Last updated 11/10/2022
Consent Requirements
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, as defined in RSA 167:4-d, II(c), within the region where the patient resides.
SOURCE: NH Revised Statutes Annotated, 167:4-d, (Accessed Nov. 2022).
Last updated 11/10/2022
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 Nov. 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 Nov. 2022).
Last updated 11/10/2022
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 Nov. 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 Nov. 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 Nov. 2022).
Last updated 11/10/2022
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 Nov. 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 Nov. 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 Nov. 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 Nov. 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 Nov. 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 Nov. 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 Nov. 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 Nov. 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 Nov. 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 Nov. 2022).
Medicaid to Schools Program
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 Nov. 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 Nov. 2022).
Last updated 11/10/2022
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 11/10/2022
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 Nov. 2022).
CONDITIONS
No Reference Found
PROVIDER LIMITATIONS
No Reference Found
OTHER RESTRICTIONS
No Reference Found
Last updated 11/10/2022
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 Nov. 2022).
ELIGIBLE SERVICES/SPECIALTIES
No Reference Found
GEOGRAPHIC LIMITS
No Reference Found
TRANSMISSION FEE
No Reference Found
