Medicaid & Medicare

Email, Phone & Fax

Approximately 30% of states allow for some type of reimbursement for audio-only delivery, although it’s often limited to specific specialties, such as mental health, or for specific services, such as case management. A few states reimburse for telephone as a result of reimbursement for a communication technology-based service (CTBS) code that allows for audio-only interaction. Secure electronic messages are also beginning to be allowed through reimbursement of the eVisit code. No state allows for reimbursement of services delivered via fax.  This section only covers CTBS codes addressed in a states telehealth policy. Codes exclusively located in a state’s Fee Schedule were not examined as a source for this research.

See overview of states with telephone reimbursement >
Click the map to scroll down to the state

Federal

Last updated 02/28/2021

For the duration of the Public Health Emergency as defined …

For the duration of the Public Health Emergency as defined in § 400.200 of this chapter, Interactive telecommunications system means multimedia communications equipment that includes, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and distant site physician or practitioner.

SOURCE: 42 CFR Sec. 410.78 (Accessed Feb. 2021).

Communication Technology-Based Services (CTBS)

‘Brief communication technology-based service, e.g. virtual check-in’ allows for real-time audio-only telephone interactions in addition to synchronous, two-way audio interactions that are enhanced with video or other kinds of data transmission.

SOURCE: CY 2019 Final Physician Fee Schedule. CMS, p. 31-40.

Interprofessional consultations are reimbursable by CMS as part of their CTBS services (CPT codes include 99451, 99452, 99446, 99447, 99448, and 99449). Cost sharing will apply. These interprofessional services may be billed only by practitioners that can bill Medicare independently for evaluation and management services.  Includes telephone and internet assessments.

SOURCE CY 2019 Final Physician Fee Schedule. CMS, p. 31-40 (Accessed Feb. 2021).

Online digital evaluation services (e-visit) are reimbursable for physicians and qualified non-physician health care professionals.  These are non-face-to-face codes that describe patient-initiated digital communications that require a clinical decision that otherwise typically would have been provided in the office.

SOURCE: CY 2020 Final Physician Fee Schedule. CMS, p. 799 (Accessed Feb. 2021).

Medicare waives the RHC and FQHC face-to-face requirements when an RHC or FQHC furnishes communication technology-based services (Includes the Brief Communication Technology-Based Service, Remote Evaluation of Pre-Recorded Patient Information) to an RHC or FQHC patient. RHCs and FQHCs receive payment for communication technology-based services or remote evaluation services when an RHC or FQHC practitioner provides at least 5 minutes of communications-based technology or remote evaluation services to a patient who has been seen in the RHC or FQHC within the previous year.

G0071 should be billed for both services.

SOURCE:  Medicare Learning Network Matters Factsheet, MM10843, Aug. 10, 2018, & Virtual Communication Services RHCs and FQHCs FAQs, December 2019, (Accessed Feb. 2021).

RHCs and FQHCs are not eligible for reimbursement of interprofessional consultation services, as only practitioners that can bill Medicare independently for evaluation and management services are eligible.

SOURCE CY 2019 Final Physician Fee Schedule. CMS, p. 31-40 (Accessed Feb. 2021).

Home Health Agencies

An individualized plan of care must be established and periodically reviewed by the certifying physician or allowed practitioner.  The plan of care must include all of the following: … Any provision of remote patient monitoring or other services furnished via telecommunications technology (as defined in § 409.46(e)) or audio-only technology. Such services must be tied to the patient-specific needs as identified in the comprehensive assessment, cannot substitute for a home visit ordered as part of the plan of care, and cannot be considered a home visit for the purposes of patient eligibility or payment.

Telecommunications technology, as indicated on the plan of care, can include: remote patient monitoring, defined as the collection of physiologic data (for example, ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient or caregiver or both to the home health agency; teletypewriter (TTY); and 2-way audio-video telecommunications technology that allows for real-time interaction between the patient and clinician. The costs of any equipment, set-up, and service related to the technology are allowable only as administrative costs. Visits to a beneficiary’s home for the sole purpose of supplying, connecting, or training the patient on the technology, without the provision of a skilled service, are not separately billable.

SOURCE:  42 CFR Sec. 409.43 & 409.46 as updated by CMS Final Rule for CY 2021 Home Health Prospective Payment System (Accessed Feb. 2021).

No reference found for email and fax.

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Alabama

Last updated 02/28/2021

No reimbursement for email.

No reimbursement for telephone.

No reimbursement …

No reimbursement for email.

No reimbursement for telephone.

No reimbursement for FAX.

SOURCE: AL Medicaid Management Information System Provider Manual, Physician Service (28-17). Jan. 2021. (Accessed Feb. 2021).

Telephone consultations are not authorized.

SOURCE:  AL Admin. Code r. 560-X-6-.14. March 31, 2020. (Accessed Feb. 2021).  

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Alaska

Last updated 02/28/2021

No reimbursement for telephone when not part of a dedicated …

No reimbursement for telephone when not part of a dedicated audio conference system.

No reimbursement for FAX.

The department will pay only for professional services for a telemedicine application of service. The department will not pay for the use of technological equipment and systems associated with a telemedicine application to render the service.

SOURCE: State of AK Dept. of Health and Social Svcs., Alaska Medical Assistance Provider Billing Manuals for Community Behavioral Health Services; Mental Health Physician Clinic (1/2/2019); Physician Services (5/13), & AK Admin Code, Title 7, 110.625 & 635 (Accessed Feb. 2021).

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Arizona

Last updated 02/28/2021

Two HCPCS codes used for a Virtual check-in with physicians …

Two HCPCS codes used for a Virtual check-in with physicians via a number of communication technology modalities including synchronous discussion over a telephone or exchange of information through video or image. Virtual check-ins are initiated by the patient and may be performed via multiple technology modalities including telephone, secure text messaging, email, or use of a patient portal. The two HCPCS codes are included in the 2020/2021 Fee Schedule.

