Private Payer

Definitions

Each state differs in how they define the term ‘telemedicine’ or ‘telehealth’. In some states both terms are explicitly defined in law and/or policy and regulations. ‘Telehealth’ is sometimes used to reflect a broader definition, while “telemedicine” is used mainly to define the delivery of clinical services.  Additional variations of the term, primarily utilizing the “tele” prefix are also becoming more prevalent.  Sometimes states use one definition that applies to Medicaid, private payers and professional regulation while other times states have separate definitions for each.

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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.

Federal

Last updated 03/18/2024

Medicare Advantage (MA)

The term “additional telehealth benefits” means services—…

Medicare Advantage (MA)

The term “additional telehealth benefits” means services—

  • For which benefits are available under part B, including services for which payment is not made under section 1834(m) due to the conditions for payment under such section; and
  • That are identified for such year as clinically appropriate to furnish using electronic information and telecommunications technology when a physician or practitioner providing the service is not at the same location as the plan enrollee.

The term “additional telehealth benefits” does not include capital and infrastructure costs and investments relating to such benefits.

SOURCE:  Social Security Act, Sec. 1852 (Accessed Mar. 2024).

Additional telehealth benefits means services:

  • For which benefits are available under Medicare Part B but which are not payable under section 1834(m) of the Act; and
  • That have been identified by the MA plan for the applicable year as clinically appropriate to furnish through electronic exchange when the physician or practitioner providing the service is not in the same location as the enrollee.

Electronic exchange means electronic information and telecommunications technology.

SOURCE:  42 CFR Sec. 422.135 (Accessed Mar. 2024).

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Alabama

Last updated 02/26/2024

No Reference Found

No Reference Found

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Alaska

Last updated 02/27/2024

“Telehealth” means the practice of health care delivery, evaluation, diagnosis, …

“Telehealth” means the practice of health care delivery, evaluation, diagnosis, consultation, or treatment, using the transfer of health care data through audio, visual, or data communications, performed over two or more locations between providers who are physically separated from the recipient or from each other or between a provider and a recipient who are physically separated from each other.

SOURCE: AK Statute Sec. 47.05.270(e), (Accessed Feb. 2024).

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Arizona

Last updated 02/09/2024

[Telehealth] means the interactive use of audio, video or other …

[Telehealth] means the interactive use of audio, video or other electronic media, including asynchronous store-and-forward technologies and remote patient monitoring technologies, for the purpose of diagnosis, consultation or treatment.  Includes:

  • The use of an audio-only telephone encounter between a subscriber who has an existing relationship with a health care provider or provider group if both of the following apply:
    • An audio-visual telehealth encounter is not reasonably available due to the subscriber’s functional status, the subscriber’s lack of technology or telecommunications infrastructure limits, as determined by the health care provider.
    • The telehealth encounter is initiated at the request of the subscriber or authorized by the subscriber before the telehealth encounter.
  • The use of an audio-only encounter between the subscriber and a health care provider, regardless of whether there is an existing relationship with the health care provider or provider group, if the telehealth encounter is for a behavioral health or substance use disorder service and both items of subdivision (a) of this paragraph apply.

Does not include the sole use of a fax machine, instant messages, voice mail or email.

SOURCE:  AZ Rev. Statutes. Sec. 20-841.09 & 20-1057.13 & 20-1376.05 & 20-1406.05  (Accessed Feb. 2024).

Under Arizona Administrative Code, Department of Insurance, Health Care Services Organizations Oversight, “telemedicine means diagnostic, consultation, and treatment services that occur in the physical presence of an enrollee on a real-time basis through interactive audio, video, or data communication.”

SOURCE: AZ Admin. Code Sec. R20-6-1902. Pg. 155 (Accessed Feb. 2024).

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Arkansas

Last updated 02/06/2024

Telemedicine means the use of electronic information and communication technology …

Telemedicine means the use of electronic information and communication technology to deliver healthcare services, including without limitation the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient.  Telemedicine includes store-and-forward and remote patient monitoring. For the purposes of this subchapter, “telemedicine” does not include the use of:

  • Audio-only communication, unless the audio-only communication is real-time, interactive, and substantially meets the requirements for a healthcare service that would otherwise be covered by the health benefit plan.
  • As with other medical services covered by a health benefit plan, documentation of the engagement between patient and provider via audio-only communication shall be placed in the medical record addressing the problem, content of conversation, medical decision-making, and plan of care after the contact.
  • The documentation described in subdivision (7)(C)(i)(b) of this section is subject to the same audit and review process required by payers and governmental agencies when requesting documentation of other care delivery such as in-office or face-to-face visits;
  • A facsimile machine;
  • Text messaging; or
  • Email.

SOURCE: AR Code 23-79-1601(7). (Accessed Feb. 2024).

Network Adequacy

“Telemedicine” means the use of electronic information and communication technology to deliver healthcare services, including without limitation the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient, as well as store-and-forward technology and remote patient monitoring.

SOURCE: AR Admin Code, Title 054, 00, Sec. 106, (Accessed Feb. 2024).

Ambulance Services

“Telemedicine” means the use of audio-visual electronic information and communication technology to deliver healthcare services, including without limitation the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient.

“Telemedicine” includes store-and-forward technology and remote patient monitoring.

“Telemedicine” does not include the use of audio-only electronic technology.

SOURCE: AR Code 20-13-108 & 23-79-2701, (Accessed Feb. 2024).

For the purposes of this subchapter, “telemedicine” does not include the use of:

  • Audio-only communication, unless the audio-only communication is real-time, interactive, and substantially meets the requirements for a healthcare service that would otherwise be covered by the health benefit plan.
  • As with other medical services covered by a health benefit plan, documentation of the engagement between patient and provider via audio-only communication shall be placed in the medical record addressing the problem, content of conversation, medical decision-making, and plan of care after the contact.
  • The documentation described in subdivision (7)(C)(i)(b) of this section is subject to the same audit and review process required by payers and governmental agencies when requesting documentation of other care delivery such as in-office or face-to-face visits;
    • A facsimile machine
    • Text messaging; or
    • Email.

