Monitor on Psychology - July/August 2012

More states reimburse for telehealth services

In October, Maryland will become the 13th state to require private sector insurance companies to pay for telehealth services. Maryland joins California, Colorado, Georgia, Hawaii, Kentucky, Louisiana, Maine, New Hampshire, Oklahoma, Oregon, Texas and Virginia in mandating that private payers cover telehealth services that are considered medically necessary and would otherwise be covered when provided face-to-face.

While reimbursement varies by insurer and state, this latest measure seems to be part of a growing trend toward reimbursement for telehealth services. Maryland’s law defines telemedicine (or telehealth) as “interactive audio, video or other telecommunications or electronic technology ... to deliver a health care service.” As such, the law does not apply to audio-only phone conversations, email messages or faxes between providers and patients.

The law requires that health insurers and managed care
organizations provide coverage for health care services
provided appropriately using telehealth technology, and that
coverage cannot be denied because services were provided
through telehealth rather than in person. Insurers are not
required to cover telehealth services if the health services would
not be a covered benefit even if provided in person, or if the
provider is out-of-network.