State Telemedicine Policy Information

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Alabama Telemedicine Policy

Alabama Telemedicine Policy

Alabama continues to pave the way for broader telemedicine coverage. Alabama was also one of the first states to join the Interstate Medical Licensing Compact, which allows physicians to consult out-of-state patients via telemedicine.

 A spin-off of Alabama’s successful Patient 1st medical home model also uses home health nurses employed by the Department of Health to remotely monitor vital signs for patients with diabetes, hypertension, and congestive heart disease.

State Policy Overview

Medicaid

Yes

Private Payer

Yes

Parity

No

Additional State Telemedicine Info

Parity Laws

Alabama enacted a partial parity law in 2016 covering mental health services.

Medicaid

Alabama state Medicaid policy does not provide an explicit definition of “telemedicine.” Telemedicine services must be administered using an interactive audio/video system which facilitates two-way communication between the physician and the recipient. The connection must be “real time,” as opposed to a correspondence exchange.

Type Of Telemedicine Covered

Alabama Medicaid reimburses for live video and will reimburse remote patient monitoring through the In-Home Monitoring Program. The following services are covered:

- Consultations

- Office and outpatient visits

- Individual psychotherapy

- Psychiatric diagnostic services

- Neurobehavioral status examinations

Covered Health Services

Alabama Medicaid reimburses for live video telemedicine for the following services:

- Medical Consults

- Office or other outpatient visits

- Individual psychotherapy

- Psychiatric diagnostic services

- Neurobehavioral status exams

For all telemedicine services, an appropriately trained staff member or employee familiar with the patient or the treatment plan must be immediately available in person to the patient. Under the Alabama Medicaid In-Home Monitoring Program, patients with the following medical conditions can get treatment via telemedicine:

- Diabetes

- Congestive Heart Failure

Eligible Healthcare Providers

Not all healthcare providers can do telemedicine under Alabama Medicaid. Here’s the list of the eligible providers: 

- Physicians

- Nurse Practitioners

- Physician Assistants

- Clinical Nurses

- Clinical Psychologists

Also, Medicaid requires physicians to enroll with the specialty of 931 (telemedicine). If you’re interested in doing telemedicine with your Medicaid patients, submit this form to Alabama Medicaid.

Online Prescriptions

While the state of Alabama has no specific stated restrictions around prescribing based on telemedicine visits, state law says “prescribing drugs to an individual the prescriber has not personally examined is usually inappropriate.”

Before prescribing a drug, the physician should make an informed medical judgment. Ordinarily, this will require that the physician personally perform an appropriate history and physical exam, make a diagnosis, and formulate a therapeutic plan, which might include a prescription.

Informed Patient Consent

The state of Alabama requires providers to get a patient’s written informed consent before doing the first telemedicine visit.

Read more about informed patient consent here.

Cross-State Telemedicine Licensing

In May 2015, Alabama joined the Interstate Medical Licensing compact. The compact will help reduce licensing requirements across states and will allow physicians to consult patients via telemedicine outside their state lines.

Restrictions On Locations

Luckily, Alabama doesn’t place many restrictions on where the patient and physician need to be located for the telemedicine visit. However, for rehabilitative services specifically, the originating site (where the patient is) must be:

- Physician’s office

- Hospital

- Critical Access Hospital

- Rural Health Clinic

- Federally Qualified Health Center

- Community mental health center (to include co-located sites with partnering agencies)

- Public health department

Reimbursement Rates

Telemedicine visits are reimbursed at the same rate as in-person visits.

 

Billing Codes

Not sure how to bill for telemedicine? No problem. Alabama Medicaid covers telemedicine visits for the following CPT codes:

- Consultations (99241-99245, 99251-99255)

- Office or other outpatient visits (99201-99205, 99211-99215)

- Individual psychotherapy (90804-90809)

- Psychiatric diagnostic (90801)

- Neurobehavioral status exam (96116)

Remember to use your GT modifier! Alabama Medicaid requires you to use the appropriate CPT code along with the modifier GT, which stands for interactive audio and video telecommunications system.

Want more details? Check out the Alabama Medicaid Handbook.