprocity Agreement. The office of professional licensure and certification shall seek reciprocity agreements with states that have licensure requirements for physicians and physicians’ assistants that are substantially equivalent to this state, as determined by the board of medicine. The office of professional licensure and certification shall issue licenses to individuals who demonstrate they have a license in good standing from a state that is a party to such agreement, and pay the requisite fee, in accordance with rules adopted by the executive director under RSA 541-A.

SOURCE: NH Revised Statutes Annotated Sec. 310 -A:1-ff as amended by SB 382 (2022 Session), (Accessed Aug. 2022).

An out-of-state physician providing services via telemedicine or teleradiology shall be deemed to be in the practice of medicine and required to be licensed in New Hampshire. This does not apply to physicians who provide consultation services.

SOURCE: NH Revised Statutes Annotated, 329:1-d-II & NH Revised Statutes Annotated, 329:1-b (Accessed Aug. 2022).

To legally qualified physicians in other states or countries when called in consultation by an individual licensed to practice in the state who bears the responsibility for the patient’s diagnosis and treatment. However, regular or frequent consultation by such an unlicensed person, as determined by the licensing board, shall constitute the practice of medicine without a license.

SOURCE: NH Revised Statutes Annotated, 329:21, (Accessed Aug. 2022).

Creates a commission on primary care workforce issues. The commission will collect and review data and information that informs decisions and planning for the primary care workforce and looking for innovative ways for expanding New Hampshire’s primary care resources including, but not limited to, interstate collaboration and the use of telehealth.

Note: Section effective through Nov. 1, 2024

SOURCE: NH Revised Statutes Annotated, Title X Chapter 126-T:3, (Accessed Aug. 2022).

Telepsychology, telehealth, and telemedicine services, as provided by psychologists, include those psychology services that utilize electronic means, including audio, video, or other electronic media, to engage in visual or virtual presence in contemporaneous time. A New Hampshire tele-pass license shall be required for provision of such care to people in New Hampshire. Contacts that are exempt from this requirement are:

  • Persons exempted by 329-B:28.
  • Screenings for inclusion in voluntary research projects that have been properly approved by a New Hampshire based institutional review board.
  • Psychologists licensed by the board, who may provide tele-psychology services to a person within the state of New Hampshire without acquiring a tele-pass psychology license.
  • Persons exempted by RSA 329-D.

The tele-pass psychology licensee shall agree to conditions including, but not limited to, conditions stipulated by the board that the licensee shall:

  • Conform to all New Hampshire statutes and rules.
  • Agree that electronic attendance for appearances shall be deemed adequate for regulatory enforcement purposes and that in-person appearances by the licensee are optional and such associated costs for in-person attendance are the full responsibility of the tele-pass psychology licensee.
  • Understand that false statements or failure to comply with official requests and official orders shall constitute sufficient cause for revocation of the tele-pass psychology license.
  • Understand that all conditions of tele-pass psychology license to practice and enforcement shall be pursuant to New Hampshire law.
  • Grant the New Hampshire board of psychologists and its investigators authority to disclose to law enforcement and related regulatory authorities, at their discretion, information including but not limited to status of application, actions and information pertinent to investigations and enforcement of the laws and rules pertaining to the licensee’s conduct.
  • Not conduct face-to-face in-person psychological services in New Hampshire.

SOURCE: NH Revised Statutes Annotated 329-B:16, (Accessed Aug. 2022).

 

Last updated 08/18/2022

Definitions

Telemedicine means the use of audio, video, or other electronic media for the purpose of diagnosis, consultation, or treatment.

SOURCE: NH Revised Statutes 330-A:15-b, NH Revised Statutes 329-B:16, NH Revised Statutes 327:1,  NH Revised Statutes 327-A:12-a , NH Revised Statutes 326-B:2, NH Revised Statutes 326-D:12-a, NH Revised Statutes Annotated 318:16-e, NH Revised Statutes Annotated, 317-A:7-B, NH Revised Statutes 328-F:11-b,  NH Revised Statutes Annotated, 329:1-d-I, NH Revised Statutes Annotated. 310-A:1-g . NH Revised Statutes 330-C:14-a, NH Revised Statutes 315:6a , NH Revised Statutes 316-A:15-a, (Accessed Aug. 2022).

 

“Telehealth” means the use of audio, video, or other electronic media for the purpose of diagnosis, consultation, or treatment.

SOURCE: NH Revised Statutes Annotated. 310-A:1-g (Accessed Aug. 2022).

Last updated 08/18/2022

Licensure Compacts

Member of the Nurse Licensure Compact.

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

Member of the Physical Therapy Compact.

SOURCE: Compact Map. Physical Therapy Compact. (Accessed Aug. 2022).

Member of the Interstate Medical Licensure Compact.

SOURCE: The IMLC. Interstate Medical Licensure Compact. (Accessed Aug. 2022).

Member of the Psychology Interjurisdictional Compact.

SOURCE: PSYPACT. Legislative Updates. (Accessed Aug. 2022).

