Last updated 04/09/2026
Consent Requirements
Last updated 04/09/2026
Definitions
Telehealth or telemedicine services are services a physician provides via two-way, interactive technology (or telehealth). Telehealth substitutes for an in-person visit and generally involves two-way, interactive technology permitting communication between the provider and patient.
For purposes of this section, the definitions and requirements in the U.S. Virgin Islands Code, Title 27, Chapter 1, Subchapter IIa apply:
- “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 the provision of consumer medical and health information that are performed as part of a telemedicine procedure.
Generally, the VI Medicaid Program uses the term telehealth, unless quoting another source. Both terms are meant to include the same services.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 38. (Accessed Apr. 2026).
Crisis Intervention Program
Telehealth Services. Delivery of health care services, through the use of interactive real-time visual and audio or other electronic media for the purpose of consultation and education concerning diagnosis, treatment, care management and self-management of patient’s physical and mental health and includes real-time interaction between the patient and the telehealth provider, synchronous encounters, asynchronous encounters, store, and forward transfers and telemonitoring.
SOURCE: VI Code annotated 19 VIC Sec. 1020. (Accessed Apr. 2026).
Last updated 04/09/2026
Email, Phone & Fax
Modifier 93 is used for audio-only communication:
- Permitted for patients in their home if patient does not have:
- Technical capacity
- Availability of real-time audio and visual interactive technology
- Permitted for patients in their home if patient does not:
- Consent to the use of two-way, audio/video technology
RHCs and FQHCs can report either modifier 93 or FQ for services provided by audio-only technology. The FQ modifier is only used by RHCs and FQHCs.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 42. (Accessed Apr. 2026).
Except as described below, only the provider at the Distant Site may receive payment for telehealth services. Providers at the Distant Site must bill for the underlying covered service using the same claims they would if it were delivered face-to-face.
When billing for Telephone Evaluation and Management Services, providers at the Distant (provider) Site must use the appropriate Evaluation and Management (E/M) code, place of service, and modifier 93, as applicable.
Any medically necessary physician service may be delivered via telehealth if the following requirements are met:
- The member is otherwise eligible for the covered service.
- The service delivered by telehealth is of comparable quality to what it would be if delivered in-person.
- The service is included in the Medicare list of telehealth services payable under the Medicare Physician Fee Schedule when furnished via telehealth.
- Coverage of services will not be limited based on geography or location.
PA is required for telehealth services only if PA is required for the underlying covered service. If required, the PA is the usual PA for the underlying covered service, rather than a PA for the mode of delivery. Unless otherwise required by law, a face-to-face encounter is not required before delivering telehealth services. Telehealth services are subject to all conditions and restrictions applicable to all providers described in this General Information manual.
The following items or services are not covered:
- Services otherwise covered but specifically excluded from telehealth coverage include, but are not limited to, the following:
- Services that require direct physical contact with a member by a healthcare provider and that cannot be delegated to another provider at the site where the member is located are not covered.
- Any service that is medically inappropriate for delivery through telehealth services, e.g., services that include providing medical procedures or administration of medications that must be conducted in person.
- Communications between healthcare providers when the member is not participating.
- Communications solely between providers and members when such communications would not otherwise be billable.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 39. (Accessed Apr. 2026).
While the VI Medicaid Program covers tobacco cessation services, the VI Medicaid Program does not cover group sessions or telephone conversations between the provider and member under the evaluation and management (E/M) procedure codes.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Physician Services Manual (2026) p. 60. (Accessed Apr. 2026).
Last updated 04/09/2026
Live Video
Policy
If a member is eligible for the underlying covered service and delivery of the covered service via telehealth is medically appropriate, as determined by the physician, the member is eligible for telehealth services.
Services are to be billed in accordance with all other applicable requirements. Payment for services delivered via telehealth will be made in the same manner as when the service is furnished in a face-to-face setting. Providers are to report appropriate place of service codes and applicable modifiers as described below.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 38, 40. (Accessed Apr. 2026).
Eligible Services/Specialties
All telemedicine services must be prior authorized, regardless of the sites of origin or destination.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 8. (Accessed Apr. 2026).
Any medically necessary physician service may be delivered via telehealth if the following requirements are met:
- The member is otherwise eligible for the covered service.
