PLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction. This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.
At A GlancePLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction. This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.
Last updated 05/27/2024
Telemedicine means the use of electronic information and communication technology to deliver healthcare services, including without limitation the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient. Telemedicine includes store-and-forward and remote patient monitoring. For the purposes of this subchapter, “telemedicine” does not include the use of:
Network Adequacy
“ Telemedicine ” means the use of electronic information and communication technology to deliver healthcare services , including without limitation the assessment , diagnosis , consultation , treatment , education , care management , and self- management of a patient , as well as store-and-forward technology and remote patient monitoring .
Ambulance Services
“Telemedicine” means the use of audio-visual electronic information and communication technology to deliver healthcare services, including without limitation the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient.
“Telemedicine” includes store-and-forward technology and remote patient monitoring.
“Telemedicine” does not include the use of audio-only electronic technology.
Last updated 05/27/2024
Health plans must reimburse “on the same basis” if the service were delivered in-person. A health benefit plan is not required to reimburse for a healthcare service provided through telemedicine that is not comparable to the same service provided in-person.
On and after January 1, 2024, a healthcare insurer [includes Medicaid] that offers, issues, or renews a health benefit plan in this state shall provide coverage for:
See statute for additional restrictions.
SOURCE: AR Code 23-79-2703, (Accessed May 2024).
The combined amount of reimbursement that a health benefit plan allows for the compensation to the distant site and the originating site shall not be less than the total amount allowed for healthcare services provided in-person.
The reimbursement rate for an ambulance service whose operators triage, treat, and transport an enrollee to an alternative destination, or triage, treat, and do not transport an enrollee if the enrollee declines to be transported against medical advice, if the ambulance service is coordinating the care of the enrollee through telemedicine with a physician for a medical-based complaint or with a behavioral health specialist for a behavioral-based complaint under this section shall be at least at the rate:
SOURCE: AR Code 23-79-2703, (Accessed May 2024).
Last updated 05/27/2024
A health benefit plan shall provide coverage and reimbursement for healthcare services provided through telemedicine on the same basis as the health benefit plan provides coverage and reimbursement for health services provided in person, unless this subchapter specifically provides otherwise. A health benefit plan is not required to reimburse for a healthcare service provided through telemedicine that is not comparable to the same service provided in-person. A health benefit plan may voluntarily reimburse for healthcare services provided through means described in Sec. 23-79-1601(7)(C).
A healthcare plan must provide a reasonable facility fee to an originating site operated by a healthcare professional or licensed healthcare entity if licensed to bill the health benefit plan.
A health benefit plan cannot prohibit its providers from charging patients directly for services provided by audio-only communication that aren’t reimbursed by the plan.
A health plan may not impose:
Screening for behavioral health conditions and behavioral health services provided as described in subsection (a) of this section may be provided via telemedicine and reimbursed as required under § 23-79-1601 et seq.
Network Adequacy
The Commissioner, pursuant to his or her discretion, may publish more detailed and specific network adequacy time/distance standards, as well as guidelines regarding the use of telemedicine to meet network adequacy standards, via SERFF Network Adequacy Data Submission Instructions, and/or annual bulletin for setting forth certification requirements for ACA submissions. Such new standards will become effective for review on January 1, of the following year.
Ambulance Services
An ambulance service’s operators may triage and transport a patient to an alternative destination in this state or treat in place if the ambulance service is coordinating the care of the patient through telemedicine with a physician for a medical-based complaint or with a behavioral health specialist for a behavioral-based complaint.
SOURCE: AR Code 20-13-108, (Accessed May 2024).
On and after January 1, 2024, a healthcare insurer [includes Medicaid] that offers, issues, or renews a health benefit plan in this state shall provide coverage for:
See statute for additional restrictions.
SOURCE: AR Code 23-79-2703, (Accessed May 2024).
