Wyoming

CURRENT STATE LAWS & POLICY

AT A GLANCE

Medicaid Program

Wyoming Medicaid

Administrator

Office of Equality Care, under the Wyoming Dept. of Health

Regional Telehealth Resource Center

Northwest Regional Telehealth Resource Center

Medicaid Reimbursement

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

Private Payer Law

Law Exists: No
Payment Parity: No

Professional Requirements

Licensure Compacts:
IMLC, NLC, ASLP-IC, EMS
Consent Requirements: Yes

Last updated 02/28/2021

Audio-Only Delivery

Medicaid: Telehealth Changes for COVID-19

STATUS: Active

Medicaid:  FQHC/RHC Tribal Facilities

STATUS: Active

Medicaid:  Home Health COVID-19

STATUS: Active

Medicaid:  BH Peer Specialist via Telehealth

STATUS: Active

Medicaid 1915(c) Waiver:  Appendix K – Supports Waiver

STATUS: Expired January 26, 2021; extended through Appendix K Addendum

Medicaid 1915(c) Waiver: Appendix K Extension – Supports Waiver

STATUS: Active, until 6 months after the conclusion of the public health emergency

Medicaid 1915(c) Waiver:  Appendix K – Children’s Mental Health Waiver

STATUS: Expired February 28, 2021

Medicaid 1915(c) Waiver: Appendix K – Community Choices Waiver

STATUS: Expired January 26, 2021; extended through Appendix K Addendum

Medicaid 1915(c) Waiver: Appendix K Extension – Community Choices Waiver

STATUS: Active, until 6 months after the conclusion of the public health emergency

Last updated 02/28/2021

Cross-State Licensing

Board of Medicine: Public Health Emergency FAQs

STATUS: Active

Mental Health Professions Board: Licensing for Telehealth Delivered Care

STATUS: Active, until 30 days after the day the Governor of the State of Wyoming lifts the state of emergency

Last updated 02/28/2021

Easing Prescribing Requirements

Board of Medicine: Public Health Emergency FAQs

STATUS: Active

Last updated 02/28/2021

Miscellaneous

No Reference Found

Last updated 02/28/2021

Originating Site

Medicaid:  Home Health COVID-19

STATUS: Active

Last updated 02/28/2021

Private Payer

Insurance Department:  Telehealth Service Delivery

STATUS: Expired

Last updated 02/28/2021

Provider Type

Medicaid:  FQHC/RHC Tribal Facilities

STATUS: Active

Medicaid:  Home Health COVID-19

STATUS: Active

Medicaid:  BH Peer Specialist via Telehealth

STATUS: Active

Medicaid:  BH Group Therapy via Telehealth

STATUS: Active

Last updated 02/28/2021

Service Expansion

Medicaid: Telehealth Changes for COVID-19

STATUS: Active

Medicaid:  FQHC/RHC Tribal Facilities

STATUS: Active

Medicaid:  Home Health COVID-19

STATUS: Active

Medicaid:  BH Peer Specialist via Telehealth

STATUS: Active

Medicaid:  BH Group Therapy via Telehealth

STATUS: Active

Last updated 04/27/2021

Definitions

“Telehealth is the use of an electronic media to link beneficiaries with health professionals in different locations.  The examination of the client is performed via a real-time interactive audio and video telecommunications system. This means that the client must be able to see and interact with the off-site practitioner at the time services are provided via telehealth technology.”

SOURCE: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 112 (Jan. 1 2021) , WY Division of Healthcare Financing Tribal Provider Manual, pg. 111 (Jan. 2021) & Institutional Provider Manual pg. 109.  (Accessed Apr. 2021).

Last updated 02/28/2021

Live Video

POLICY

Reimbursement is made for exams performed via a real-time interactive audio and video telecommunications system. The quality must be sufficient enough to assure the accuracy of the assessment, diagnosis, and visible evaluation of symptoms and potential medication side effects. A medical professional is not required to be present with the client at the originating site unless medically indicated. See manual for additional billing requirements.

SOURCE: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 113-114 (Jan. 2021). (Accessed Feb. 2021).


ELIGIBLE SERVICES/SPECIALTIES

See manual for billing examples.

Quality assurance/improvement activities relative to telehealth delivered services need to be identified, documented and monitored. An evaluation process must also be instituted.

Documentation must indicate the visit took place via telehealth and must clearly identify the location of the hub and spoke sites.

Group psychotherapy is not a covered service.

For ESRD-related services, at least one face-to-face “hands on” visit must be furnished each month to examine the vascular access site by a qualified provider.

The same procedure codes and rates apply for telehealth as in person.  The modifier GT is used to identify the professional telehealth service.  Services must be medically necessary, follow generally accepted standards of care and be a service covered by Medicaid.