- The service delivered by telehealth is of comparable quality to what it would be if delivered in-person.
- The service is included in the Medicare list of telehealth services payable under the Medicare Physician Fee Schedule when furnished via telehealth.
- Coverage of services will not be limited based on geography or location.
PA is required for telehealth services only if PA is required for the underlying covered service. If required, the PA is the usual PA for the underlying covered service, rather than a PA for the mode of delivery. Unless otherwise required by law, a face-to-face encounter is not required before delivering telehealth services. Telehealth services are subject to all conditions and restrictions applicable to all providers described in this General Information manual.
The following items or services are not covered:
- Services otherwise covered but specifically excluded from telehealth coverage include, but are not limited to, the following:
- Services that require direct physical contact with a member by a healthcare provider and that cannot be delegated to another provider at the site where the member is located are not covered.
- Any service that is medically inappropriate for delivery through telehealth services, e.g., services that include providing medical procedures or administration of medications that must be conducted in person.
- Communications between healthcare providers when the member is not participating.
- Communications solely between providers and members when such communications would not otherwise be billable.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 38-39. (Accessed Apr. 2026).
When billing for Telephone Evaluation and Management Services, providers at the Distant (provider) Site must use the appropriate Evaluation and Management (E/M) code, place of service, and modifier 93, as applicable.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 40. (Accessed Apr. 2026).
Billing modifier G0 applies when Telehealth services are furnished for purposes of diagnosis, evaluation, or treatment of symptoms of an acute stroke and the Telehealth Distant Site codes are billed with place of service (POS) code 02. See manual for more information on telehealth billing modifiers.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 42. (Accessed Apr. 2026).
Eligible Providers
To be eligible for reimbursement for telehealth services, a provider must:
- Act within the scope of their license
- Be enrolled as a USVI Medicaid provider
- Be otherwise eligible to deliver the covered service according to the requirements of USVI Medicaid
For physician providers located outside of USVI, the provider must have been issued a telemedicine license by the USVI Board of Medical Examiners. This license authorizes certain physicians who hold a full and unrestricted license to practice medicine in another state or territory of the United States to provide telehealth services in the Virgin Islands.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 38-39. (Accessed Apr. 2026).
Except as described below, only the provider at the Distant Site may receive payment for telehealth services. Providers at the Distant Site must bill for the underlying covered service using the same claims they would if it were delivered face-to-face.
When billing for Telephone Evaluation and Management Services, providers at the Distant (provider) Site must use the appropriate Evaluation and Management (E/M) code, place of service, and modifier 93, as applicable.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 40. (Accessed Apr. 2026).
For institutional billing, use modifier 95 when:
- The clinician is in the hospital, and the patient is in their home.
- Outpatient therapy provided via telehealth by physical therapists (PTs), occupational therapists (OTs), or speech-language pathologists (SLPs) employed by hospitals.
See manual for more information on billing modifiers.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 42. (Accessed Apr. 2026).
Eligible Sites
All telemedicine services must be prior authorized, regardless of the sites of origin or destination.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 8. (Accessed Apr. 2026).
Providers must maintain documentation at the Originating Site and the Distant Site to verify services provided, except when the Originating Site is the member’s residence. The documentation must indicate the services that were rendered via telehealth and the location of both the Originating and Distant Sites.
The providers at the Distant and Originating Sites may be part of the same organization.
Originating (Member) Site
- The provider at the Originating Site may not bill for assisting the provider at the Distant Site with an examination.
- No separate transmission fees will be paid for telehealth services.
- The healthcare provider at the Originating (Member) Site may bill for any clinical services provided on-site on the same day that a telehealth service claim is made, except as specifically excluded elsewhere in this section.
- Telehealth services may be included in the FQHC scope of practice, as approved by USVI. If approved, these facilities may serve as the provider site and bill under the encounter rate.
- If the technical component of an X-ray, ultrasound, or electrocardiogram is performed at the Originating (member) Site during a telehealth service, the technical components are billed by the healthcare provider at the Originating (member) Site.
- The professional component of the procedure and the appropriate visit code are billed by the Distant Site.