SOURCE: AR Code 23-79-2701, (Accessed Feb. 2024).

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California

Last updated 04/02/2024

“Telehealth means the mode of delivering health care services and …

“Telehealth means the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store-and-forward transfers.”

SOURCE: CA Business & Professions Code Sec. 2290.5. (Accessed Apr. 2024).

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Colorado

Last updated 01/29/2024

Telehealth means a mode of delivery of healthcare services through …

Telehealth means a mode of delivery of healthcare services through HIPAA compliant telecommunications systems, including information, electronic, and communication technologies, remote monitoring technologies, and store-and-forward transfers, to facilitate the assessment, diagnosis, consultation, treatment, education, care management, or self-management of a covered person’s health care while the covered person is located at an originating site and the provider is located at a distant site.

SOURCE: CO Revised Statutes 10-16-123(4)(e). (Accessed Jan. 2024).

Workers’ Compensation

Telemedicine means two-way, real time interactive communication between the injured worker and the provider at a distant site. This electronic communication involves, at a minimum, audio and video telecommunications equipment. Telemedicine enables the remote evaluation and diagnosis of injured workers in addition to the ability to detect fluctuations in their medical condition(s) at a remote site in such a way as to confirm or alter the treatment plan, including medications and/or specialized therapy.

SOURCE: CO Permanent Rules, Sec. 7 CCR 1101-3 Rules 1-17. (Accessed Jan. 2024).

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Connecticut

Last updated 04/12/2024

“Telehealth” means the mode of delivering health care or other …

“Telehealth” means the mode of delivering health care or other health services via information and communication technologies to facilitate the diagnosis, consultation and treatment, education, care management and self-management of an insured’s physical, oral and mental health, and includes interaction between the insured at the originating site and the telehealth provider at a distant site, synchronous interactions, asynchronous store and forward transfers or remote patient monitoring, but does not include interaction through (A) facsimile, texting or electronic mail, or (B) audio-only telephone if the policy uses a provider network and the telehealth provider is out-of-network.

SOURCE: HB 5596 (2021 Session)& SB 2 (2022 Session). (Accessed Apr. 2024).

Permanent Statute

“Telehealth” means the mode of delivering health care or other health services via information and communication technologies to facilitate the diagnosis, consultation and treatment, education, care management and self-management of a patient’s physical and mental health, and includes (A) interaction between the patient at the originating site and the telehealth provider at a distant site, and (B) synchronous interactions, asynchronous store-and-forward transfers or remote patient monitoring. Telehealth does not include the use of facsimile, audio-only telephone, texting or electronic mail.

SOURCE: CT General Statute 19a, Sec. 906(a)(11). (Accessed Apr. 2024).

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Delaware

Last updated 04/24/2024

Group and Blanket Insurance, & Health Insurance Contracts

“Telehealth” means …

Group and Blanket Insurance, & Health Insurance Contracts

“Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health-care provider consultation, patient and professional health-related education, public health, health administration, and other services as authorized in Chapter 60 of Title 24.

SOURCE: Title 18, Ch. 33, Sec. 3370(4); Title 18, Ch. 35 Sec. 3571R & DE Administrative Code Title 18: 1409(2). (Accessed Apr. 2024).

“Telemedicine” is a subset of telehealth which is the delivery of clinical health-care services and other services, as authorized in Chapter 60 of Title 24, by means of real time 2-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support health-care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care by a health-care provider legally allowed to practice in the state and practicing within the health-care provider’s scope of practice as would be practiced in-person with a patient, while such patient is at an originating site and the health-care provider is at a distant site.

SOURCE: Title 18, Ch. 33, Sec. 3370; Title 18, Ch. 35 Sec. 3571R, & DE Administrative Code Title 18: 1409(2). (Accessed Apr. 2024).

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District of Columbia

Last updated 03/21/2024

“Telehealth” means the delivery of healthcare services through the use …

“Telehealth” means the delivery of healthcare services through the use of interactive audio, video, or other electronic media used for the purpose of diagnosis, consultation, or treatment; provided, that services delivered through email messages or facsimile transmissions are not included.

SOURCE: DC Code Sec. 31-3861. (Accessed Mar. 2024).

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Florida

Last updated 02/23/2024

“Telehealth” means the use of synchronous or asynchronous telecommunications technology …

“Telehealth” means the use of synchronous or asynchronous telecommunications technology by a telehealth provider to provide health care services, including, but not limited to, assessment, diagnosis, consultation, treatment, and monitoring of a patient; transfer of medical data; patient and professional health-related education; public health services; and health administration. The term does not include e-mail messages or facsimile transmissions.

SOURCE: FL Statute 456.47, (Accessed Feb. 2024).

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Georgia

Last updated 01/31/2024

‘Telehealth’ means the use of information and communications technologies, including, …

‘Telehealth’ means the use of information and communications technologies, including, but not limited to, telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health related education, public health, and health administration.

‘Telemedicine’ means a form of telehealth which is the delivery of clinical health care services by means of real-time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store-and-forward transfer technology to provide or support health care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care by a health care provider practicing within his or her scope of practice as would be practiced in-person with a patient as prescribed by applicable federal and state laws, rules, and regulations, and legally allowed to practice in this state, while such patient is at an originating site and the health care provider is at a distant site.  Such term includes audio-only telephone only when no other means of real-time two-way audio, visual, or other telecommunications or electronic communications are available to the patient due to lack of availability of such real-time two-way audio, visual, or other telecommunications or electronic communications, due to lack of adequate broadband access, or because the use of other means of real-time two-way audio, visual, or other telecommunications or electronic communications is infeasible, impractical, or otherwise not medically advisable, as determined by the health care provider providing telemedicine services to the patient or as determined by another health care provider with an existing relationship with the patient.