  • G2010 – Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment.
  • G2012 – Brief communication technology-based service, e.g., virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion.

SOURCE: AZ Physician Fee Schedule (2020-2021) ; AZ  Evaluation and Management Codes & AZ Administrative Code Title 20, Ch. 5, pg. 435. (Accessed Feb. 2021).

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Arkansas

Last updated 02/28/2021

Once a professional relationship is established, the healthcare provider may …

Once a professional relationship is established, the healthcare provider may provide healthcare services through telemedicine, including interactive audio, if the healthcare services are within the scope of practice for which the healthcare provider is licensed or certified and in accordance with the safeguards established by the healthcare professionals licensing board. The use of interactive audio is not reimbursable under Arkansas Medicaid.

SOURCE: AR Medicaid Provider Manual. Section I General Policy.  Rule 105.190. p. I-14 Updated Aug. 1, 2018. & AR Admin. Rule 016.06.18.(Accessed Feb. 2021).

Provider-Led Arkansas Shared Savings Entity (PASSE) Program

The following activities will not be considered a reportable encounter when delivered to a member of the PASSE:

  • Audio-only communication including without-limitation, interactive audio;
  • A facsimile machine;
  • Text messaging; or
  • Electronic mail systems

SOURCE: PASSE Program, p. II-8, (3/1/19).  (Accessed Feb. 2021). 

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California

Last updated 02/28/2021

E-Consult includes interprofessional telephone/internet/electronic health record assessment and management services.…

E-Consult includes interprofessional telephone/internet/electronic health record assessment and management services.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual.  Telehealth.  (Aug. 2020), Pg. 9. (Accessed Feb. 2021).

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Colorado

Last updated 02/28/2021

Telemedicine includes interactive audio (including but not limited to telephone …

Telemedicine includes interactive audio (including but not limited to telephone and relay calls), interactive video (including but not limited to interactive audiovisual modalities), or interactive data communication (including but not limited to live chat and excluding text messaging, electronic mail, and facsimile transmission). Any health benefits provided through interactive audio, interactive video, or interactive data communication must meet the same standard of care as in-person care.

SOURCE:  Colorado Adopted Rule 8.200.3.B. (Accessed Feb. 2021).

No reimbursement for telephone.

No reimbursement for FAX.

No reimbursement for email.

SOURCE: CO Department of Health Care Policy and Financing.  “Telemedicine Billing Manual” 11/20.  (Accessed Feb. 2021).

Recently adopted Rule – Behavioral Health

“Face-to-Face clinical assessment” means a formal and continuous process of collecting and evaluating information about an individual for service planning, treatment, referral, and funding eligibility as outlined in 21.190, and takes place at a minimum upon a request from the responsible person for funded services through the Children and Youth Mental Health Treatment Act. This information establishes justification for services and Children and Youth Mental Health Treatment Act funding. The child or youth must be physically in the same room as the professional person during the Face-to-Face clinical assessment. If the child is out of state or otherwise unable to participate in a Face- to-Face assessment, video technology may be used. If the Governor or local government declares an emergency or disaster, telephone may be used. Telephone shall only be used as necessary because of circumstances related to the disaster or emergency.

SOURCE: 2 CO Code of Regulation 520-1, 21.200.41. pg. 37 (Accessed Feb. 2021).

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Connecticut

Last updated 02/28/2021

The department shall not pay for information or services provided …

The department shall not pay for information or services provided to a client over the telephone except for case management behavioral health services for patients aged 18 and under.

SOURCE: CT Provider Manual. Clinic. Sec. 17b-262-823. Jan. 31, 2018. Ch. 7, pg. 20;  Behavioral Health. Sec. 17b-262-918. Jan. 2021. Ch. 7, Pg. 6; CT Provider Manual. Physician and Psychiatrist. Sec. 17b-262-342 & 17b-262-456. Oct. 2020 Pg. 9 & 20; CT Provider Manual. Psychologist. Sec. 17b-262-472. Oct. 2020. Ch. 7, pg. 7; CT Provider Manual. Hospital Inpatient Services. Sec. 150.2(E)(III)(l). Oct. 2020. Ch. 7, pg. 44; CT Provider Manual. Chiropractic. Sec. 17b-262-540. Oct. 2020. Ch. 7, pg. 6; CT Provider Manual. Dental. Sec. 17b-262-698. Oct. 2020. Ch. 7, Pg. 44; CT Provider Manual. Home Health. Sec. 17b-262-729. Jan. 1, 2008. Ch. 7, pg. 12; CT Provider Manual. Natureopath. Sec. 17b-262-552. Oct. 2020. Ch. 7, pg. 6; CT Provider Manual. Nurse Practitioner/Midwife. Sec. 17b-262-578. Oct. 2020. Ch. 7, pg. 7; CT Provider Manual. Podiatry. Sec. 17b-262-624. Oct. 2020. Ch. 7, pg. 6; CT Provider Manual. Vision Care. Sec. 17b-262-564. Oct. 2020. Ch. 7, pg. 4. (Accessed Feb. 2021).

The price for any supply listed in the fee schedule published by the department shall include and the department shall pay the lowest: … information furnished by the provider to the client over the telephone.

SOURCE: CT Provider Manual. Medical Services, Sec. 17b-262-720, p. 7.  (Accessed Feb. 2021).

Telephonic consultations are not reimbursable under CMAP.

SOURCE:  CT Policy Transmittal 2019-12.  Effective Jan. 1, 2019. Released Mar. 1, 2019.  (Accessed Feb. 2021).

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Delaware

Last updated 02/28/2021

Telephone, chart review, electronic mail messages, facsimile transmissions or internet …

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

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

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District of Columbia

Last updated 02/28/2021

DC Medicaid does not reimburse for service delivery using e-mail …

DC Medicaid does not reimburse for service delivery using e-mail messages or facsimile transmissions.