Last updated 05/27/2024
Healthcare services provided by telemedicine, including without limitation a prescription through telemedicine, shall be held to the same standard of care as healthcare services provided in person. A healthcare provider providing telemedicine services within Arkansas shall follow applicable state and federal laws, rules and regulations regarding:
Occupational Therapy, Physical Therapy and Speech-Language Pathology Services
Parental or guardian consent is required prior to telemedicine service delivery
Provider-Led Arkansas Shared Savings Entity (PASSE) Program
Virtual and telehealth services are provided in lieu of providing the same services at a practice site or provided at the individual’s place of residence. Therefore, these services must have patient consent, be documented in the patient integrated medical records, and submitted as a claims or encounter from a contracted provider as medically necessary service. The provision of virtual care can include an interdisciplinary care team or be provided by individual clinical service provider.
Last updated 05/27/2024
Telemedicine is defined as the use of electronic information and communication technology to deliver healthcare services including without limitation, the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a client. Telemedicine includes store-and-forward technology and remote client monitoring.
Provider-Led Arkansas Shared Savings Entity (PASSE) Program
The use of electronic information and communication technology to deliver healthcare services, including without limitation the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient. It included store-and-forward technology and remote patient monitoring. The following activities will not be considered a reportable encounter when delivered to a member of the PASSE:
Virtual services are telemedicine, telehealth, e-consulting, and provider home visits that are part of a patient care treatment plan and are provided at the individual’s home or in a community setting. These services are provided using mobile secure telecommunication devices, electronic monitoring equipment, and include clinical provider care, behavioral health therapies, speech, occupational and physical therapy services, and treatment provided to an individual at their residence.
Rural Health Centers
Arkansas Medicaid defines telemedicine services as medical services performed as electronic transactions in real time.
“Telemedicine” means the use of electronic information and communication technology to deliver healthcare services, including without limitation the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient.
Telemedicine includes store-and-forward and remote patient monitoring.
For the purposes of this subchapter, “telemedicine” does not include the use of:
Ambulance Services
“Telemedicine” means the use of audiovisual electronic information and communication technology to deliver healthcare services, including without limitation the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient.
“Telemedicine” includes store-and-forward technology and remote patient monitoring.
“Telemedicine” does not include the use of audio-only electronic technology.
Last updated 05/27/2024
A health benefit plan (includes Medicaid) may voluntarily reimburse for healthcare services provided through Sec. 23-79-1601(7)(C). See below.
For the purposes of this subchapter, “telemedicine” does not include the use of:
Telemedicine does not include the use of:
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:
Targeted Care Management – Covered Case Management Services
Face to face or telephone contacts with the beneficiary and/or other individuals for the purpose of assisting in the beneficiary’s needs being met
Life360 HOMES
The Rural Life360 will provide the following care coordination supports: … Provide intensive care coordination and coaching supports for enrolled clients. Intensive care coordination and coaching include: … Providing supports through any of the following:
Life Choices Lifeline and Continuum of Care Program
Program services may be provided, as appropriate, in person through existing facilities or remotely through a telephonic system or other comparable technological system. Any technological or telephonic system used must maintain the confidentiality of Participant information obtained while providing Program services, including security of data in compliance with HIPAA and HITECH, and all state or federal privacy laws.
Last updated 05/27/2024
Arkansas Medicaid provides payment to a licensed or certified healthcare professional or a licensed or certified entity for services provided through telemedicine if the service provided through telemedicine is comparable to the same service provided in-person.
Coverage and reimbursement for services provided through telemedicine will be on the same basis as for services provided in-person. While a distant site facility fee is not authorized under the Telemedicine Act, if reimbursement includes payment to an originating site (as outlined in the above paragraph), the combined amount of reimbursement to the originating and distant sites may not be less than the total amount allowed for healthcare services provided in-person.
Arkansas Medicaid shall provide payment for telemedicine healthcare services to licensed or certified healthcare professionals or entities that are authorized to bill Arkansas Medicaid directly for healthcare services. Coverage and reimbursement for healthcare services provided through telemedicine shall be reimbursed on the same basis as healthcare services provided in person.
Rural Health Centers
In order for a telemedicine encounter to be covered by Medicaid, the practitioner and the patient must be able to see and hear each other in real time.
Occupational Therapy, Physical Therapy and Speech-Language Pathology Services
An enrolled provider may be reimbursed for medically necessary occupational therapy, physical therapy, and speech-language pathology services delivered through telemedicine.
The service provider is responsible for ensuring service delivery through telemedicine is equivalent to in-person, face-to-face service delivery.
