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Reimbursement for video appointments

As a physician who is practicing in the US, your options for offering video appointments can depend on the telemedicine legislation in your location.


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Confrere is HIPAA compliant. It meets all security and data protection requirements so that it's fit for the US healthcare sector. However, if you want to integrate video appointments - a.k.a. live synchronous video - into your practice, you first need to ensure that you can get reimbursed for those appointments.

Reimbursement policy varies

Medicare reimburses in all 50 states, while individual states determine reimbursement requirements for Medicaid and private insurance companies.

Medicare

Medicare reimburses for telemedicine, including several types of video appointments, according to federal policy. For detailed information about circumstantial limitations, requirements, and billing codes, please refer to this list provided by the Centers for Medicaid & Medicare Services.

Medicaid

49 states and D.C. have telehealth coverage laws through which Medicaid reimburses for video appointments. However, states may restrict reimbursement based on medical specialty type, the type of service, the location of the patient (a.k.a. originating site), and the location of the provider (a.k.a. distant site).

Private insurance companies

35 states and D.C. have telehealth parity laws, through which private insurance companies must reimburse the same rate for a video appointment as an in-person appointment, provided the quality of care is equal.

No two states are alike when it comes to telehealth reimbursement. To learn about your state's policy, please refer to the ATA's State Policy Resource Center.

Telehealth Parity Laws

Currently, 35 states and D.C. have enacted parity laws, with laws pending in 4 more states. Telehealth parity laws mandate that private insurance companies reimburse providers for telehealth services at the same rate as the same in-person services, given the quality of care is equal

There are 35 states (and D.C.) with parity laws, 4 with pending parity laws, and 11 without.

Map containing the states with parity laws, for the specific states read the following list

States with parity laws

Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Georgia
Hawaii
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Dakota
Oklahoma
Oregon
Rhode Island
Tennessee
Texas
Vermont
Virginia
Washington

States with pending parity laws

Alaska
Massachusetts
Pennsylvania
South Dakota

States without parity laws

Alabama
Florida
Idaho
Illinois
North Carolina
Ohio
South Carolina
Utah
West Virginia
Wisconsin
Wyoming

For specifications on your state's parity laws, please visit the ATA’s website.

Anders Aspaas
Anders Aspaas
Head of Sales
anders@confrere.com
Phone number +47 984 24 471
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