State Telemedicine Policy Information
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Missouri Telemedicine Policy
Missouri Telemedicine Policy
Missouri has had a parity law since 2013 and continues to make strides in telemedicine availability and reimbursement. In 2016, the Missouri legislature enacted a statute that helped increase telehealth access to school and home settings.
State Policy Overview
Additional State Telemedicine Info
Missouri’s telehealth parity law requires coverage for telehealth services by private payers, state employee health plans, and Missouri HealthNet (state Medicaid program). This means the state of Missouri currently requires payers to cover telemedicine in the same way they would medically necessary, in-person medical services.
Missouri’s Medicaid program currently covers a range of medical services provided via live video, store-and-forward, and remote patient monitoring telehealth technologies.
Type Of Telemedicine Covered
Missouri’s HealthNet will reimburse for two-way live video, store-and-forward technology, and home monitoring tech.
Covered Health Services
Missouri Medicaid provides a long list of covered medical services. For live video, the program merely stipulates that the care is medically necessary. For store-and-forward technologies, the service must be for orthopedics, dermatology, ophthalmology, burn and wound care, dental services, ultrasounds, or diabetic retinopathy.
And for remote patient monitoring, the patient must have one of the following conditions:
- Heart disease
- Chronic obstructive pulmonary disease
- Congestive heart failure
- Mental illness or serious emotional disturbance
- Myocardial infarction
Eligible Healthcare Providers
In order to be reimbursed for telehealth services under Missouri Medicaid, health care providers must be one the following:
- Physicians, assistant physicians, and physician assistants
- Advanced practice registered nurses
- Dentists, oral surgeons, and dental hygienists under the supervision of a currently registered and licensed dentist
- Psychologists and provisional licensees
- Speech, occupational, or physical therapists
- Clinical social workers
- Licensed professional counselors
- Eligible health care providers under subdivisions (1) to (10) practicing in a rural health clinic, federally qualified health center, or community mental health center.
Health care providers doing telemedicine must be enrolled as a MO HealthNet provider.
Missouri law states that “prescribing drugs without sufficient examination is prohibited.” This means that providers cannot e-prescribe solely on the basis of a telephone consult or an internet questionnaire. The state also allows a physician-patient relationship to be established through a telemedicine visit.
Informed Patient Consent
The Missouri HealthNet guidebook states health care providers must obtain written informed consent from telehealth patients. We recommend this as a telemedicine best practice.
Cross-State Telemedicine Licensing
Physicians must hold a full Missouri medical license to practice in the state, even via telehealth technology. However, informational consultations are allowed. Missouri has not yet joined the Interstate Medical Licensure Compact, which facilitates medical licensing across state lines.
Restrictions On Locations
Missouri policy lists several possible locations as eligible patient settings for telemedicine, including:
- An office of a physician or health care provider
- A hospital
- A critical access hospital
- A rural health clinic
- A federally qualified health center
- A long-term care facility licensed under chapter 198
- A dialysis center
- A Missouri state habilitation center or regional office
- A community mental health center
- A Missouri state mental health facility
- A Missouri state facility
- A Missouri residential treatment facility licensed by and under contract with the children’s division
- A comprehensive substance treatment and rehabilitation (CSTAR) program
- A school
- The MO HealthNet recipient’s home
- A clinical designated area in a pharmacy
- A child assessment center
Missouri recently removed a policy that limited telehealth reimbursement to rural areas.
Private payer and Missouri HealthNet reimbursement rates are the same for telemedicine and in-person care.
The Missouri Medicaid program advises providers to use the appropriate CPT code for the service along with the “GT” modifier (to denote telemedicine). Here are a few examples of behavioral health services codes that could be billed, along with the GT modifier:
- 90791 GT – Psychiatric Diagnostic Evaluation
- 90792 GT – Psychiatric diagnostic evaluation with medical services
- 90832 GT – Psychotherapy, approximately 16 to 37 minutes face-to-face with the patient and/or family member
- 90834 GT – Psychotherapy, approximately 38 to 52 minutes face-to-face with the patient and or family member