SOURCE: DC Code Sec. 31-3861 & Physicians Billing Manual.  DC Medicaid.  (Jan.13, 2021) Sec. 15.9 p. 66.  (Accessed Feb. 2021).

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Florida

Last updated 02/28/2021

No reimbursement for telephone, chart review, electronic mail messages or …

No reimbursement for telephone, chart review, electronic mail messages or facsimile transmissions.

SOURCE: FL Admin Code 59G-1.057.  (Accessed Feb. 2021).

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Georgia

Last updated 02/28/2021

Non-covered Services Modalities

  • Telephone conversations.
  • Electronic mail messages.
  • Facsimile.
  • Services

Non-covered Services Modalities

  • Telephone conversations.
  • Electronic mail messages.
  • Facsimile.
  • Services rendered via a webcam or internet-based technologies (i.e., Skype, Tango, etc.) that are not part of a secured network and do not meet HIPAA encryption compliance.
  • Video cell phone interactions.
  • The cost of telehealth equipment and transmission.
  • ailed or unsuccessful transmissions.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 10 (Jan. 2021). (Accessed Feb. 2021).

 

 

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Hawaii

Last updated 02/28/2021

No Reimbursement for:

  • Telephone
  • Facsimile machine
  • Electronic mail

SOURCE: Code

No Reimbursement for:

  • Telephone
  • Facsimile machine
  • Electronic mail

SOURCE: Code of HI Rules 17-1737.-51.1(c) (Accessed Feb. 2021).

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Idaho

Last updated 02/28/2021

No reimbursement for telephone, email, text or fax.

SOURCE:  Idaho

No reimbursement for telephone, email, text or fax.

SOURCE:  Idaho Medicaid Provider Handbook.  General Information and Requirements for Providers. Jan. 19, 2021, Section 8.9 p. 122. (Accessed Feb. 2021).

Fee for service reimbursement is not available for an electronic mail message (e-mail), or facsimile transmission (fax).

SOURCE: ID Administrative Code 16.03.09 Sec. 210 (09). (Accessed Feb. 2021).

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Illinois

Last updated 02/28/2021

No reimbursement for telephone.

No reimbursement for FAX.

No reimbursement …

Indiana

Last updated 02/28/2021

Telemedicine is not the use of:

  • Telephone transmitter for transtelephonic

Telemedicine is not the use of:

  • Telephone transmitter for transtelephonic monitoring; or
  • Telephone or any other means of communication for consultation from one provider to another.

SOURCE: IN Medicaid Telemedicine and Telehealth Module, Oct. 1, 2019. p. 1. (Accessed Feb. 2021).

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Iowa

Last updated 02/28/2021

Note that in almost all program-specific manuals, telephonic interpretive services …

Note that in almost all program-specific manuals, telephonic interpretive services are allowed.

SOURCE:  Iowa Dep. of Human Services.  Provider Manual.  Ch. III Provider Specific Policies.  Physician Services. July 1, 2014, p. 63 (Accessed Jan. 2021).  For other manuals, see:  Medicaid Provider Manual.  Provider Specific Manuals. (Accessed Feb. 2021).

Case management can occur by face-to-face contact, telephone, letter, email or fax.

SOURCE:  Iowa Dep. of Human Services.  Provider Manual.  Ch. III Provider Specific Policies.  Targeted Case Management. May 1, 2018, p. 10 (Accessed Feb.  2021).

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Kansas

Last updated 02/28/2021

Telemedicine does not include communication between:

  • A healthcare provider that

Telemedicine does not include communication between:

  • A healthcare provider that consists solely of a telephone voice-only conversation, email, or facsimile transmission.
  • A physician and a patient that consists solely of an email or facsimile transmission.

Email, telephone, and facsimile transmissions are not covered as telemedicine services.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-30 & 2-31 (Jan. 2020) & FQHC/RHC, 8-13, (Jan. 2021). (Accessed Feb. 2021).

Hospital E&M

A “comprehensive exam” is considered a “hands on” specialist examination. Telephone consultation with a specialist is not the equivalent of comprehensive exam.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, FFS Provider Manual, Hospital, p. 22 (Aug. 2020). (Accessed Feb. 2021).

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Kentucky

Last updated 02/28/2021

No reimbursement for email. No reimbursement for telephone. No reimbursement …

No reimbursement for email.
No reimbursement for telephone.
No reimbursement for FAX.

SOURCE: KY Revised Statutes § 205.559 (2)(b). (Accessed Feb. 2021).

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Louisiana

Last updated 02/28/2021

Hospices may report some social worker calls as a visit.…

Maine

Last updated 02/28/2021

Telephonic services may be reimbursed if the following conditions are …

Telephonic services may be reimbursed if the following conditions are met:

  • Interactive telehealth services are unavailable; and
  • A telephonic service is medically appropriate for the underlying covered service.

Except as specified in the manual, services may not be delivered through electronic mail.

Interprofessional telephone/internet assessment are among the listed reimbursable procedure codes.

New Medicaid Policy (Effective Upon Approval from CMS)

The Department will reimburse providers for Telephone Evaluation and Management Services provided to members.  These services are separate from the telephonic services described above.  Telephonic Evaluation and Management Services must be rendered by a qualified professional actively enrolled in MaineCare or contracted through an enrolled MaineCare provider. Telephone Evaluation and Management Services are not to be billed if clinical decision-making dictates a need to see the member for an office visit within 24 hours or at the next available appointment.

Coverage also includes the virtual check-in, which can occur telephonically or through interactive services.  See manual for requirements.

SOURCE: MaineCare Benefits Manual, Telehealth, 10-144 Ch. 101, Ch. 1, Sec. 4. p. 5-8 & 10. (June 15, 2020). (Accessed Feb. 2021). 

For Indian Health Services, a second-tier consultation can utilize direct email communications or telephone consultation.

SOURCE: MaineCare Benefits Manual, Indian Health Services, 10-144 Ch. II, Sec. 9, p. 5 (March 21, 2012). (Accessed Feb. 2021). 