SOURCE: Official Code of GA Annotated Sec. 33-24-56.4. (Accessed Jan 2024).

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Hawaii

Last updated 02/13/2024

“Telehealth” means the use of telecommunications services, as defined in …

“Telehealth” means the use of telecommunications services, as defined in section 269‑1, to encompass four modalities:  store-and-forward technologies, remote monitoring, live consultation, and mobile health; and which shall include but not be limited to real-time video conferencing-based communication, secure interactive and non‑interactive web-based communication, and secure asynchronous information exchange, to transmit patient medical information, including diagnostic-quality digital images and laboratory results for medical interpretation and diagnosis, for the purpose of delivering enhanced health care services and information while a patient is at an originating site and the health care provider is at a distant site.  Except as provided through an interactive telecommunication system, standard telephone contacts, facsimile transmissions, or e-mail text, in combination or alone, do not constitute telehealth services.

SOURCE: HI Revised Statutes § 431:10A-116.3(g); 432D-23.5(g); & 432:1-601.5(g). Amended by HB 907 (Will be repealed after December 31, 2025).  (Accessed Feb. 2024).

Applies to network adequacy:  

Telehealth means “health care services provided through telecommunications technology by a health care professional who is at a location other than where the covered person is located.”

SOURCE: HI Revised Statutes § 431:26-101. (Accessed Feb. 2024).

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Idaho

Last updated 02/13/2024

No reference found.

No reference found.

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Illinois

Last updated 02/27/2024

“Telehealth services” has the meaning given to that term in …

“Telehealth services” has the meaning given to that term in Section 5 of the Telehealth Act. As used in this Section, “telehealth services” do not include asynchronous store and forward systems, remote patient monitoring technologies, e-visits, or virtual check-ins.

“Interactive telecommunications system” has the meaning given to that term in Section 5 of the Telehealth Act. As used in this Section, “interactive telecommunications system” does not include virtual check-ins.

SOURCE: IL Insurance Code. Sec. 356z.22.  (Accessed Feb. 2024).

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Indiana

Last updated 03/20/2024

“Telehealth services” means health care services delivered by use of …

“Telehealth services” means health care services delivered by use of technology allowed under IC 25-1-9.5-6, including the following:

  • Medical exams and consultations
  • Behavioral health, including substance abuse evaluations and treatment

SOURCE: IN Code, 27-8-34-5 & 27-13-1-34. (Accessed Mar. 2024)

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Iowa

Last updated 04/22/2024

“Telehealth” means the delivery of health care services through the …

“Telehealth” means the delivery of health care services through the use of real-time interactive audio and video, or other real-time interactive electronic media, regardless of where the health care professional and the covered person are each located. “Telehealth” does not include the delivery of health care services delivered solely through an audio-only telephone, electronic mail message, or facsimile transmission.

SOURCE: IA Code 514C.34(1)(f) (Accessed Apr. 2024).

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Kansas

Last updated 03/04/2024

‘‘Telemedicine,’’ including ‘‘telehealth,’’ means the delivery of healthcare services or …

‘‘Telemedicine,’’ including ‘‘telehealth,’’ means the delivery of healthcare services or consultations while the patient is at an originating site and the healthcare provider is at a distant site. Telemedicine shall be provided by means of real-time two-way interactive audio, visual, or audio-visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support healthcare delivery, that facilitate the assessment, diagnosis, consultation, treatment, education and care management of a patient’s healthcare. ‘‘Telemedicine’’ does not include communication between:

    1. Healthcare providers that consist solely of a telephone voice-only conversation, email or facsimile transmission; or
    2. a physician and a patient that consists solely of an email or facsimile transmission.

SOURCE:  KS Statute Ann. § 40-2,211(5).  (Accessed Mar. 2024).

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Kentucky

Last updated 03/18/2024

“Telehealth” or “digital health” means a mode of delivering healthcare …

“Telehealth” or “digital health” means a mode of delivering healthcare services through the use of telecommunication technologies, including but not limited to synchronous and asynchronous technology, remote patient monitoring technology, and audio-only encounters, by a health care provider to a patient or to another health care provider at a different location. Shall not include:

  • The delivery of health care services through electronic mail, text, chat, or facsimile unless a state agency authorized or required to promulgate administrative regulations relating to telehealth determines that health care services can be delivered via these modalities in ways that enhance recipient health and well-being and meet all clinical and technology guidelines for recipient safety and appropriate delivery of services; or
  • Basic communication between a health care provider and a patient, including but not limited to appointment scheduling, appointment reminders, voicemails, or any other similar communication intended to facilitate the actual provision of healthcare services either in-person or via telehealth; and

Unless waived by the applicable federal authority, shall be delivered over a secure communications connection that complies with the federal Health Insurance Portability and Accountability Act of 1996.

SOURCE: KY Revised Statute, Sec. 304.17A.138 which cites 211.332, (Accessed Mar. 2024).

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Louisiana

Last updated 02/15/2024

“Telehealth” shall have the same meaning as defined in R.S. …

“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).

SOURCE: LA Revised Statute Sec. 22: 1841; as amended by Senate Bill 66 (2023 Session), (Accessed Feb. 2024).

“Telehealth” shall have the same meaning as that term defined in R.S. 40:1223.3.

SOURCE: LA Revised Statute Sec. 37:1262; as amended by Senate Bill 66 (2023 Session), (Accessed Feb. 2024).

“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.

NOTE: Subparagraph (6)(b) eff. until Jan. 1, 2024. See Acts 2023, No. 322.

SOURCE: LA Revised Statute Sec. 40:1223.3; as amended by Senate Bill 66 (2023 Session), (Accessed Feb. 2024).

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Maine

Last updated 02/03/2024

“Telehealth,” as it pertains to the delivery of health care …

“Telehealth,” as it pertains to the delivery of health care services, means the use of information technology and includes synchronous encounters, asynchronous encounters, store and forward transfers and telemonitoring.