Member of Audiology and Speech Language Pathology Compact.

SOURCE: ASLP-IC, Compact States, (Accessed Aug. 2022).

Member of Occupational Therapy Compact.

SOURCE: Occupational Therapy Licensure Compact, Compact Map, (Accessed Aug. 2022).

Member of Counseling Compact.

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

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

Last updated 08/18/2022

Miscellaneous

A Commission was created to study telehealth services and report to the legislature by December 1, 2022.

SOURCE: NH Revised Statutes 329:1-f.  (Accessed Aug. 2022).

Last updated 08/18/2022

Online Prescribing

“Physician-patient relationship” means a medical connection between a licensed physician and a patient that includes an in-person or face-to-face 2-way real-time interactive communication exam, a history, a diagnosis, a treatment plan appropriate for the licensee’s medical specialty, and documentation of all prescription drugs including name and dosage. A licensee may prescribe for a patient whom the licensee does not have a physician-patient relationship under the following circumstances:

  • Writing admission orders for a newly hospitalized patient;
  • For a patient of another licensee for whom the prescriber is taking call;
  • For a patient examined by a physician assistant, nurse practitioner, or other licensed practitioner; or
  • For medication on a short-term basis for a new patient prior to the patient’s first appointment or when providing limited treatment to a family member in accordance with the American Medical Association Code of Medical Ethics.

Prescribing drugs to individuals without a physician-patient relationship shall be unprofessional. The definition of a physician-patient relationship shall not apply to a physician licensed in another state who is consulting to a New Hampshire licensed physician with whom the patient has a relationship.

SOURCE: NH Revised Statutes Annotated, Sec. 329:1-c. (Accessed Aug. 2022).

It is unlawful to prescribe through telemedicine a controlled drug classified in schedule II through IV, except substance use disorder (SUD) treatment as permitted in locations enumerated in paragraph IV. Methadone hydrochloride, as defined in RSA 318-B:10, VII(d)(2) shall not be included in the exemption.

(IV) The prescribing of a non-opioid controlled drug classified in schedule II through IV by means of telemedicine shall be limited to prescribers as defined in RSA 329:1-d, I and RSA 326-B:2, XII(a), who are treating a patient with whom the prescriber has an in-person practitioner-patient relationship, for purposes of monitoring or follow-up care. A provider shall not be required to establish care via face-to-face in-person service when:

  • The provider is a Department of Veteran Affairs (VA) practitioner or VA-contracted practitioner not required to obtain a special registration
  • The patient is being treated by, and is physically located in a correctional facility administered by the state of New Hampshire or a New Hampshire county;
  • The patient is being treated by, and is physically located in a Doorway as defined in RSA 167:4-d, II(c);
  • The patient is being treated by and is physically located in a state designated community mental health center pursuant to RSA 135; or
  • The patient is being treated by, and physically located in, a hospital or clinic registered in a manner fully consistent with 21 U.S.C. section 823(f).

Subsequent in-person exams shall be by a practitioner licensed to prescribe the drug at intervals appropriate for the patient, medical condition, and drug, but not less than annually.

The prescribing of an opioid controlled drug classified in schedule II through IV by means of telemedicine shall be limited to prescribers as defined in RSA 329:1-d, I and RSA 326-B:2, XII(a).

A provider shall not be required to establish care via face-to-face in-person service when:

  • The provider is a Department of Veteran Affairs (VA) practitioner or VA-contracted practitioner not required to obtain a special registration
  • The patient is being treated by, and is physically located in a correctional facility administered by the state of New Hampshire or a New Hampshire county;
  • The patient is being treated by, and is physically located in a Doorway as defined in RSA 167:4-d, II(c);
  • The patient is being treated by and is physically located in a state designated community mental health center pursuant to RSA 135; or
  • The patient is being treated by, and physically located in, a hospital or clinic registered in a manner fully consistent with 21 U.S.C. section 823(f).

Subsequent in-person exams shall be by a practitioner licensed to prescribe the drug at intervals appropriate for the patient, medical condition, and opioid, but not less than annually.

See Statute for specific requirements for physicians providing services via telemedicine, and those issuing a prescription for spectacle lenses, or contact lenses by means of telemedicine.

The prescription authority under this paragraph shall be limited to a practitioner licensed to prescribe the drug and in compliance with all federal laws, including the United States Drug Enforcement Agency registration or waiver when required. An initial face-to-face in person exam shall be required with the exception of the locations enumerated in this paragraph.

SOURCE: NH Revised Statutes Annotated, 329:1-d, (Accessed Aug. 2022).

An individual providing services by means of telemedicine or telehealth directly to a patient shall:

  • Use the same standard of care as used in an in-person encounter;
  • Maintain a medical record; and
  • Subject to the patient’s consent, forward the medical record to the patient’s primary care or treating provider, if appropriate.

SOURCE: NH Revised Statutes Annotated Sec. 310-A:1-g, (Accessed Aug. 2022).