Under Targeted Case Management, monitoring and follow-up activities may involve either face-to-face or telephone contact.

SOURCE:  MaineCare Benefits Manual, Targeted Case Management Services, 10-144 Ch. 101, Sec. 13.02, p. 6 (Mar. 20, 2014). (Accessed Feb. 2021). 

For crisis resolution services, under Behavioral health, covered services do include direct telephone contacts with both the member and the member’s parent or guardian or adult’s member’s guardian when at least one face-to-face contact is made with the member within seven (7) days prior to the first contact related to the crisis resolution service. The substance of the telephone contact(s) must be such that the member is the focus of the service, and the need for communication with the parent or guardian without the member present must be documented in the member’s record.

SOURCE:  MaineCare Benefits Manual, Behavioral Health Services, 10-44 Ch. II, Sec. 65, p. 12 (Aug, 19, 2020). (Accessed Feb. 2021).

An examination following use of restraint or seclusion can be done by a telephone in consult with a registered nurse.  When a telephonic consult occurs, the physician, or nurse practitioner must examine the member in person within the following time constraints:

  • Within one (1) hour of when the registered nurse requests an examination;
  • Within one (1) hour of when information relayed is suggestive of causes leading to physical harm to the member;
  • Within one (1) hour if an examination has not yet occurred during the member’s stay; or
  • Within six (6) hours in all other circumstances.

SOURCE:  MaineCare Benefits Manual, Psychiatric Residential Treatment Facility Services, 10-44 Ch. II, Sec. 65, p. 32 (Oct. 3, 2018). (Accessed Feb. 2021).

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Maryland

Last updated 02/28/2021

No reimbursement for email.

No reimbursement for telephone.

No reimbursement …

No reimbursement for email.

No reimbursement for telephone.

No reimbursement for FAX.

No reimbursement for telephone conversation, electronic mail message or facsimile transmission between the originating and distant site providers.  There is also no reimbursement for telecommunication between providers without the participant present.

SOURCE: MD Medicaid Telehealth Program. Telehealth Provider Manual. Updated April 2020. p. 4, (Accessed Feb. 2021).

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Massachusetts

Last updated 02/28/2021

Newly Passed Legislation (Now Effective)

“Telehealth”, the use of synchronous …

Newly Passed Legislation (Now Effective)

“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.

The rate of payment for telehealth services provided via interactive audio-video technology and audio-only telephone may be greater than the rate of payment for the same service delivered by other telehealth modalities.

SOURCE: Massachusetts Senate No. 2984. Section 40 (Accessed Feb. 2021)

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Michigan

Last updated 02/28/2021

No Reference Found

No Reference Found

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Minnesota

Last updated 02/28/2021

No reimbursement for email

No reimbursement for phone

No reimbursement …

No reimbursement for email

No reimbursement for phone

No reimbursement for fax

SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telemedicine), As revised Jan. 28, 2020. (Accessed Feb. 2021).

“A communication between licensed health care providers, or a licensed health care provider and a patient that consists solely of a telephone conversation, e-mail or facsimile transmission does not constitute a telemedicine consultation or service.”

SOURCE: MN Statute Sec. 256B.0625, Subsection 3(b)(d). (Accessed Feb. 2021).

Case management for Child Welfare Transitional Case Management services is covered through telephone in certain circumstances.

SOURCE: MN Dept. of Human Svcs., Provider Manual, Child Welfare Case Management Services, As revised September 22, 2020. (Accessed Feb. 2021).

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Mississippi

Last updated 02/28/2021

The following are not considered telehealth services:

  • Telephone conversation
  • Chart

The following are not considered telehealth services:

  • Telephone conversation
  • Chart reviews
  • Electronic mail messages
  • Facsimile transmission
  • Internet services for online medical evaluation, or
  • Communication through social media or,
  • Any other communication made in the course of usual business practices including, but not limited to,
    1. Calling in a prescription refill, or
    2. Performing a quick virtual triage.

SOURCE: MS Admin. Code 23, Part 225, Rule. 1.4(F). (Accessed Feb. 2021).

Not considered telehealth:

  • Telephone conversations;
  • Chart reviews;
  • Electronic mail messages;
  • Facsimile transmission;
  • Internet services for online medical evaluations; or
  • The installation or maintenance of any telecommunication devices or systems.

SOURCE: State of Mississippi. State Plan Under Title XIX of the Social Security Act. Medical Assistance Program. Attachment 3.1-A. 3/31/15.  (Accessed Feb. 2021).

During a state of emergency, Telehealth services are expanded to include use of telephonic audio that does not include video when authorized by the State of Mississippi. A beneficiary may use the beneficiary’s personal telephonic land line in addition to a cellular device, computer, tablet, or other web camera-enabled device to seek and receive medical care in a synchronous format with a distant-site provider.

SOURCE: MS Admin. Code Title 23, Part 225, Rule. 1.7. (Accessed Feb. 2021).

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Missouri

Last updated 02/28/2021

No Reference Found

No Reference Found

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Nebraska

Last updated 02/28/2021

No reimbursement for telephone. Follow-up calls after the initial evaluation …

No reimbursement for telephone. Follow-up calls after the initial evaluation are included in the cost of the evaluation. Reimbursement may be made for telephone consultations with another physician if the name of the consulting physician is indicated on or in the claim.

SOURCE: NE Admin. Code Title 471, Sec. 18-004.38, Ch. 18, Manual Letter #59-2003 & NE Admin. Code Title 471, Sec. 18-004.50B, Ch. 18, Manual Letter #93-2008. (Accessed Feb. 2021).

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Nevada

Last updated 02/28/2021

No reimbursement for email.

No reimbursement for telephone.

No reimbursement …

No reimbursement for email.

No reimbursement for telephone.

No reimbursement for FAX.

No reimbursement for text messages.

SOURCE: NV Dept. of Health and Human Svcs., Medicaid Services Manual, Telehealth Services Chapter 3400, Section 3403.6, p. 3 (Jul. 27, 2017) (Accessed Feb. 2021).