“Telemonitoring,” as it pertains to the delivery of health care services, means the use of information technology to remotely monitor an enrollee’s health status via electronic means, allowing the provider to track the enrollee’s health data over time. Telemonitoring may be synchronous or asynchronous.

SOURCE: Maine Revised Statutes Annotated, Title 24-A, Sec. 4316. (Accessed Feb. 2024).

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Maryland

Last updated 02/21/2024

Recently Passed Legislation

Telehealth means, as it relates to the …

Recently Passed Legislation

Telehealth means, as it relates to the delivery of health care services, the use of interactive audio, video, or other telecommunications or electronic technology by a licensed health care provider to deliver a health care service within the scope of practice of the health care provider at a location other than the location of the patient.

“Telehealth” includes from July 1, 2021, to June 30, 2025, both inclusive, an audio–only telephone conversation between a health care provider and a patient that results in the delivery of a billable, covered health care service. “Telehealth” does not include:

  • except as provided in paragraph (2) of this subsection, an audio–only telephone conversation between a health care provider and a patient;
  • an electronic mail message between a health care provider and a patient; or
  • a facsimile transmission between a health care provider and a patient.

SOURCE: MD Insurance Code 15-139, as amended by HB 1148/SB 582/SB 534 (2023 Session). (Accessed Feb. 2024).

Network Adequacy

“Telehealth” has the meaning stated in Insurance Article, §15-139, Annotated Code of Maryland.

SOURCE: Code of Maryland Admin. Regs Sec. 31.10.44.02(B)(32). (Accessed Feb. 2024).

Network Adequacy (Dental)

“Telehealth” means, as it relates to the delivery of dental services, the use of interactive audio, video, or other telecommunications or electronic technology by a provider to deliver a dental service within the scope of practice of the provider at a location other than the location of the patient.

“Telehealth” does not include:

  • An audio-only telephone conversation between a provider and a patient;
  • An electronic mail message between a provider and a patient; or
  • A facsimile transmission between a provider and a patient.

SOURCE: Code of Maryland Admin. Regs Sec. 31.10.45.02(B)(15). (Accessed Feb. 2024).

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Massachusetts

Last updated 04/15/2024

”Telehealth”, the use of synchronous or asynchronous audio, video, electronic …

”Telehealth”, the use of synchronous or asynchronous audio, video, electronic media or other telecommunications technology, including, but not limited to: (i) interactive audio-video technology; (ii) remote patient monitoring devices; (iii) audio-only telephone; and (iv) online adaptive interviews, for the purpose of evaluating, diagnosing, consulting, prescribing, treating or monitoring of a patient’s physical health, oral health, mental health or substance use disorder condition.

SOURCE: Massachusetts General Laws, Part 1, Title XXII, Ch. 175, Sec. 47MM, (Accessed Apr. 2024). 

Section repeated in Civil Service, Retirement and Pensions section applying to active or retired employees of the commonwealth; Non-profit hospital service corporations; medical service corporation; health maintenance organizations; preferred provider arrangement

SOURCE: Massachusetts General Laws Part 1, Title IV, Ch. 32A, Section 30 & Part 1, Title XXII, Ch. 176A, Sec. 38, Ch. 176B, Sec. 25, Ch. 176G Sec. 33, Ch. 176I Sec. 13. (Accessed Apr. 2024).

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Michigan

Last updated 01/19/2024

“Telemedicine means the use of an electronic media to link …

“Telemedicine means the use of an electronic media to link patients with health care professionals in different locations. To be considered telemedicine under this section, the health care professional must be able to examine the patient via a HIPPA compliant, secure interactive audio or video, or both, telecommunications system, or through the use of store and forward online messaging.”

SOURCE: MI Compiled Law Svcs. Sec. 500.3476(2)(b) (Accessed Jan. 2024).

Worker’s Compensation

“Telemedicine” means the use of an electronic media to link patients with health care professionals in different locations. To be considered telemedicine, the health care professional must be able to examine the patient via a real-time, interactive audio and video telecommunications system, and the patient must be able to interact with the off-site health care professional at the time the services are provided. 

Source: Admin Rule Sec. 418.10109, (Accessed Jan. 2024).

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Minnesota

Last updated 02/29/2024

“Telehealth” means the delivery of health care services or consultations …

“Telehealth” means the delivery of health care services or consultations through the use of real time two-way interactive audio and visual communications to provide or support health care delivery and facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient’s health care. Telehealth includes the application of secure video conferencing, store-and-forward technology, and synchronous interactions between a patient located at an originating site and a health care provider located at a distant site. Until July 1, 2025, telehealth also includes audio-only communication between a health care provider and a patient in accordance with subdivision 6, paragraph (b). Telehealth does not include communication between health care providers that consists solely of a telephone conversation, email, or facsimile transmission. Telehealth does not include communication between a health care provider and a patient that consists solely of an email or facsimile transmission. Telehealth does not include telemonitoring services as defined in paragraph (i).

“Telemonitoring services” means the remote monitoring of clinical data related to the enrollee’s vital signs or biometric data by a monitoring device or equipment that transmits the data electronically to a health care provider for analysis. Telemonitoring is intended to collect an enrollee’s health-related data for the purpose of assisting a health care provider in assessing and monitoring the enrollee’s medical condition or status.

SOURCE: MN Statute Sec. 62A.673(h) (Accessed Feb. 2024).

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Mississippi

Last updated 04/05/2024

“Telemedicine” means the delivery of health care services such as …

“Telemedicine” means the delivery of health care services such as diagnosis, consultation, or treatment through the use of HIPAA-compliant telecommunication systems, including information, electronic and communication technologies, remote patient monitoring services and store-and-forward telemedicine services. Telemedicine, other than remote patient monitoring services and store-and-forward telemedicine services, must be “real-time” audio visual capable. The Commissioner of Insurance may adopt rules and regulations addressing when “real-time” audio interactions without visual are allowable, which must be medically appropriate for the corresponding health care services being delivered.