Report the following POS as appropriate for telehealth services to indicate where the patient was located when receiving telehealth services:
- POS 02 — Telehealth Provided Other than in Patient’s Home
- Description: The location where health services and health related services are provided or received, through telecommunication technology. Patient is not located in the home when receiving health services or health related services through telecommunication technology.
- POS 10 — Telehealth Provided in Patient’s Home
- Description: The location where health services and health related services are provided or received through telecommunication technology. Patient is in the home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health related services through telecommunication technology.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 40-41. (Accessed Apr. 2026).
Geographic Limits
Coverage of services will not be limited based on geography or location.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 38. (Accessed Apr. 2026).
Facility/Transmission Fee
VI Medicaid will not separately reimburse providers for any charge related to the purchase, installation, or maintenance of telehealth equipment or technology, nor any transmission fees. Providers shall not bill members for such costs or fees.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 40. (Accessed Apr. 2026).
Last updated 04/09/2026
Miscellaneous
Providers must ensure that the telecommunication technology and equipment used at the Distant (provider) Site and the Originating (member) Site are sufficient to allow the provider to appropriately provide services to the member.
Providers must comply with all federal, state, and local regulations that apply to their business. Any telehealth services that use networked services must comply with HIPAA requirements. A telehealth service shall be performed on a secure telecommunications line or utilize a method of encryption adequate to protect the confidentiality and integrity of the telehealth service information in accordance with state and federal laws, rules, and regulations.
Both the Originating Site and the Distant Site shall use authentication and identification to ensure confidentiality.
All providers shall implement confidentiality protocols that include, but are not limited to:
- Identifying personnel who have access to a telehealth transmission
- Usage of unique passwords or identifiers for each employee or person with access to a telehealth transmission
- Preventing unauthorized access to a telehealth transmission
A provider’s protocols and guidelines shall be available for inspection by DHS upon request.
Members may access services via telehealth through their personal computer by using a vrtual private network (VPN) established and maintained by the provider that meets the equipment standards stated in this policy.
Telehealth services are available via web-based applications and/or Medicaid agency phone applications (apps) as long as they meet the current HIPAA and other federal and territory requirements and use a VPN.
Providers must maintain documentation at the Originating Site and the Distant Site to verify services provided, except when the Originating Site is the member’s residence. The documentation must indicate the services that were rendered via telehealth and the location of both the Originating and Distant Sites.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 39-40. (Accessed Apr. 2026).
Crisis Intervention Program
The Director with the approval of the Commissioner shall establish Crisis Intervention and Prevention Services. This is a community-based program shall provide counseling, consultation, evaluation, treatment and referral, education, and training services, delivered by a crisis intervention team. The program must be designed for persons with behavioral challenges, mental health disorders or substance use disorders who experience a behavioral crisis that threatens their ability to live a full, productive life due to hospitalizations, law enforcement involvement, or placement in restrictive settings. The Department of Health, Division of Behavioral Health shall support persons in the development of behavioral assessments, individualized behavior treatment plans, and intensive intervention with a focus on family coaching.
The program shall provide the following services:
- Emergency room services. Crisis intervention and psychiatric emergency services based in a hospital emergency room;
- Outreach services. Outreach services and crisis intervention beyond the hospital setting;
- Telephone hot-line services. A community-based telephone crisis intervention hot-line offering 24-hour, 7-days-a-week counseling, consultation, evaluation, treatment and referral services;
- Telehealth Services. Delivery of health care services, through the use of interactive real-time visual and audio or other electronic media for the purpose of consultation and education concerning diagnosis, treatment, care management and self-management of patient’s physical and mental health and includes real-time interaction between the patient and the telehealth provider, synchronous encounters, asynchronous encounters, store, and forward transfers and telemonitoring;
- Transportation of persons in crisis to and from the hospital or institution; and
- Suicide Prevention and School Counseling Program: a program in cooperation and coordination with the Department of Education, Department of Human Services, and the Police shall develop a suicide prevention strategy and an evidence-based model suicide prevention program, counseling for bullying, cyberbullying, and peer pressure counseling to be presented in the elementary, junior, middle, and high schools in the Territory which must include the preparation of relevant educational materials that must be distributed in the schools.
SOURCE: VI Code annotated 19 VIC Sec. 1020. (Accessed Apr. 2026).