Medicaid does not reimburse physicians for telephone calls between physicians and patients (including those in which the physician gives advice or instructions to or on behalf of a patient) except documented psychiatric treatment in crisis intervention (e.g. threatened suicide).

SOURCE: NV Dept. of Health and Human Svcs., Medicaid Services Manual, Section, Physician Services Chapter, Section 603.2, p. 4 (Jan. 1, 2020) (Accessed Feb. 2021).

For crisis intervention, modifier GT includes telephonic services.

SOURCE: NV Dept. of Health and Human Svcs., Medicaid Services Manual, Behavioral Health Outpatient Treatment, p. 9 (2/24/20), (Accessed Feb. 2021)NV Dept. of Health and Human Svcs., Provider Type 82 Billing Guide, Behavioral Health Rehabilitative Treatment, p. 3. (2/1/19). (Accessed Feb. 2021).

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New Hampshire

Last updated 02/28/2021

“Telehealth services” shall comply with 42 C.F.R. section 410.78, except …

“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 excludes telephone, facsimile machines and electronic mail systems from the definition of an interactive telecommunications system.

SOURCE: NH Revised Statutes 167:4-d & 42 CFR Sec. 410.78(a)(3). (Accessed Feb. 2021).

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, (NH HB 1623, 2020 Session), (Accessed Feb. 2021).

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New Jersey

Last updated 02/28/2021

Telephones, facsimile machines, and electronic mail systems do not meet …

Telephones, facsimile machines, and electronic mail systems do not meet the definition of an interactive telecommunications system. Sessions may not be recorded.

SOURCE: NJ Division of Medical Assistance and Health Services. Newsletter Vol. 28, No. 17, Sept. 2018, p. 2 (Accessed Feb. 2021).

Telemedicine does not include the use, in isolation, of audio-only telephone conversation, electronic mail, instant messaging, phone text or facsimile transmission.

Telehealth includes the use of telephones.

SOURCE: NJ Statute C.45:1-61. (Accessed Feb. 2021).

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New Mexico

Last updated 02/28/2021

Applied Behavior Analysis

Telephonic is the use of a telephone …

Applied Behavior Analysis

Telephonic is the use of a telephone or cell phone to render services in real time with only audio. Currently only under an Emergency Order from the Governor may some services be rendered telephonically. A MAD supplement is issued informing providers and practitioners of the Emergency Order and codes allowed to be rendered telephonically.

SOURCE: NM Applied Behavior Analysis Agency Manual Instructions, pg. 3, (Accessed Feb. 2021).

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New York

Last updated 02/28/2021

Telehealth shall not include delivery of health care services by …

Telehealth shall not include delivery of health care services by means of facsimile machines, or electronic messaging alone, though use of these technologies is not precluded if used in conjunction with telemedicine, store and forward technology, or remote patient monitoring. For purposes of this section, telehealth shall be limited to telemedicine, store and forward technology, remote patient monitoring and audio-only telephone communication, except that with respect to the medical assistance program shall include audio-only telephone communication only to the extent defined in regulations as may be promulgated by the commissioner.

SOURCE: NY Public Health Law Article 29 – G Section 2999-cc. & NY Senate (S 8416 2020 Session), (Accessed Feb. 2021).

The commissioner may specify in regulation additional acceptable modalities for the delivery of health care services via telehealth, including but not limited to audio-only telephone communications, online portals and survey applications, and may specify additional categories of originating sites at which a patient may be located at the time health care services are delivered to the extent such additional modalities and originating sites are deemed appropriate for the populations served.

SOURCE: NY Public Health Law Article 29 – G Section 2999-ee. (Accessed Feb. 2021).

Telemental health services do not include telephone, video cell phone, or e-mail.  Services also do not include consultation between two professionals or clinical staff.

SOURCE: NY Code of Rules and Regs.  Title 14, Sec. 596.4(r) (Accessed Feb. 2021).

Telephone conversations, e-mail or text messages, and facsimile transmissions between a dentist and a Medicaid member or between two dentists are not considered telehealth services and are not covered by Medicaid when provided as standalone services.

SOURCE: NY Dental Policy and Procedure Code Manual January 1, 2020, page 82 (Accessed Feb. 2021).

 

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North Carolina

Last updated 02/28/2021

No reference found for email or fax.

Covered virtual communication …

No reference found for email or fax.

Covered virtual communication services include: telephone conversations (audio only); virtual portal communications (secure messaging); and store and forward (transfer of data from beneficiary using a camera or similar device that records (stores) an image that is sent by telecommunication to another site for consultation).

Covered virtual communication services include telephone evaluation and management codes (audio only): 99441-99443 and G2012.

SOURCE: NC Div. of Medical Assistance, Medicaid and Health Choice Manual, Clinical Coverage Policy No: 1H, Telehealth, Virtual Communications and Remote Patient Monitoring, p. 2 & 14, Nov. 15, 2020. (Accessed Feb. 2021).

Outpatient Behavioral Health

Telephonic services may be transmitted between a patient and provider in a manner that is consistent with the CPT code definition for those services. This service delivery method is reserved for circumstances when: a. the beneficiary’s physical or behavioral health status prevents them from participating in in-person or telehealth services; or b. access issues (e.g., transportation, telehealth technology) prevent the beneficiary from participating in in-person or telehealth services.

Excluding psychotherapy for crisis services, Medicaid and NCHC shall require prior approval for services provided via the telephonic, audio-only communication method.

See Outpatient Behavioral Health manual for telephone-specific criteria, eligible providers, and covered codes.

SOURCE: NC Div. of Medical Assistance, Medicaid and Health Choice Manual, Clinical Coverage Policy No: 8C, Outpatient Behavioral Health Services, p. 4 & 10, Jan. 1, 2021. (Accessed Feb. 2021).