SOURCE: MS Code Sec. 83-9-351. (Accessed Apr. 2024).

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Missouri

Last updated 01/20/2024

“Telehealth” or “telemedicine”, the delivery of health care services by …

“Telehealth” or “telemedicine”, the delivery of health care services by means of information and communication technologies which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care while such patient is at the originating site and the health care provider is at the distant site. Telehealth or telemedicine shall also include the use of asynchronous store-and-forward technology.

SOURCE: MO Revised Statute Title XXIV Business and Professions, Sec. 376.1900, which references Sec. Title XII Public Health and Welfare Sec. 208.670 which references Title XII Sec. 191.1145. (Accessed Jan. 2024).

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Montana

Last updated 02/13/2024

“Telehealth” means the use of audio, video, or other telecommunications …

“Telehealth” means the use of audio, video, or other telecommunications technology or media, including audio-only communication, that is:

  • Used by a health care provider or health care facility to deliver health care services; and
  • delivered over a secure connection that complies with state and federal privacy laws.

The term does not include delivery of health care services by means of facsimile machines or electronic messaging alone. The use of facsimile and electronic message is not precluded if used in conjunction with other audio, video, or telecommunications technology or media.

For physicians providing written certification of a debilitating medical condition pursuant to 50-46-310, the term does not include audio-only communication unless the physician has previously established a physician-patient relationship through an in-person encounter.”

SOURCE: MT Code Annotated Sec. 33-22-138(6)(d), (Accessed Feb. 2024).

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Nebraska

Last updated 04/10/2024

Telehealth means the use of medical information electronically exchanged from …

Telehealth means the use of medical information electronically exchanged from one site to another, whether synchronously or asynchronously, to aid a health care provider in the diagnosis or treatment of a patient.

Telehealth includes (A) services originating from a patient’s home or any other location where such patient is located, (B) asynchronous services involving the acquisition and storage of medical information at one site that is then forwarded to or retrieved by a health care provider at another site for medical evaluation, and (C) telemonitoring.

Telehealth also includes audio-only services for the delivery of individual behavioral health services for an established patient, when appropriate, or crisis management and intervention for an established patient as allowed by federal law; and

Telemonitoring means the remote monitoring of a patient’s vital signs, biometric data, or subjective data by a monitoring device which transmits such data electronically to a health care provider for analysis and storage.

SOURCE: NE Revised Statutes. Sec. 44-312(1), (Accessed Apr. 2024).

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Nevada

Last updated 03/26/2024

“Telehealth” means the delivery of services from a provider of …

“Telehealth” means the delivery of services from a provider of health care to a patient at a different location through a synchronous interaction using information and audio-visual communication technology, not including audio-only technology, facsimile or electronic mail.

SOURCE: NV Revised Statutes Sec. 616C.730.(6)(d), (Accessed Mar. 2024).

“Telehealth” means the delivery of services from a provider of health care to a patient at a different location through the use of information and audio-visual communication technology, not including facsimile or electronic mail. The term includes, without limitation, the delivery of services from a provider of health care to a patient at a different location through the use of:

  • Synchronous interaction or an asynchronous system of storing and forwarding information; and
  • Audio-only interaction, whether synchronous or asynchronous.

SOURCE: NV Revised Statutes Sec. 629.515(c), (Accessed Mar. 2024).

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New Hampshire

Last updated 03/29/2024

“Telemedicine,” as it pertains to the delivery of health care …

“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 Mar. 2024).

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New Jersey

Last updated 02/02/2024

Telemedicine means the delivery of a health care service using …

Telemedicine means the delivery of a health care service using electronic communications, information technology, or other electronic or technological means to bridge the gap between a health care provider who is located at a distant site and a patient who is located at an originating site, either with or without the assistance of an intervening health care provider. Telemedicine does not include the use, in isolation, of electronic mail, instant messaging, phone text, or facsimile transmission.

Telehealth means the use of information and communications technologies, including telephones, remote patient monitoring devices or other electronic means to support clinical health care, provider consultation, patient and professional health related education, public health, health administration and other services.

SOURCE: NJ Statute C.26:2S-29 & C.45:1-61. (Accessed Feb. 2024).

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New Mexico

Last updated 02/26/2024

Telemedicine means the use of telecommunications and information technology to …

Telemedicine means the use of telecommunications and information technology to provide clinical health care from a distance. “Telemedicine” allows health care professionals to evaluate, diagnose and treat patients in remote locations using telecommunications and information technology in real time or asynchronously, including the use of interactive simultaneous audio and video or store-and-forward technology, or remote patient monitoring and telecommunications in order to deliver health care services to a site where the patient is located, along with the use of electronic media and health information. “Telemedicine” allows patients in remote locations to access medical expertise without travel.

SOURCE: NM Statute. 59A-22-49.3(L (6)) (Accessed Feb. 2024).

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New York

Last updated 03/13/2024

Telehealth means the use of electronic information and communications technologies …

Telehealth means the use of electronic information and communications technologies by a health care provider to deliver health services to an insured individual while such individual is located at a site that is different from the site where the health care provider is located.

SOURCE: NY Insurance Law Article 32 Section 3217-h & Article 43 Section 4306-g. (Accessed Mar. 2024).

Telehealth means the use of electronic information and communication technologies, including the telephone, by a health care provider to deliver health care services to an insured while such insured is located at a site that is different from the site where the health care provider is located, pursuant to Insurance Law sections 3217-h and 4306-g.

SOURCE: NY Codes, Rules, & Regs. Title 11, Sec. 52.16 (q)(3). (Accessed Mar. 2024).

