Posted June 3, 2019
The recent 2019 Kentucky Telehealth Summit, held May 23 in Bowling Green, provided clarification and updates on the telehealth law passed in 2018 and becomes effective July 1, 2019. The law requires Medicaid, managed care organizations (MCOs) and commercial health plans to cover medical services provided via telehealth to the same extent they cover medical services provided in-person.
Stephanie Bates, Deputy Commissioner, Kentucky Department for Medicaid Services, confirmed the Medicaid rate for telehealth services will be 100 percent of the Medicaid Fee Schedule and Medicaid MCOs will reimburse at least that amount.
The Telehealth Summit Payer Panel also clarified the following:
- Healthcare providers enrolled in Medicaid may perform any medically necessary service face-to-face within their scope of practice via telehealth.
- A Medicaid provider letter, coming out soon, will address billing and coding questions. For example, all Medicaid telehealth services may be required to use a place of service 02 code to distinguish between face-to-face and telehealth for data collection and reimbursement purposes.
- Physicians using telehealth must be licensed in Kentucky and physicians and other healthcare providers may be required to include the patient location on the claims form.
Additionally, a health plan may not:
- Require a provider to be physically present with a patient unless the provider determines that it is necessary to perform those services in person.
- Require prior authorization, medical review, or administrative clearance for telehealth that would not be required if the service were provided in person.
- Restrict or deny coverage of telehealth based solely on the communication technology or application used to deliver the telehealth services, as long as other requirements are met
- Require a provider to be part of a telehealth network.
KMA will keep members updated on the transition through Kentucky Health e-News and social media.