Services delivered through telemedicine are reimbursed in the same manner and subject to the same benefit limits as in-person, face-to-face service delivery. View or print the billable telecommunication codes and descriptions.
A health benefit plan [includes Arkansas Medicaid] shall provide coverage and reimbursement for healthcare services provided through telemedicine on the same basis as the health benefit plan provides coverage and reimbursement for health services provided in person, unless this subchapter specifically provides otherwise.
A health benefit plan is not required to reimburse for a healthcare service provided through telemedicine that is not comparable to the same service provided in person.
Covered counseling services are outpatient services. Specific Counseling Services are available to inpatient hospital patients (as outlined in Sections 240.000 and 220.100), through telemedicine, and to nursing home residents. Counseling Services are billed on a per unit or per encounter basis as listed. All services must be provided by at least the minimum staff within the licensed scope of practice to provide the service.
Telemedicine is listed as an allowed delivery mode for certain services throughout the Counseling Services Manual (formerly the Outpatient Behavioral Health Services manual).
Occupational Therapy, Physical Therapy and Speech-Language Pathology Services
An enrolled provider may be reimbursed for medically necessary occupational therapy, physical therapy, and speech-language pathology services delivered through telemedicine.
Occupational therapy, physical therapy, and speech-language pathology evaluation and treatment planning services may not be conducted through telemedicine and must be performed through traditional in-person methods.
Rural Health Centers
Arkansas Medicaid covers RHC encounters and two ancillary services (fetal echography and echocardiography) as “telemedicine” services.
Arkansas Medicaid defines telemedicine services as medical services performed as electronic transactions in real time. In order for a telemedicine encounter to be covered by Medicaid, the practitioner and the patient must be able to see and hear each other in real time. Physician interpretation of fetal ultrasound is covered as a telemedicine service if the physician views the echography or echocardiography output in real time while the patient is undergoing the procedure.
Patient-Led Arkansas Shared Savings Entity (PASSE) Program
Virtual services can be provided using mobile secure telecommunication devices, electronic monitoring equipment and include clinical provider care, behavioral health therapies, speech, occupational and physical therapy services, and treatment provided to an individual at their residence. Virtual provider services may use various evidence-based and innovative independence at-home strategies. They may include the provision of on-going care management, remote telehealth monitoring and consultation, face to face or through the use secure web-based communication and mobile telemonitoring technologies to remotely monitor and evaluate the patient’s functional and health status. Virtual and telehealth services are provided in lieu of providing the same services at a practice site or provided at the individual’s place of residence.
A healthcare professional may use telemedicine to perform group meetings for healthcare services, including group therapy.
Telemedicine for group therapy provided to adults who are participants in a program or plan authorized and funded under 42 U.S.C. § 1396a, as approved by the United States Secretary of Health and Human Services, may only be permitted if the Centers for Medicare and Medicaid Services allows telemedicine for group therapy provided to adults.
Telemedicine shall not be used for group therapy provided to a child who is eighteen (18) years of age or younger.
Home Health
The face-to-face encounter may occur through telemedicine when applicable to the program manual of the performing provider of the encounter.
Behavioral Health Conditions and Services
Screening for behavioral health conditions and behavioral health services as described in subsection (a) of this section may be provided via telemedicine and reimbursed by the Arkansas Medicaid Program as required under § 20-77-141.
SOURCE: AR Code 20-77-149, (Accessed May 2024).
Ambulance Services – Newly Passed Legislation
An ambulance service’s operators may triage and transport a patient to an alternative destination in this state or treat in place if the ambulance service is coordinating the care of the patient through telemedicine with a physician for a medical-based complaint or with a behavioral health specialist for a behavioral-based complaint.
SOURCE: AR Code 20-13-108, (Accessed May 2024).
On and after January 1, 2024, a healthcare insurer [includes Medicaid] that offers, issues, or renews a health benefit plan in this state shall provide coverage for:
See statute for additional restrictions.
The reimbursement rate for an ambulance service whose operators triage, treat, and transport an enrollee to an alternative destination, or triage, treat, and do not transport an enrollee if the enrollee declines to be transported against medical advice, if the ambulance service is coordinating the care of the enrollee through telemedicine with a physician for a medical-based complaint or with a behavioral health specialist for a behavioral-based complaint under this section shall be at least at the rate:
SOURCE: AR Code 23-79-2703, (Accessed May 2024).