Workers’ Compensation

Telehealth shall mean treatment by physicians, podiatrists, psychologists, nurse practitioners, physician assistants, and licensed clinical social workers authorized by the Chair to provide treatment and care under the Workers’ Compensation Law using two-way audio and visual electronic communication, or audio only.

SOURCE: Title 12 NYCRR Section. 325-1.26 as proposed to be added by Notice Of Adoption. (Accessed Mar. 2024).

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North Carolina

Last updated 03/17/2024

No reference found.

No reference found.

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North Dakota

Last updated 02/19/2024

Telehealth:

  • Means the use of interactive audio, video or other

Telehealth:

  • Means the use of interactive audio, video or other telecommunications technology that is used by a health care provider or health care facility at a distant site to deliver health services at an originating site and that is delivered over a secure connection that complies with the requirements of state and federal laws.
  • Includes the use of electronic media for consultation relating to the health care diagnosis or treatment of a patient in real-time or through the use of store-and-forward technology.
  • Does not include the use of electronic mail, facsimile transmissions, or audio-only unless for the purpose of e-visits or a virtual check-in.

SOURCE: ND Century Code Sec. 26.1-36-09.15(1)(g). p. 20 (Accessed Feb. 2024).

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Ohio

Last updated 02/16/2024

“Telehealth services” has the same meaning as in section 4743.09 …

“Telehealth services” has the same meaning as in section 4743.09 of the Revised Code.

SOURCE: OH Revised Code Annotated, 3902.30(A)(5).( Accessed Feb. 2024).

“Telehealth services” means health care services provided through the use of information and communication technology by a health care professional, within the professional’s scope of practice, who is located at a site other than the site where either of the following is located:

  • The patient receiving the services;
  • Another health care professional with whom the provider of the services is consulting regarding the patient.

SOURCE: OH Revised Code Section 4743.09. (Accessed Feb. 2024).

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Oklahoma

Last updated 03/06/2024

“Telemedicine” or “telehealth” means technology-enabled health and care management and …

“Telemedicine” or “telehealth” means technology-enabled health and care management and delivery systems that extend capacity and access, which includes:

  • Synchronous mechanisms, which may include live audiovisual interaction between a patient and a health care professional or real-time provider-to-provider consultation through live interactive audiovisual means,
  • Asynchronous mechanisms, which include store and forward transfers, online exchange of health information between a patient and a health care professional and online exchange of health information between health care professionals, but shall not include the use of automated text messages or automated mobile applications that serve as the sole interaction between a patient and a health care professional,
  • Remote patient monitoring, and
  • Other electronic means that support clinical health care, professional consultation, patient and professional health-related education, public health and health administration.

SOURCE: OK Statute, Title 36, Sec. 6802 (Accessed Mar. 2024).

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Oregon

Last updated 03/30/2024

“Telemedicine” means the mode of delivering health services using information …

“Telemedicine” means the mode of delivering health services using information and telecommunication technologies to provide consultation and education or to facilitate diagnosis, treatment, care management or self-management of a patient’s health care.

“Audio only” means the use of audio telephone technology, permitting real-time communication between a health care provider and a patient for the purpose of diagnosis, consultation or treatment.  “Audio only” does not include:

  • The use of facsimile, electronic mail or text messages.
  • The delivery of health services that are customarily delivered by audio telephone technology and customarily not billed as separate services by a health care provider, such as the sharing of laboratory results.

SOURCE: OR Revised Statutes Ch. 743A.058. (Accessed Mar. 2024).

Treatment of Diabetes

“Telemedical means delivered through a two-way electronic communication, including but not limited to video, audio, Voice over Internet Protocol or transmission of telemetry that allows a health professional to interact with a patient, a parent or guardian of a patient or another health professional on a patient’s behalf, who is at an originating site.”

SOURCE: OR Revised Statutes Sec. 743A.185(1)(c). (Accessed Mar. 2024).

Worker’s Compensation

“Telehealth” means providing healthcare remotely by means of telecommunications technology, including but not limited to telemedicine and telephonic or online digital services.

“Telemedicine” means synchronous medical services provided via a real-time interactive audio and video telecommunications system between a patient at an originating site and a provider at a distant site.

SOURCE: OR Administrative Rules 436-009-0012, (Accessed Mar. 2024).

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Pennsylvania

Last updated 01/22/2024

No Reference Found

No Reference Found

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Puerto Rico

Last updated 03/22/2024

No reference found.

No reference found.

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Rhode Island

Last updated 02/01/2024

“Telemedicine” means the delivery of clinical healthcare services by use …

“Telemedicine” means the delivery of clinical healthcare services by use of real time, two-way synchronous audio, video, telephone-audio-only communications or electronic media or other telecommunications technology including, but not limited to: online adaptive interviews, remote patient monitoring devices, audiovisual communications, including the application of secure video conferencing or store-and-forward technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, counseling and prescribing treatment, and care management of a patient’s health care while such patient is at an originating site and the healthcare provider is at a distant site, consistent with applicable federal laws and regulations. “Telemedicine” does not include an, email message, or facsimile transmission between the provider and patient, or an automated computer program used to diagnose and/or treat ocular or refractive conditions.

SOURCE:  RI General Law, Sec. 27-81-3. (Accessed Feb. 2024).

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South Carolina

Last updated 02/08/2024

No Reference Found

No Reference Found

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South Dakota

Last updated 04/02/2024

“Telehealth,” the delivery of health care services through the use …

“Telehealth,” the delivery of health care services through the use of HIPAA-compliant interactive audio-video. The term does not include the delivery of health care services through audio-only telephone, electronic mail message, text message, mail service, facsimile transmission, or any combination thereof.

SOURCE: SD Codified Laws Sec. 58-17-167. (Accessed Apr. 2024).