The prescribing of a non-opioid controlled drug classified in schedule II through IV by means of telemedicine shall be limited to prescribers as defined in RSA 329:1-d, I and RSA 326-B:2, XII(a), who are treating a patient with whom the prescriber has an in-person practitioner-patient relationship, for purposes of monitoring or follow-up care. A provider shall not be required to establish care via face-to-face in-person service when:

  • The provider is a Department of Veteran Affairs (VA) practitioner or VA-contracted practitioner not required to obtain a special registration pursuant to 21 U.S.C. section 831(h);
  • The patient is being treated by, and is physically located in a correctional facility administered by the state of New Hampshire or a New Hampshire county;
  • The patient is being treated by, and is physically located in a doorway as defined in RSA 167:4-d, II(c);
  • The patient is being treated by and is physically located in a state designated community mental health center pursuant to RSA 135; or (E) The patient is being treated by, and physically located in, a hospital or clinic registered in a manner fully consistent with 21 U.S.C. section 823(f)

Subsequent in-person exams must be by a practitioner licensed to prescribe the drug at intervals appropriate for the patient, medical condition, and drug, but not less than annually.

The prescribing of an opioid controlled drug classified in schedule II through IV by means of telemedicine shall be limited to prescribers as defined in RSA 329:1-d, I and RSA 326-B:2, XII(a), who are treating a patient with whom the prescriber has an in-person practitioner-patient relationship, for purposes of monitoring or follow-up care.

SOURCE: NH Revised Statutes Annotated 318-B:2(XVI). (Accessed Aug. 2022).

A physician issuing a prescription for spectacle lenses, as defined in RSA 327-A:1, III, or a prescription for contact lenses, as defined in RSA 327-A:1, IV, by means of telemedicine directly to a patient shall:

  • Obtain an updated medical history at the time of prescribing;
  • Make a diagnosis at the time of prescribing;
  • Conform to the standard of care expected of in-person care as appropriate to the patient’s age and presenting condition, including when the standard of care requires the use of diagnostic testing and performance of a physical examination, which may be carried out through the use of peripheral devices appropriate to the patient’s condition;
  • Not determine an ophthalmic prescription solely by use of an online questionnaire; and
  • Upon request, provide patient records in a timely manner in accordance with the provisions of RSA 332-I and all other state and federal laws and regulations.

SOURCE: NH Revised Statutes Annotated, 329:1-d(VI), (Accessed Aug. 2022).

Last updated 08/18/2022

Professional Board Standards

Explicit permission is given to specific professionals to provide services through use of telemedicine.  These professionals include:

  • Podiatrists
  • Chiropractic Examiners
  • Midwifery
  • Optometry
  • Ophthalmic dispensers
  • Naturopathic Medicine
  • Allied Health professionals
  • Acupuncture
  • Psychologists
  • Pharmacists and pharmacies
  • Dentists and dentistry
  • Alcohol and other drug use professional
  • Nurses (APRNs)
  • Mental Health Practice
  • Physicians and Surgeons
  • Medical technicians
  • Medical Imaging and Radiation Therapy

SOURCE: NH Revised Statutes 315:6a , NH Revised Statutes 316-A:15-a, NH Revised Statutes 326-D:12-a, NH Revised Statutes 327:25-c, NH Revised Statutes 327-A:12-a, NH Revised Statutes 328-E:4, NH Revised Statutes 328-F:11-b, NH Revised Statutes 328-G:10, NH Revised Statutes 329-B:16, NH Revised Statutes Annotated 318:16-e , NH Revised Statutes Annotated, 317-A:7-B. NH Revised Statutes 330-C:14-a , NH Revised Statutes 326-B:2NH Revised Statutes 330-A:15-b, NH Revised Statutes 329:1-d, NH Revised Statutes 328-I:16, NH Revised Statutes 328-J:12-a, (Accessed Aug. 2022),

Individuals licensed, certified, or registered pursuant to RSA 137-F; RSA 151-A; RSA 315; RSA 316-A; RSA 317-A; RSA 326-B; RSA 326-D; RSA 326-H; RSA 327; RSA 328-E; RSA 328-F; RSA 328-G; RSA 329-B; RSA 330-A; RSA 330-C; RSA 327-A; RSA 329; RSA 326-B; RSA 318; RSA 328-I; RSA 328-J may provide services through telemedicine or telehealth, provided the services rendered are authorized by scope of practice. Nothing in this provision shall be construed to expand the scope of practice for individuals regulated under this chapter.

An individual providing services by means of telemedicine or telehealth directly to a patient shall:

  • Use the same standard of care as used in an in-person encounter;
  • Maintain a medical record; and
  • Subject to the patient’s consent, forward the medical record to the patient’s primary care or treating provider, if appropriate.

SOURCE: NH Revised Statute 310-A:1-g, (Accessed Aug. 2022).

A board of medical imaging professionals and radiation therapists shall adopt rules relative to standards of care for the practice of telemedicine or telehealth.

SOURCE: NH Revised Statutes Annotated, 328-J:7-XIII. (Accessed Aug. 2022).