SOURCE: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 114-116 (Jan. 2021). (Accessed Feb. 2021).

Diabetes Prevention Program (DPP)

The first session of a DPP program cannot be performed via telehealth, but sessions 2-16 can be.  The GT modifier should be used.

SOURCE: WY Dept. of Public Health Insurance, Medicaid, Bulletin:  Introducing Medicaid’s Diabetes Prevention Program.  12/19.  (Accessed Feb.  2021).


ELIGIBLE SITES

Each site will be able to bill for their own services as long as they are an enrolled Medicaid provider (this includes out-of-state Medicaid providers). Providers shall not bill for both the spoke and hub site; unless, the provider is at one location and the client is at a different location even though the pay to provider is the same.

The Originating Site or Spoke site is the location of an eligible Medicaid client at the time the service is being furnished via telecommunications system occurs.

Authorized originating sites:

  • Hospitals;
  • Physician or practitioner offices (includes medical clinics);
  • Psychologists or neuropsychologists offices;
  • Community mental health or substance abuse treatment centers (CMHC/SATC);
  • Advanced practice nurses with specialty of psychiatry/mental health offices;
  • Office of a Licensed Mental Health Professional;
  • Federally Qualified Health Centers;
  • Rural Health Clinics;
  • Skilled nursing facilities;
  • Indian Health Services Clinics;
  • Hospital-based or Critical Access Hospital-based renal dialysis centers (including satellites). Independent renal dialysis facilities are not eligible originating sites;
  • Development Center;
  • Family Planning Clinics;
  • Public Health Offices

A medical professional is not required to be present at the originating site, unless medically indicated.

SOURCE: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 112-113 (Jan. 2021), WY Division of Healthcare Financing Tribal Provider Manual, pg. 112, (Jan. 2021) & Institutional Provider Manual pg. 110. (Accessed Feb. 2021).


GEOGRAPHIC LIMITS

No Reference Found


FACILITY/TRANSMISSION FEE

Providers are not allowed to bill Q3014 for the originating site when the originating site is the client’s home. This applies to when the client uses personal telephone or computer while at an authorized originating site or when the client is at any location that is not listed below:

  • Hospitals
  • Office of a physician or other practitioner (this includes medical clinics)
  • Office of a psychologist or neuropsychologist
  • Community mental health or substance abuse treatment center (CMHC/SATC)
  • Office of an advanced practice nurse (APN) with specialty of psych/mental health
  • Office of a Licensed Mental Health Professional (LCSW, LPC, LMFT, LAT)
  • Federally Qualified Health Center (FQHC)
  • Rural Health Clinic (RHC)
  • Skilled nursing facility (SNF)
  • Indian Health Services Clinic (IHS)
  • Hospital-based or Critical Access Hospital-based renal dialysis centers (including satellites).
  • Independent Renal Dialysis Facilities are not eligible originating sites
  • Developmental Center
  • Family Planning Clinics
  • Public Health Offices

SOURCE: WY Medicaid Bulletin, Telehealth Providers Originating Site. 12/10/20. (Accessed Feb. 2021).

Yes, for originating site fees.

No reimbursement for transmission fees.

Providers cannot bill for Q3014 if clients used their own equipment, such as personal phones or computers.

SOURCE: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 114-115 (Jan. 2021). (Accessed Feb. 2021).

Miscellaneous

Telehealth services must be properly documented when offered at the discretion of the provider as deemed medically necessary.

A single pay to provider can bill both the originating site (spoke site) and the distant site provider (hub site) when applicable.

SOURCE: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 112-113 (Jan. 2021). (Accessed Feb. 2021).

No reimbursement for:

  • The use or upgrade of technology;
  • Transmission charges;
  • Charges of an attendant who instructs a patient on the use of the equipment or supervises/monitors a patient during the telehealth encounter; or
  • Consults between health professionals.

The GT modifier must be billed by the distant site.

SOURCE: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 114-115 (Jan. 2021). (Accessed Feb. 2021).

Last updated 02/28/2021

Out of State Providers

Out-of-state providers are allowed if they are enrolled as a Wyoming Medicaid provider.

SOURCE WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 112 (Jan. 2021). (Accessed Feb. 2021).

Last updated 04/27/2021

Overview

Wyoming Medicaid reimburses for live video under some circumstances. There is no reference to store-and-forward or remote patient monitoring reimbursement.

Last updated 02/28/2021

Remote Patient Monitoring

POLICY

No Reference Found


CONDITIONS

No Reference Found


PROVIDER LIMITATIONS

No Reference Found


OTHER RESTRICTIONS

No Reference Found

Last updated 02/28/2021

Store and Forward

POLICY

Wyoming Medicaid states that for payment to occur, real-time interactive audio and video telecommunications must be used.