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Tennessee

Last updated 01/21/2024

Telehealth means the use of real-time interactive audio, video telecommunications …

Telehealth means the use of real-time interactive audio, video telecommunications or electronic technology, or store-and-forward telemedicine services by a healthcare services provider to deliver healthcare services to a patient within the scope of practice of the healthcare services provider when:

  • Such provider is at a qualified site other than the site where the patient is located; and
  • The patient is at a qualified site at a school clinic staffed by a healthcare services provider and equipped to engage in the telecommunications described in this section or a public elementary or secondary school staffed by a health care services provider and equipped to engage in the telecommunications described in this section; and
  • Does not include:
    • Audio only conversation;
    • An electronic mail message; or
    • Facsimile transmission;

SOURCE: TN Code Annotated, Sec. 56-7-1002, (Accessed Jan. 2024).

“Provider-based telemedicine”: Means the use of Health Insurance Portability and Accountability Act (HIPAA) (42 U.S.C. § 1320d et seq.) compliant real-time, interactive audio, video telecommunications, or electronic technology, or store-and-forward telemedicine services, used over the course of an interactive visit by a healthcare services provider to deliver healthcare services to a patient within the scope of practice of the healthcare services provider when:

  • The healthcare services provider is at a qualified site other than the site where the patient is located and has access to the relevant medical record for that patient;
  • The patient is located at a location the patient deems appropriate to receive the healthcare service that is equipped to engage in the telecommunication described in this section; and
    • The healthcare services provider makes use of HIPAA compliant real-time, interactive audio, video telecommunications or electronic technology, or store-and-forward telemedicine services to deliver healthcare services to a patient within the scope of practice of the healthcare services provider as long as the healthcare services provider, the healthcare services provider’s practice group, or the healthcare system has established a provider-patient relationship by submitting to a health insurance entity evidence of an in-person encounter between the healthcare service provider, the healthcare services provider’s practice group, or the healthcare system and the patient within sixteen (16) months prior to the interactive visit; and
    • The requirement of an in-person encounter between the healthcare services provider, the healthcare services provider’s practice group, or the healthcare system and the patient within sixteen (16) months prior to the interactive visit is tolled for the duration of a state of emergency declared by the governor pursuant to § 58-2-107; provided, that the healthcare services provider or the patient, or both, are located in the geographical area covered by the applicable state of emergency;
    • The requirement of an in-person encounter between the healthcare services provider, the healthcare services provider’s practice group, or the healthcare system and the patient within sixteen (16) months prior to the interactive visit does not apply to a patient who is receiving an initial behavioral health evaluation or assessment.
  • Does not include:
    • An audio-only conversation;
    • An electronic mail message or phone text message;
    • A facsimile transmission;
    • Remote patient monitoring; or
    • Healthcare services provided pursuant to a contractual relationship between a health insurance entity and an entity that facilitates the delivery of provider-based telemedicine as the substantial portion of the entity’s business.

Notwithstanding subdivisions (a)(6)(A) and (B), includes Health Insurance Portability and Accountability Act (HIPAA) (42 U.S.C. § 1320d et seq.) compliant audio-only conversation for the provision of behavioral health services or healthcare services when the means described in subdivision (a)(6)(A) are unavailable.

SOURCE: TN Code Annotated, Sec. 56-7-1003 (Accessed Jan. 2024).

Workers Compensation

“Telehealth” means the distribution of health-related services and information via electronic information and telecommunication technologies.

“Telemedicine” means the use of telehealth by a telehealth provider to provide clinical health care.

SOURCE:  TN Admin Code 0800-02-31.02, (Accessed Jan. 2024).

Telehealth: the definitions, licensing and processes for the purpose of these Rules shall be the same as adopted by the Tennessee Department of Health and Medicare. The maximum reimbursement for services provided via telehealth is the lesser of billed charges or the amounts listed in this fee schedule. Services that are eligible to be provided via telehealth are identified with a star (*) in the rate tables.

SOURCE:  TN Admin Code 0800-02-17.05, (Accessed Aug. 2023).

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Texas

Last updated 01/07/2024

“Telehealth service” means a health service, other than a telemedicine …

“Telehealth service” means a health service, other than a telemedicine medical service, delivered by a health professional licensed, certified, or otherwise entitled to practice in this state and acting within the scope of the health professional’s license, certification, or entitlement to a patient at a different physical location than the health professional using telecommunications or information technology.

“Telemedicine medical service” means a health care service delivered by a physician licensed in this state, or a health professional acting under the delegation and supervision of a physician licensed in this state, and acting within the scope of the physician’s or health professional’s license to a patient at a different physical location than the physician or health professional using telecommunications or information technology.

“Teledentistry dental service” means a health care service delivered by a dentist, or a health professional acting under the delegation and supervision of a dentist, acting within the scope of the dentist’s or health professional’s license or certification to a patient at a different physical location than the dentist or health professional using telecommunications or information technology.

SOURCE: TX Insurance Code Sec. 1455.001 (refers to Occupations Code Sec. 111.001). (Accessed Jan. 2024)

Workers Compensation Health Care Networks

Telehealth service, telemedicine medical service, and teledentistry dental service–Have the meanings assigned by Occupations Code §111.001, concerning Definitions.

SOURCE: TX Administrative Code Title 28, Part 1 Ch. 10, Rule 10.2 (Accessed Jan. 2024).

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Utah

Last updated 02/28/2024

“Telemedicine services” means telehealth services including:

  • clinical care;
  • health education;

“Telemedicine services” means telehealth services including:

  • clinical care;
  • health education;
  • health administration;
  • home health;
  • facilitation of self-managed care and caregiver support; or
  • remote patient monitoring occurring incidentally to general supervision; and

provided by a provider to a patient through a method of communication that:

  • uses asynchronous store and forward transfer or synchronous interaction; and
  • meets industry security and privacy standards, including compliance with the federal Health Insurance Portability and Accountability Act of 1996 and the federal Health Information Technology for Economic and Clinical Health Act.

SOURCE: UT Code Sec. 26B-4-704 (Accessed Feb. 2024).

“Telemedicine services” means the same as that term is defined in Section 26B-4-704.