FQHCs/RHCs

Telephonic services may be transmitted between a patient and provider in a manner that is consistent with the CPT code definition for those services. This service delivery method is reserved for circumstances when: a. the beneficiary’s physical or behavioral health status prevents them from participating in in-person or telehealth services; or b. access issues (e.g., transportation, telehealth technology) prevent the beneficiary from participating in in-person or telehealth services.

See manual for specific requirements for telephonic services.

FQHCs and RHCs may conduct telephonic evaluation and management services using HCPCS code G0071. Eligible providers include physicians, nurse practitioners, psychiatric nurse practitioners, physician assistants, and certified nurse midwives.

SOURCE: NC Div. of Medical Assistance, Medicaid and Health Choice Manual, Clinical Coverage Policy No: 1D-4, Core Services Provided in Federally Qualified Health Centers and Rural Health Clinics, p. 19, Dec. 1, 2020. (Accessed Feb. 2021).

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North Dakota

Last updated 02/28/2021

Telephonic encounters are not covered by ND Medicaid.

ND Medicaid …

Telephonic encounters are not covered by ND Medicaid.

ND Medicaid does not cover non face to face services (e.g., telephone, email).

No reference found for FAX.

SOURCE: North Dakota Department of Human Services: General Information for Providers. North Dakota Medicaid and Other Medical Assistance Programs.  (Jan. 2021) P. 55 & 86 (Accessed Feb. 2021).

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Ohio

Last updated 02/28/2021

Telehealth is the interaction with a patient via synchronous, interactive, …

Telehealth is the interaction with a patient via synchronous, interactive, real-time electronic communication that includes both audio and video elements; OR

The following activities that are asynchronous or do not have both audio and video elements:

  • Telephone calls
  • Remote patient monitoring
  • Communication with a patient through secure electronic mail or a secure patient portal

SOURCE: The Ohio Department of Medicaid.  Telehealth Billing Guide.  Revised 2/8/2021 & OAC 5160-1-18.  (Accessed Feb. 2021).

Pre-admission Screening and Resident Review

Pre-admission Screenings and Resident Reviews (PASRR) should be completed via the electronic HENS system as they are today as these screenings are primarily via desk review. In instances where a face-to-face is required, a telephonic and/or desk review is permissible. Level II evaluations can be provided either by telephone or desk review when appropriate. There is no system or reimbursement impact as these functions are supported by the level II entities and the applicable contractor.

SOURCE: The Ohio Department of Medicaid.  Telehealth Billing Guide.  Revised 2/8/2021.  (Accessed Feb. 2021). 

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Oklahoma

Last updated 02/28/2021

No reimbursement for email.

No reimbursement for telephone.

No reimbursement …

No reimbursement for email.

No reimbursement for telephone.

No reimbursement for FAX.

SOURCE: OK Admin. Code Sec. 317:30-3-27(a). (Accessed Feb. 2021).

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Oregon

Last updated 02/28/2021

Telephonic and online services, including services related to diagnostic workup …

Telephonic and online services, including services related to diagnostic workup are covered for services for new and established patients.

Covered telephone and online services billed using these codes do not include either of the following:

  • Services related to a service performed and billed by the physician or qualified health professional within the previous seven days, regardless of whether it is the result of patient-initiated or physician-requested follow-up.
  • Services which result in the patient being seen within 24 hours or the next available appointment.

SOURCE: Oregon Health Authority, Health Evidence Review Commission, Guideline Note Changes for the February 1, 2021 Prioritized List of Health Services, p. C-2. (02/01/21). (Accessed Feb. 2021).

Telehealth services may be transmitted via landlines and wireless communications, including the Internet and telephone networks.

SOURCE: OR OAR 410-120-1990 & OAR 410-141-3566, Health Systems Division: Medical Assistance Programs, Telehealth. (Accessed Feb. 2021).

Behavioral Health

Patient consultations using telephone and online or electronic mail (e-mail) are covered when billed services comply with the practice guidelines set forth by the Health Evidence Review Commission and the applicable HERC-approved code requirements, delivered consistent with the HERC Evidence-Based Guidelines; Patient consultations using videoconferencing, a synchronous (live two-way interactive) video transmission resulting in real time communication between a provider located in a distant site and the recipient being evaluated and located in an originating site, is covered when billed services comply with the billing requirements in rule.  Behavioral health services specifically identified as allowable for telephonic delivery are listed on the Behavioral Health Fee schedule published by the Authority.

Unless expressly authorized in OAR 410-120-1200 (Exclusions), other types of telecommunications are not covered such as images transmitted via facsimile machines and electronic mail when:

  • Those methods are not being used in lieu of videoconferencing, due to limited videoconferencing equipment access; or
  • Those methods and specific services are not specifically allowed pursuant to the Oregon Health Evidence Review Commission’s Prioritized List of Health Services and Evidence Based Guidelines.

SOURCE: OR OAR 410-172-0850, Health Systems Division: Medical Assistance Programs, Medicaid Payment for Behavioral Health Services, Telemedicine for Behavioral Health. (Accessed Feb. 2021).

Teledentistry

Mobile communication devices such as cell phones, tablet computers, or personal digital assistants may support mobile dentistry and health care and public health practices and education.

Unless authorized in OAR 410-120-1200 Exclusions or OAR 410-130-0610 Telemedicine, other types of telecommunications such as telephone calls, images transmitted via facsimile machines, and electronic mail are not covered:

  • When those types are not being used in lieu of teledentistry, due to limited teledentistry equipment access; or
  • When those types and specific services are not specifically allowed in this rule per the Oregon Health Evidence Review Commission’s Prioritized List of Health Services.

SOURCE: OR OAR 410-123-1265, Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Teledentistry. (Effective Jan. 1, 2021). (Accessed Feb. 2021).

School Based Health Services

Telehealth can be interactive audio/telephonic services provided to a child/student in a geographical area where synchronous audio and video is not available or consent for audio/video is refused for services provided to a child/student.