Mobile Integrated Healthcare Programs
Mobile Integrated Healthcare (“MIH”) means patient-centered care delivered in a patient’s home or in a mobile environment that focuses on improving patient outcomes by integrating the larger spectrum of community healthcare and technology.
MIH components include traditional emergency medical services (“EMS”) response, community paramedics, physician assistants, nurse practitioners, community health workers, social workers, mental health providers, 911 nurse triage lines, public safety, telemedicine, and alternate destination or emergency room diversion.
A Department-approved MIH program, including MIH programs with an emergency department avoidance component, that utilizes healthcare personnel to deliver healthcare services to patients in an out-of-hospital environment in coordination with healthcare facilities or healthcare providers may provide healthcare services such as chronic disease management, dental care, behavioral health, maternal and infant health, preventative care, post-discharge follow-up visits, or transport or referral to facilities other than a hospital emergency department.
The Virgin Islands Department of Health (“Department”) shall develop and approve mobile integrated healthcare programs consistent with its role as the territorial lead agency for healthcare-related services. In so doing, the Department shall consider the following:
- the type of healthcare that can be provided under the program;
- the training, educational, and certification requirements for community paramedics and other healthcare personnel in providing services under the program;
- the degree of oversight, reporting, and enforcement needed for the program;
- relevant standards and criteria developed or adopted by nationally recognized agencies or organizations; and
- the recommendations of interested stakeholders.
The Department, pursuant to its mandate under 3 V.I.C. § 418(a) and its responsibility under 3 V.I.C. § 418(a)(11), and its licensing and certification authority under chapter 15 of this title, shall establish or approve MIH programs that meet the following criteria:
- provide pre-hospital and post-hospital services as a coordinated continuum of care that fully supports the patient’s medical needs;
- address gaps in service delivery and prevent unnecessary hospitalizations, or other harmful and wasteful resource delivery;
- focus on partnerships through contracts or otherwise between healthcare providers and healthcare facilities, as defined in this chapter, respectively, that promote coordination and utilization of existing personnel and resources without duplication of services;
- adhere to clinical standards and protocols adopted by the Department to ensure that MIH healthcare providers employed by healthcare facilities provide healthcare services or treatment within their scope of practice;
- dispatch only those community paramedics or other healthcare providers employed by a healthcare facility who have—received appropriate training and demonstrate competency in the MIH clinical protocols;
- meet appropriate standards related to capacity, location, personnel, and equipment;
- provide access to qualified medical control and medical direction;
- provide a secure and effective medical communication subsystem linkage for online medical direction;
- have an activated 911 system to ensure that if an MIH program patient experiences a medical emergency during an MIH visit there will be a rapid response by emergency services;
- ensure compliance with all territorial and federal privacy requirements regarding patient medical records and other individually identified patient health information; and
- ensure that healthcare providers operating MIH programs collect and maintain data of mobile integrated health services, including statistics on mortality and morbidity; the information needed to review access, availability, quality, cost, and third-party reimbursement for the services; and coordinate and perform the data collection in conjunction with other data-collection activities.
In addition, the Department shall examine how 911 triage assessment tools may be incorporated into MIH, with the objective of enhancing the efficiency and effectiveness of MIH programs.
SOURCE: VI Statute, 19 VIC Sec. 156. (Accessed Apr. 2026).
School Health Program
The Commissioner of Education, with the collaboration of the Commissioner of Health as hereinafter provided, shall establish, maintain and administer a school health program in the Virgin Islands. Such program shall include; health services, health education and instruction, and healthful environment. The Commissioner of Education shall employ a school nurse supervisor per district. School nurse supervisors must be a registered nurse or physician assistant empowered to hire and directly supervise school health technicians who work under the supervision of the school nurse supervisors. The Commissioner of Education shall develop a job description and standard operating procedures including telehealth for the school nurse supervisors and school health technicians. The Commissioner of Health must review and approve the job descriptions and standard operating procedures.
SOURCE: 17 V.I.C. § 111. (Accessed Apr. 2026).
