State Telemedicine Policy Information
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Indiana Telemedicine Policy
Indiana Telemedicine Policy
Indiana has made some great strides forward in their telemedicine policy in the last few years. Indiana’s telemedicine parity law went into effect in 2015, requiring private payers and Medicaid to cover telehealth services. And in 2017, Indiana Governor Eric Holcomb signed HB 1337, which allows healthcare providers to prescribe controlled substances based on a telehealth visit and without an in-person exam.
State Policy Overview
Additional State Telemedicine Info
Indiana’s parity law went into effect in 2015. A parity law means that private payers are required to cover telemedicine visits in the same way as in-person visits. Some state parity laws also extend to Medicaid or state plans.
Indiana Medicaid covers a range of services provided via live-video and remote patient monitoring. The program uses the hub-and-spoke model of care, where the patient visits a spoke site to access the technology to consult a remote provider at the “hub” or distant site.
If prior authorization has been obtained, Indiana Medicaid will cover services offered by home health agencies. Diabetes, congestive heart failure, and COPD are eligible for reimbursements as long as they have had two emergency room or hospital visits.
Type Of Telemedicine Covered
Covered forms of telehealth include interactive audio-video and remote patient monitoring for patients with diabetes, congestive heart failure, or chronic obstructive pulmonary disease. Store-and-forward is also covered, but only “to facilitate other reimbursable services.”
Covered Health Services
Indiana’s Medicaid program covers live video telemedicine for the following medical services:
- Office Visit
- Psychiatric diagnostic interview
- End-stage renal disease (ESRD) services
- Pharmacologic management
The state also covers remote patient monitoring services (with prior authorization) for patients with:
- Chronic obstructive pulmonary disease
- Congestive heart failure
Eligible Healthcare Providers
- Clinical nurse specialists
- Nurse practitioners
- Physician assistants
- Clinical psychologists
- Home health agencies
Indiana state law allows healthcare providers to prescribe controlled substances to patients on the basis of a telemedicine visit. However, providers need to meet a few requirements, including basing the diagnosis on the treatment plan or previous physical exam of another licensed Indiana health care provider.
Informed Patient Consent
Indiana state law does not require health providers to get an additional written patient consent for telemedicine. However, if you’re billing through Indiana Medicaid, you will need to get patient consent.
Cross-State Telemedicine Licensing
Indiana is not yet part of the Interstate Medical Licensure Compact, which expedites medical licensing across state lines. However, a provider located outside of Indiana may treat a patient if they certify that they will comply with the courts of Indiana as well as Indiana’s Substantive and Procedural Laws.
Restrictions On Locations
Indiana Medicaid does require the patient to receive telehealth services at an eligible “spoke site,” which includes:
- Rural Health Clinic
- Community Mental Health Centers
- Critical Access Hospital
Telehealth reimbursement rates for Indiana are the same as for in-person services under the state’s parity law.
Need a list of the eligible Indiana Medicaid codes for telemedicine? We’ve got you covered:
99201 – 99205 and 99211 – 99215, Office or other outpatient visits
90832 – 90834, 90836-90840, 90846, 90847, and 90853, Psychotherapy
90791 and 90792, Psychiatric diagnostic interview
90951 – 90970, End-stage renal disease (ESRD) services
You’ll also need to use the Modifier GT to indicate the service was provided via telehealth. Use modifier 95 for live-video telemedicine.
For more details, see the Indiana Medicaid Telehealth Manual.