Ground ambulance triage, treat, and transport to alternative location/destination services (T3AL) may be covered only when provided by an ambulance company that is licensed and is an enrolled provider in the Arkansas Medicaid Program. An ambulance service may triage and transport a beneficiary to an alternative destination or treat in place if the ambulance service is coordinating the care of the beneficiary through telemedicine with a physician for a medical-based complaint or with a behavioral health specialist for a behavioral-based complaint. Telemedicine rules are described in Section 105.190 and must be followed unless instructions are given within Section II of the prevailing Medicaid manual. The use of audio-only electronic technology is not allowed for T3AL services.
For the purposes of T3AL, a behavioral health specialist is a board-certified psychiatrist or an Independently Licensed Practitioner who can provide counseling services to Medicaid beneficiaries in the Outpatient Behavioral Health program.
Group Therapy – General Professional Requirement (Not Medicaid exclusive)
A healthcare professional may use telemedicine to perform group meetings for healthcare services, including group therapy.
Telemedicine for group therapy provided to adults who are participants in a program or plan authorized and funded under 42 U.S.C. § 1396a, as approved by the United States Secretary of Health and Human Services, may only be permitted if the Centers for Medicare and Medicaid Services allows telemedicine for group therapy provided to adults.
Telemedicine shall not be used for group therapy provided to a child who is eighteen (18) years of age or younger.
Life360 HOMES
The Rural Life360 will provide the following care coordination supports: … Provide intensive care coordination and coaching supports for enrolled clients. Intensive care coordination and coaching include: … Providing supports through any of the following:
AR Independent Assessment (ARIA)
Behavioral Health Services:
A reassessment will be completed by staff employed by the independent assessment contractor utilizing the current approved assessment instrument (ARIA), which was approved prior to April 1, 2021, to assess functional need. An interview will be conducted in person for initial assessments, with the option of using telemedicine to complete Behavioral Health reassessments. The telemedicine tool must meet the 1915(i) requirement for the use of telemedicine under 42 CFR 441.720 (a)(1)(i)(A) through (C).
To continue to receive Complex Care services, members must receive a complex care assessment annually and be assessed as needing Complex Care services. A reassessment will be completed by appropriate DHS-approved staff using the appropriate Complex Care assessment tool. If a member does not meet the need for Complex Care services, the member will be placed back in Tier 3. An in-person interview will be conducted for initial assessments, with the option of using telemedicine to complete reassessments for members who meet the criteria for Complex Care. The telemedicine tool must meet the 1915(i) requirement for the use of telemedicine under 42 CFR 441.720 (a)(1)(i)(A) through (C).
Life Choices Lifeline and Continuum of Care Program
The purpose of the Life Choices Lifeline and Continuum of Care Program is to provide a statewide telemedicine network and care program to provide community outreach, direct services, support, social services case management, care coordination, consultation, and referrals to:
Covered EIDT services are clinic-based services and cannot be delivered through telemedicine or at any location other than the licensed EIDT facility.
The distant site is the location of the healthcare provider delivering telemedicine services.
Services at the distant site must be provided by an enrolled Arkansas Medicaid Provider who is authorized by Arkansas law to administer healthcare.
The professional or entity at the distant site must be an enrolled Arkansas Medicaid Provider.
The provider of the distant site must submit claims for telemedicine services using the appropriate CPT or HCPCS code for the professional service delivered. The provider must use Place of Service two (02) (telemedicine distant site) when billing the CPT or HCPCS codes.
The distant site healthcare provider will not utilize telemedicine services with a client unless a professional relationship exists between the provider and the client. A professional relationship exists when, at a minimum:
See Miscellaneous section for additional restrictions.
Medication Assisted Treatment (MAT) for Opioid Use Disorder
The provider at the distance site shall use both the GT modifier and the X2 or X4 modifier on the service claim.
Providers are encouraged to use telemedicine services when in-person treatment is not readily accessible.
Patient-Led Arkansas Shared Savings Entity (PASSE) Program
The provision of virtual care can include an interdisciplinary care team or be provided by individual clinical service provider.