Last updated 04/09/2026
Out of State Providers
To be eligible for reimbursement for telehealth services, a provider must:
- Act within the scope of their license
- Be enrolled as a USVI Medicaid provider
- Be otherwise eligible to deliver the covered service according to the requirements of USVI Medicaid
For physician providers located outside of USVI, the provider must have been issued a telemedicine license by the USVI Board of Medical Examiners. This license authorizes certain physicians who hold a full and unrestricted license to practice medicine in another state or territory of the United States to provide telehealth services in the Virgin Islands.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 38-39. (Accessed Apr. 2026).
Last updated 04/10/2026
Overview
According to a recently published United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual, U.S. VI Medicaid covers live video and audio-only telehealth services in certain circumstances. Services eligible for reimbursement should be included in the Medicare list of telehealth services. Payment for services delivered via telehealth will be made in the same manner as when the service is furnished in a face-to-face setting.
New U.S. VI Medicaid provider manual references to telehealth coverage largely align with previously cited references to telehealth as a Medicaid covered benefit in COVID-19 documentation as well (see COVID-19 Telehealth Information Beneficiary Flyer, Virgin Islands Medical Assistance Program (VIMAP) Telemedicine and Telehealth Policy Statement, and Virgin Islands State Plan Amendment for more information), indicating the COVID-19 documentation continues to be active and applicable outside of the Public Health Emergency. See the United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual for the most up-to-date and comprehensive telehealth reimbursement information.
Last updated 04/09/2026
Remote Patient Monitoring
Policy
Telehealth or telemedicine services are services a physician provides via two-way, interactive technology (or telehealth). Telehealth substitutes for an in-person visit and generally involves two-way, interactive technology permitting communication between the provider and patient.
For purposes of this section, the definitions and requirements in the U.S. Virgin Islands Code, Title 27, Chapter 1, Subchapter IIa apply:
- “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 the provision of consumer medical and health information that are performed as part of a telemedicine procedure.
Generally, the VI Medicaid Program uses the term telehealth, unless quoting another source. Both terms are meant to include the same services.
Services eligible for reimbursement must be included in the Medicare list of telehealth services payable under the Medicare Physician Fee Schedule when furnished via telehealth.
The following items or services are not covered:
- Services otherwise covered but specifically excluded from telehealth coverage include, but are not limited to, the following:
- Services that require direct physical contact with a member by a healthcare provider and that cannot be delegated to another provider at the site where the member is located are not covered.
- Any service that is medically inappropriate for delivery through telehealth services, e.g., services that include providing medical procedures or administration of medications that must be conducted in person.
- Communications between healthcare providers when the member is not participating.
- Communications solely between providers and members when such communications would not otherwise be billable.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 38-39. (Accessed Apr. 2026).
Conditions
No reference found.
Provider Limitations
No reference found.
Other Restrictions
No reference found.
Last updated 04/09/2026
Store and Forward
Policy
Telehealth or telemedicine services are services a physician provides via two-way, interactive technology (or telehealth). Telehealth substitutes for an in-person visit and generally involves two-way, interactive technology permitting communication between the provider and patient.
For purposes of this section, the definitions and requirements in the U.S. Virgin Islands Code, Title 27, Chapter 1, Subchapter IIa apply:
- “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 the provision of consumer medical and health information that are performed as part of a telemedicine procedure.
Generally, the VI Medicaid Program uses the term telehealth, unless quoting another source. Both terms are meant to include the same services.
Services eligible for reimbursement must be included in the Medicare list of telehealth services payable under the Medicare Physician Fee Schedule when furnished via telehealth.
The following items or services are not covered:
- Services otherwise covered but specifically excluded from telehealth coverage include, but are not limited to, the following:
- Services that require direct physical contact with a member by a healthcare provider and that cannot be delegated to another provider at the site where the member is located are not covered.
- Any service that is medically inappropriate for delivery through telehealth services, e.g., services that include providing medical procedures or administration of medications that must be conducted in person.
- Communications between healthcare providers when the member is not participating.
- Communications solely between providers and members when such communications would not otherwise be billable.
SOURCE: United States Virgin Islands Department of Human Services Medicaid Division Providers’ General Information Manual (2026) p. 38-39. (Accessed Apr. 2026).
Eligible Services/Specialties
No reference found.
Geographic Limits
No reference found.
Facility/Transmission Fee
No reference found.