SOURCE: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 114 (Jan. 2021). (Accessed Feb. 2021).


ELIGIBLE SERVICES

No Reference Found


GEOGRAPHIC LIMITS

No Reference Found


TRANSMISSION FEE

No Reference Found

Last updated 02/28/2021

Definition

No Reference Found

Last updated 02/28/2021

Parity

SERVICE PARITY

No Reference Found


PAYMENT PARITY

No Reference Found

Last updated 02/28/2021

Requirements

No Reference Found

Last updated 02/28/2021

Cross State Licensing

No Reference Found

Last updated 02/28/2021

Definitions

Physicians and Surgeons

“Telemedicine means the practice of medicine by electronic communication or other means from a physician in a location to a patient in another location, with or without an intervening health care provider.”

SOURCE: WY Statutes Sec. 33-26-102.(a(xxix))  (Accessed Feb. 2021).

Occupational Therapy

“Occupational therapy telehealth means the provision of occupational therapy services across a distance, using telecommunications technology for the evaluation, intervention or consultation without requiring the occupational therapist and recipient to be physically located in the same place.”

SOURCE: WY Statutes Sec. 33-40-102.(a(v)) (Accessed Feb. 2021).

Board of Chiropractic Examiners

“Telehealth” means the delivery of healthcare services using electronic communications, information technology, or other means between a licensee in one location and a patient in another location with or without an intervening healthcare provider.

SOURCE: WY Admin Rules. Board of Chiropractic Examiners. Ch. 1, Sec. 3 (t). (Accessed Feb. 2021).

Physical Therapy

“Consultation by means of telecommunications” means that a physical therapist renders professional or expert opinion or advice to another physical therapist or health care provider via telecommunications or computer technology from a distant location. It includes the transfer of data or exchange of educational or related information by means of audio, video, or data communications.

SOURCE: WY Admin Rules. Board of Physical Therapy. Ch. 1 Sec. 4 (d). (Accessed Feb. 2021).

Audiology

“Telehealth” means the application of telecommunication technology to deliver audiology or speech-language pathology services at a distance for assessment, intervention, and/or consultation.

SOURCE: WY Statutes Annotated Sec. 33-33-402, Sec. 2(y). (Accessed Feb. 2021).

Speech Language Pathology

“Telehealth” means the delivery of speech-language pathology or audiology services using electronic communications, information technology, or other means between a Licensee in one location and a patient in another location.

SOURCE: WY Admin Rules. Board of Examiners of Speech-Language Pathology and Audiology Ch. 13, Sec. 2(b). (Accessed Feb. 2021).

Last updated 02/28/2021

Licensure Compacts

Member of the Interstate Medical Licensure Compact.

SOURCE: Interstate Medical Licensure Compact. The IMLC (Accessed Feb. 2021).

Member of the Audiology and Speech-Language Pathology Interstate Compact.

SOURCE: ASLP Compact.  (Accessed Feb. 2021).

Member of the Nurse Licensure Compact

SOURCE: Nurse Licensure Compact (Accessed Feb. 2021).

Member of Recognition of EMS Personnel Licensure Interstate Compact.

SOURCE: MS Compact Member States & Commissioners. (Accessed Feb. 2021).

Last updated 02/28/2021

Miscellaneous

Boards have power to adopt telehealth/telemedicine definitions applicable to their regulated profession and standards for the practice of telemedicine/telehealth.

SOURCE:  WY Code 33-1-303(a(iv)) (HB 164 – 2017). (Accessed Feb. 2021).

Last updated 02/28/2021

Online Prescribing

Prescribing a controlled substance through the Internet, World Wide Web or any similar proprietary or common carrier electronic system without a documented physician-patient relationship is subject to review, discipline and consequences to license.

SOURCE: WY Statutes Annotated Sec. 33-26-402(a(xxxiii)). (Accessed Feb. 2021).

Last updated 02/28/2021

Professional Board Standards

WY Board of Chiropractic Examiners

SOURCE: WY Admin. Code, Chiropractic Board, Ch. 11, Accessed Feb. 2021.

WY Board of Occupational Therapy

SOURCE: WY Admin Rules. Board of Occupational Therapy. Ch. 3, (Accessed Feb. 2021).

WY Board of Physical Therapy

SOURCE: WY Admin Rules. Board of Physical Therapy. Ch. 1, (Accessed Feb. 2021).

WY Board of Examiners of Speech-Language Pathology and Audiology

SOURCE: WY Admin Rules, Speech Language Pathology and Audiology, Ch. 13, Sec. 2(b). Accessed Feb. 2021.