The Arkansas Medicaid Program shall reimburse for the following behavioral and mental health services provided via telemedicine:
Ambulance Service
An ambulance service may:
An encounter between an ambulance service and a beneficiary that results in no transport of the enrollee is allowable if the beneficiary declines to be transported against medical advice and the ambulance service is coordinating the care of the beneficiary through telemedicine with a physician for a medical-based complaint.
An encounter between an ambulance service and a beneficiary is billable as follows:
Patient-Led Arkansas Shared Savings Entity (PASSE) Program
Virtual and telehealth services can be provided at the individual’s home or in a community setting.
“Originating site” means a site at which a patient is located at the time healthcare services are provided to him or her by means of telemedicine, which includes the home of a patient.
School Based
Regardless of whether the provider is compensated for healthcare services, if a healthcare provider seeks to provide telemedicine services to a minor in a school setting and the minor client is enrolled in Arkansas Medicaid, the healthcare provider shall:
If the minor client does not have a designated PCP, this section does not apply. Only the parent or legal guardian of the minor client may designate a PCP for a minor client.
Early Intervention Day Treatment (EIDT)
Since EIDT services are clinic-based services, three services cannot be delivered through telemedicine or at any location other than through the licensed EIDT clinic. EIDT providers are considered all-inclusive, meaning a beneficiary attending an EIDT should have all of their habilitative occupational therapy, physical therapy, and speech-language pathology service needs performed by the EIDT program at the EIDT clinic.
No Reference Found
Payment will include a reasonable facility fee to the originating site (the site at which the patient is located at the time telemedicine healthcare services are provided). In order to receive reimbursement, the originating site must be operated by a healthcare professional or licensed healthcare entity that is authorized to bill Medicaid directly for healthcare services.
There is no facility fee for the distant site. The professional or entity at the distant site must be an enrolled Arkansas Medicaid Provider. Any other originating sites are not eligible to bill a facility fee.
The originating site shall submit a telemedicine claim under the billing providers “pay to” information, using HCPCS code Q3014. The code must be submitted for the same date of service as the professional code and must indicate the place of service (where the member was at the time of the telemedicine encounter). Except in the case of hospital facility claims, the provider who is responsible for the care of the member at the originating site shall be entered as the performing provider in the appropriate field of the claim. For outpatient claims that occur in a hospital setting, the provider must also use Place of Service code twenty-two (22) with the originating site billing Q3014. In the case of in-patient services, HCPCS code Q3014 is not separately reimbursable because it is included in the hospital per diem.
Federally Qualified Health Centers
Use procedure code and type of service code Y (paper claims only) to indicate telemedicine charges.
The charge associated with this procedure code should be an amount attributable to the telemedicine service, such as line (or wireless) charges. Medicaid will deny the charge and capture it in the same manner as with ancillary charges.
A health benefit plan shall provide a reasonable facility fee to an originating site operated by a healthcare professional or a licensed healthcare entity if the healthcare professional or licensed healthcare entity is authorized to bill the health benefit plan directly for healthcare services.
Last updated 05/27/2024
The distant site provider is prohibited from utilizing telemedicine with a patient unless a professional relationship exists between the provider and patient. See manual for ways to establish the relationship. A professional relationship is established if the provider performs a face-to-face examination using real time audio and visual telemedicine technology that provides information at least equal to such information as would have been obtained by an in-person examination; or if the establishment of a professional relationship is permitted via telemedicine under the guidelines outlined in ASMB regulations. Telemedicine may be used to establish the professional relationship only for situations in which the standard of care does not require an in-person encounter and only under the safeguards established by the healthcare professional’s licensing board (See ASMB Regulation 38 for these safeguards including the standards of care). See manual for full list of requirements on establishing a professional relationship. Special requirements also exist for providing telemedicine services to a minor in a school setting (see manual).
A healthcare provider providing telemedicine services within Arkansas shall follow applicable state and federal laws, rules and regulations regarding:
A health record is created with the use of telemedicine, consists of relevant clinical information required to treat a client, and is reviewed by the healthcare professional who meets the same
standard of care for a telemedicine visit as an in-person visit. A professional relationship does not include a relationship between a healthcare provider and a client established only by the following:
The existence of a professional relationship is not required when:
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.
