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State Medicaid telehealth coverage

Federal waivers allow broad coverage for telehealth through Medicaid, but COVID-19 reimbursement policies vary state to state.

Medicaid coverage differs from state to state. Most states have expanded Medicaid coverage for telehealth during the COVID-19 public health emergency. For instance, many states are now allowing:

  • Telehealth services via telephone, electronic and virtual means
  • Home as the originating site for telehealth
  • Coverage and pay parity for telehealth services
  • Asynchronous telehealth services

For the latest information on state-specific billing and reimbursement policies, the National Policy Center - Center for Connected Health Policy has created an inventory of COVID-19 related state actions that details each state’s requirements for billing telehealth during the emergency period (and in some cases, even after the emergency declaration ends). The Center for Connected Health Policy also has information on permanent state telehealth laws and reimbursement policies.

Billing tips for providers:

Learn more on the Billing for Providers - What Should I Know? Tip Sheet

This tip sheet provides an overview on reimbursement for telehealth services with Medicare, Medicaid, and private payors.

Preventing Medicaid and CHIP coverage lapse

You can help your patients prevent lapses in coverage through the “unwinding” process if they are insured through state Medicaid and/or Children’s Health Insurance Program (CHIP).

The Centers for Medicare & Medicaid Services offer education and information on patient communication with Consumer Research on Unwinding Phase 1 — Preventing the Churn (PDF).

You can ensure patients are aware that action is required and let them know what action must be taken to prevent a coverage lapse. This includes keeping their address updated, monitoring their mail, and being aware of their Medicaid or CHIP expiration dates.

The Centers for Medicare & Medicaid Services offers these patient resources in English and Spanish:

Did you know?

Medicaid programs have the ability to cover and reimburse for Medicaid services delivered using audio-only telehealth technologies. Learn more here: State Medicaid & CHIP Telehealth Toolkit: Supplement #1 (PDF)

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