The Authority may reimburse telehealth, tele-electronic/telephonic School-Based Health Services (SBHS) provided to the same extent the services would be covered if they were provided in person and billed to Medicaid using appropriate SBHS procedure codes and modifiers.  See rule for requirements.

For services covered using synchronous audio and video with modifiers GT, the Division will cover the same services provided by synchronous audio (e.g. telephone), when billed with the same codes but without modifier GT when provision of the same service via synchronous audio and video is not available or feasible, when the patient declines to enable video, or necessary consents cannot reasonably be obtained with appropriate documentation in the child/student’s plan of care

SOURCE: OR OAR 410-133-0040 & 410-133-0080, Health Systems Division: Medical Assistance Programs, School-Based Health Services, Coverage (Accessed Feb. 2021).

Indian Health Services

Telephone encounters qualify as a valid encounter for specific services. Telephone encounters must include all the same components of the service when provided face-to-face. Providers may not make telephone contacts at the exclusion of face-to-face visits.

SOURCE: OR OAR 410-147-0120, Healthy Systems Division: Medical Assistance Programs, American Indian/Alaska Native.  (Accessed Feb. 2021).

Federally Qualified Health Center and Rural Health Clinics

For the provision of services defined in Titles XIX and XXI and provided through an FQHC or RHC, an “encounter” is defined as a face-to-face or telephone contact between a health care professional and an eligible OHP client within a 24-hour period ending at midnight, as documented in the client’s medical record. See rule for limitations for telephone contacts that qualify as encounters. Telephone encounters qualify as a valid encounter for specific services.

SOURCE: OR OAR 410-147-0120, Healthy Systems Division: Medical Assistance Programs, Federally Qualified Health Center and Rural Health Clinics Services.  (Accessed Feb. 2021).

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Pennsylvania

Last updated 02/28/2021

No reimbursement for email.

No reimbursement for telephone.

No reimbursement …

No reimbursement for email.

No reimbursement for telephone.

No reimbursement for FAX.

SOURCE: PA Department of Public Welfare, Medical Assistance Bulletin 09-12-31, 31-12-31, 33-12-30, May 23, 2012 (Accessed Feb. 2021).

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Rhode Island

Last updated 02/28/2021

No Reference Found

No Reference Found

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South Carolina

Last updated 02/28/2021

No reimbursement for email. No reimbursement for telephone. No reimbursement …

No reimbursement for email.
No reimbursement for telephone.
No reimbursement for FAX.
No reimbursement for video cell phone interactions.

SOURCE: SC Health and Human Svcs. Dept. Physicians Provider Manual, p. 157 (Feb. 2021) (Accessed Feb. 2021).

FQHCs Behavioral Health Services
Family Therapy: Billing for telephone calls is not allowed.

SOURCE: SC Health and Human Svcs. Dept. Federally Qualified Health Center Behavioral Health Services Provider Manual, p. 25, (July 2019), (Accessed Feb. 2021).

Medicaid Targeted Case Management
Electronic visual encounters (e.g., Skype, teleconferencing or other media) with the beneficiary are not considered a face-to-face contact and will be reimbursed at the T1016 MTCM encounter rate.

  • A telephone contact is in lieu of a face-to-face contact when environmental considerations preclude a face-to-face encounter, for the purpose of rendering one or more MTCM components. Documentation must include details precluding a face-to-face encounter.
  • A relevant email contact via secured transmittal, on behalf of the beneficiary for the purpose of rendering one or more MTCM components.

For Medicaid purposes, a face-to-face contact is preferable with phone and/or email contact being acceptable if necessary.

SOURCE: SC Health and Human Svcs. Dept., Medicaid Targeted Case Management Provider Guide, p. 20 (Jan. 2020), (Accessed Feb. 2021).

Dental Telephonic Encounters
Reimbursement for the telephonic services described above is available if the interaction with a Healthy Connections Medicaid member includes at least one telephonic component between patient and provider or provider and provider. Interactions that also include video interaction may also be billed, but other forms of electronic communication, such as email and instant and text messaging, are not eligible for reimbursement. To qualify for reimbursement, the interactions must include the necessary audio and video components, of sufficient quality and resolution, to provide the care that is being billed.

Source: SC Health and Human Svcs. Dental Services Provider Manual. (Oct. 2021), Pg. 77. (Accessed Feb. 2021).

Licensed Independent Practitioner’s Rehabilitative Services.
Service Plan Development (SPD) is a face-to-face or telephonic interaction between the beneficiary and a qualified clinical professional or a team of professionals.

Crisis Management (CM) is a face-to-face, or telephonic, short-term service is to assist a beneficiary, who is experiencing a marked deterioration of functioning related to a specific precipitant, in restoring his/her level of functioning and/or to stabilize the beneficiary.

When necessary/appropriate, consultation shall only include telephone or face-to-face contact by a Psychologist/LPES to the family, school, or another health care provider to interpret or explain the results of psychological testing and/or evaluations related to the care and treatment of the beneficiary. The Psychologist/LPES must document the recommended course of action.

SOURCE: SC Health and Human Svcs. Dept. Licensed Independent Practitioner’s Rehabilitative Provider Manual, p. 17 & 19. (Jan. 2020). (Accessed Feb. 2021).

Telephone contact related to office procedures or appointment times are not covered.

SOURCE: SC Health and Human Svcs. Dept. Licensed Independent Practitioner’s Rehabilitative Provider Manual, p. 21. (Jan. 2020). (Accessed Feb. 2021).

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South Dakota

Last updated 04/29/2021

Telephones, facsimile machines, and electronic mail systems do not meet …

Telephones, facsimile machines, and electronic mail systems do not meet the definition of an interactive telecommunications system.

Non-covered telephone services that are unrelated to COVID-19 should only be billed to a recipient if the provider would bill the general public for this service and the telephone service is not part of the provider’s obligation as a Primary Care Provider/Health Home.