Occupational Therapy, Physical Therapy and Speech-Language Pathology Services
The plan of care and client service record must include the following:
Patient-Led Arkansas Shared Savings Entity (PASSE) Program
If the PASSE allows the use of telemedicine, the PASSE must document what services the PASSE allows, the settings allowed, and the qualifications for individuals to perform services via telemedicine.
The Department of Human Services shall establish the “Continuum of Care Program” for certain women and parents. The purpose of the program is to facilitate the operation of a statewide telemedicine support network that provides community outreach, consultations, and care coordination for women who are challenged with unexpected pregnancies. See statute for details.
For purposes of a complex care home (which is a specific type of Provider owned, leased, or controlled supportive living residential setting that is certified to offer eligible beneficiaries a twenty-four (24) hour, seven (7) days a week specialized medical, clinical, and habilitative support and service array), a face-to-face crisis assessment of a beneficiary includes telemedicine.
Supportive Living: Face-to-face crisis assessment of a beneficiary within two (2) hours of an emergency/crisis (which may be conducted through telemedicine) unless a different time frame is within clinical standards guidelines and mutually agreed upon by the requesting party and the responding MHP.
Last updated 05/27/2024
A healthcare provider treating patients in Arkansas through telemedicine shall be fully licensed or certified to practice in Arkansas and is subject to the rules of the appropriate state licensing or certification board. This requirement does not apply to the acts of a healthcare provider located in another jurisdiction who provides only episodic consultation services.
Last updated 05/27/2024
Arkansas Medicaid reimburses for live video when the telemedicine service is comparable to an in-person service. Store-and-forward and remote patient monitoring are included in Medicaid’s definition of telemedicine, but there was no specific information found regarding reimbursement of the modalities, with the exception of mobile telemonitoring in the Patient-Led Arkansas Shared Savings Entity (PASSE) Program. Audio-only communication is covered in certain circumstances.
Last updated 05/27/2024
Remote client monitoring means the use of electronic information and communication technology to collect personal health information and medical data from a client at an originating site that is transmitted to a healthcare provider at a distant site for use in the treatment and management of medical conditions that require frequent monitoring.
Although remote patient monitoring is included in Medicaid’s definition of telemedicine, no information was found regarding reimbursement of store-and-forward.
Patient-Led Arkansas Shared Savings Entity (PASSE) Program
Virtual providers can use mobile telemonitoring technologies to remotely monitor and evaluate the patient’s functional and health status.
No Reference Found
No Reference Found
As previously communicated, Arkansas Medicaid is updating the billing processes for diabetic supplies including Continuous Glucose Monitors (CGM), which will be changing to a pharmacy claim type submission by both pharmacies and DME providers. Because the rule is still pending approval, the official start date is postponed. Additional communications will be provided closer to the date of implementation.
Last updated 05/27/2024
Store-and-forward technology is the transmission of a client’s medical information from a healthcare provider at an originating site to a healthcare provider at a distant site. An originating site includes the home of a client.
Although store-and-forward is included in Medicaid’s definition of telemedicine, no information was found regarding reimbursement of store-and-forward.
Patient-Led Arkansas Shared Savings Entity (PASSE) Program
Virtual providers can use secure web-based communication to remotely monitor and evaluate the patient’s functional and health status.
Occupational Therapy, Physical Therapy and Speech-Language Pathology Services
All services delivered through telemedicine must be delivered in a synchronous manner, meaning through real-time interaction between the practitioner and client via a telecommunication link.
A store and forward telecommunication method of service delivery where either the client or practitioner records and stores data in advance for the other party to review at a later time is prohibited, although correspondence, faxes, emails, and other non-real time interactions may supplement synchronous telemedicine service delivery.
Electrocardiograms
In keeping with Medicare’s policy regarding coverage of electrocardiogram interpretations, payment is allowed to the attending physician for electrocardiogram interpretation performed at the hospital. This is allowed as a basic service even if additional services such as Computer Telemed Service and associated over reads are performed through the hospital. This policy is based on the fact that physicians usually interpret their own EKGs unless they refer to a specialist to perform this service. In cases involving the attending physician interpreting the electrocardiogram and referring the case to a cardiologist, the attending physician is allowed payment for the interpretation. The cardiologist will be paid for his/her interpretation of the electrocardiogram by including this service in the consultation fee.