“Telepsychiatric consultation” means a consultation between a physician and a board certified psychiatrist, both of whom are licensed to engage in the practice of medicine in the state, that utilizes:

  • the health records of the patient, provided from the patient or the referring physician;
  • a written, evidence-based patient questionnaire; and
  • telehealth services that meet industry security and privacy standards, including compliance with the:
    • Health Insurance Portability and Accountability Act; and
    • Health Information Technology for Economic and Clinical Health Act, Pub. L. No. 111-5, 123 Stat. 226, 467, as amended.

SOURCE: Utah Code 31A-22-649 & 649.5 (Accessed Feb. 2024).

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Vermont

Last updated 03/05/2024

“Telemedicine” means the delivery of health care services, including dental …

“Telemedicine” means the delivery of health care services, including dental services, such as diagnosis, consultation, or treatment through the use of live interactive audio and video over a secure connection that complies with the requirements of the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191.

SOURCE: VT Statutes Annotated, Title 8 Sec. 4100k(h)(7), (Accessed Mar. 2024).

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Virgin Islands

Last updated 03/25/2024

As used in this subchapter the term—

  • Telemedicine means the

As used in this subchapter the term—

  • Telemedicine means the use of medical information exchanged from one distant site to another via electronic communications to improve, maintain, or assist patients’ health status. Videoconferencing, transmission of still images, and e-health including patient centers are all considered part of telemedicine and telehealth.
  • Telemedicine services means specialist referral services, patient consultations, remote patient monitoring, medical education, and consumer medical and health information, that are performed as part of a telemedicine

Source: Title 22, Chapter 65, Subchapter IV, Sec. 1901 (a) & (b).  (Accessed Mar. 2024).

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Virginia

Last updated 04/22/2024

“Telemedicine services” as it pertains to the delivery of health …

“Telemedicine services” as it pertains to the delivery of health care services, means the use of electronic technology or media, including interactive audio or video, for the purpose of diagnosing or treating a patient, providing remote patient monitoring services, or consulting with other health care providers regarding a patient’s diagnosis or treatment, regardless of the originating site and whether the patient is accompanied by a health care provider at the time such services are provided. “Telemedicine services” does not include an audio-only telephone, electronic mail message, facsimile transmission, or online questionnaire. Nothing in this section shall preclude coverage for a service that is not a telemedicine service, including services delivered through real-time audio-only telephone.

SOURCE: VA Code Annotated Sec. 38.2-3418.16 (Accessed Apr. 2024).

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Washington

Last updated 03/29/2024

“Telemedicine” means the delivery of health care services through the …

“Telemedicine” means the delivery of health care services through the use of interactive audio and video technology, permitting real-time communication between the patient at the originating site and the provider, for the purpose of diagnosis, consultation, or treatment. For purposes of this section only, “telemedicine” includes audio-only telemedicine, but does not include facsimile or email.

“Audio-only telemedicine” means the delivery of health care services through the use of audio-only technology, permitting real-time communication between the patient at the originating site and the provider, for the purpose of diagnosis, consultation, or treatment.
For purposes of this section only, “audio-only telemedicine” does not include:
  • The use of facsimile or email; or
  • The delivery of health care services that are customarily delivered by audio-only technology and customarily not billed as separate services by the provider, such as the sharing of laboratory results.

“Store and forward technology” means use of an asynchronous transmission of a covered person’s medical information from an originating site to the health care provider at a distant site which results in medical diagnosis and management of the covered person, and does not include the use of audio-only telephone, facsimile, or email.

SOURCE: WA Rev. Code Sec. 48.43.735 & Sec. 41.05.700. (Accessed Mar. 2024).

“Telemedicine” means the delivery of health care services through the use of interactive audio and video technology or audio-only technology, permitting real-time communication between the patient at the originating site and the provider, for the purpose of diagnosis, consultation, or treatment. For purposes of this chapter, “telemedicine” does not include facsimile, email, or text messaging, unless the use of text-like messaging is necessary to ensure effective communication with individuals who have a hearing, speech, or other disability.

“Audio-only telemedicine” means the delivery of health care services through the use of audio-only technology, permitting real-time communication between the patient at the originating site and the provider, for the purpose of diagnosis, consultation, or treatment.

“Audio-only telemedicine” does not include:

  • The use of facsimile, email, or text messages, unless the use of text-like messaging is necessary to ensure effective communication with individuals who have a hearing, speech, or other disability; or
  • The delivery of health care services that are customarily delivered by audio-only technology and customarily not billed as separate services by the provider, such as the sharing of laboratory results.

SOURCE: WA Admin. Code Sec. 284-170-130, as amended by Insurance Commissioner Permanent Rule. (Accessed Mar. 2024).

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West Virginia

Last updated 02/14/2024

“Telehealth services” means the use of synchronous or asynchronous telecommunications …

“Telehealth services” means the use of synchronous or asynchronous telecommunications technology or audio only telephone calls by a health care practitioner to provide health care services, including, but not limited to, assessment, diagnosis, consultation, treatment, and monitoring of a patient; transfer of medical data; patient and professional health-related education; public health services; and health administration. The term does not include e-mail messages or facsimile transmissions.

“Virtual telehealth” means a new patient or follow-up patient for acute care that does not require chronic management or scheduled medications.

SOURCE: WV Statute Sec. 5-16-2 & 33-57-1. (Accessed Feb. 2024).

Network Adequacy: “Telemedicine” or “Telehealth” means health care services provided through telecommunications technology by a health care professional who is at a location other than where the covered person is located.

SOURCE: WV Code Sec. 33-55-1 & WV Admin. Law Sec. 114-100. (Accessed Feb. 2024).

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Wisconsin

Last updated 04/19/2024

No Reference Found

No Reference Found

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Wyoming

Last updated 01/31/2024

No Reference Found

No Reference Found

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Private Payer

Definitions

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