SOURCE: SD Medicaid Billing and Policy Manual: Telemedicine, p. 8, 13 (Mar. 2021) (Accessed Apr. 2021).

Crisis assessment and intervention services are covered which includes an immediate therapeutic response available 24 hours a day 7 days a week that involves direct telephone or face-to-face contact with a recipient exhibiting acute psychiatric symptoms and/or inappropriate behavior that left untreated, presents an immediate threat to the recipient or others.

SOURCE: SD Medicaid Billing and Policy Manual: Community Mental Health Center Services, p. 6 (Dec. 2020), (Accessed Apr. 2021).

Collateral contacts is covered which involves Telephone or face-to-face contact with an individual other than the identified recipient to plan appropriate treatment, assist others so they can respond therapeutically regarding the recipient’s difficulty or illness, or link the recipient, family, or both, to other necessary and therapeutic community support.

SOURCE: SD Medicaid Billing and Policy Manual: Community Mental Health Center Services, p. 6 (Dec. 2020) & Substance Use Disorder Agency Services, p. 4 (Dec. 2020) (Accessed Apr. 2021).

SD Medicaid does not cover physician telephone patient services, online medical evaluation, interprofessional telephone/internet/electronic health record consultations.

SOURCE: SD Medicaid Billing and Policy Manual: Physician Services, p. 8 (Dec. 2020), (Accessed Apr. 2021).

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Tennessee

Last updated 02/28/2021

No reimbursement for telephone.

No reimbursement for fax.

No reimbursement …

No reimbursement for telephone.

No reimbursement for fax.

No reimbursement for email.

SOURCE: TN Code Annotated, Title 56, Ch. 7, Part 1002(a)(7)(B). (Accessed Feb. 2021).

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Texas

Last updated 02/28/2021

A health benefit plan, including a Texas Medicaid managed care …

A health benefit plan, including a Texas Medicaid managed care organization (MCO), is not required to provide reimbursement for telemedicine medical services that are provided through only synchronous or asynchronous audio interactions including:

  • An audio-only telephone consultation
  • A text-only email message
  • A facsimile transmission

SOURCE: TX Medicaid Telecommunication Services Handbook, pg. 8 & 14 (Feb. 2021). (Accessed Feb. 2021).

For behavioral health and case management services, service coordination funded as TCM can be reimbursed as a Supportive Encounter, which can be face-to-face, telephone telemedicine contact with an individual or with a collateral on the individual’s behalf to provide service coordination.

SOURCE: TX Medicaid Behavioral Health and Case Management Services Handbook, pg. 38 (Feb. 2021). (Accessed Feb. 2021).

A cardiac rehabilitation program in which the cardiac monitoring is done using telephonically transmitted electrocardiograms (ECGs) to a remote site is not a benefit of Texas Medicaid.

SOURCE: TX Medicaid and Nursing Specialists, Physicians, and Physician Assistants Handbook, pg. 64. (Feb. 2021). (Accessed Feb. 2021).

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Utah

Last updated 02/28/2021

Interprofessional telephone/internet assessment and management services are listed as a …

Interprofessional telephone/internet assessment and management services are listed as a covered service for psychiatrists.

SOURCE: Utah Medicaid Provider Manual: Section I: General Information, p. 49 (Jul. 2020), (Accessed Feb. 2021).

Telephone contact can be billed in the Targeted Case Management for Early Childhood program.

SOURCE: Utah Medicaid Provider Manual: Targeted Case Management, Early Childhood Ages 0-4, p. 10, (Jul. 2016).  (Accessed Feb. 2021).

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Vermont

Last updated 02/28/2021

No reimbursement for email.

No reimbursement for telephone.

No reimbursement …

No reimbursement for email.

No reimbursement for telephone.

No reimbursement for FAX.

SOURCE: VT Health Care Administrative Rules 13.174.003 (3.101.7), Telehealth, (Accessed Feb. 2021).

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Virginia

Last updated 02/28/2021

No reimbursement for email. No reimbursement for telephone. No reimbursement …

Washington

Last updated 02/28/2021

No reimbursement for email.

No reimbursement for telephone.

No reimbursement …

No reimbursement for email.

No reimbursement for telephone.

No reimbursement for FAX.

Teledermatology does not include single-mode consultations by telephone calls, images transmitted via facsimile machines, or electronic mail.

SOURCE: WA State Health Care Authority, Medicaid Provider Guide, Physician-Related Svcs./Health Care Professional Svcs., p. 88 (Jan. 2021), School-Based Health Care Services, p. 33 (Oct. 2020); Applied Behavioral Analysis (ABA) Program, p. 34, (Accessed Feb. 2021).

HCA pays for telephone services when used by a physician to report and bill for episodes of care initiated by an established patient (i.e., someone who has received a face-to-face service from you or another physician of the same specialty in your group in the past three years) or by the patient’s guardian. See manual for codes and additional requirements.

SOURCE: WA State Health Care Authority, Medicaid Provider Guide, Physician-Related Svcs./Health Care Professional Svcs., p. 48 (Feb. 2021), (Accessed Feb. 2021).

Effective for dates of service on and after March 1, 2021, the agency will no longer reimburse CDT code D9992 for triage and care coordination over the telephone.

The agency does not cover email, audio only telephone, and facsimile transmissions as teledentistry services.

SOURCE: WA State Health Care Authority, Medicaid Provider Guide, Dental-Related Services, p. 68, Mar. 2021, (Accessed Feb. 2021). 

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Wisconsin

Last updated 02/28/2021

The Department may promulgate rules specifying any telehealth service that …

The Department may promulgate rules specifying any telehealth service that is provided solely by audio-only telephone, facsimile machine or electronic mail as reimbursable under Medical Assistance.

SOURCE: WI Statute Sec. 49.45 (61). (Accessed Feb. 2021).

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Wyoming

Last updated 02/28/2021

No reimbursement for email.

No reimbursement for telephone.

No reimbursement …

Medicaid & Medicare

Email, Phone & Fax

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