State Telemedicine Policy Information

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Ohio Telemedicine Policy

OhioTelemedicine Policy

Ohio has a comprehensive telemedicine outlook that includes behavioral health services, school-based speech therapy and pharmacological management. Though their parity law has yet to be enacted, the state is making strides in other areas.

For example, though Ohio is not yet part of the Interstate Medical Licensure Compact, the state has some of the least-restrictive policies for out-of-state physicians. Ohio offers a special telemedicine permit rather than requiring full state licensure for practicing physicians.

State Policy Overview

Medicaid

Yes

Private Payer

Yes

Parity

Yes

Additional State Telemedicine Info

Parity Laws

Ohio proposed a parity law for private insurance and Medicaid a few years ago, but it failed to pass. However, many private insurance companies will still cover telehealth policies even when it’s not required. 

Medicaid

Ohio’s Medicaid program covers a range of evaluative and management services or psychiatric services, including behavioral health and speech therapy, when delivered via live video telemedicine. Currently, the program doesn’t reimburse for not store-and-forward or remote patient monitoring solutions. Medicaid also places a few limitations on eligible providers and the location of the patient at the time of care.

Type Of Telemedicine Covered

Ohio’s Medicaid program defines telemedicine only as interactive, real-time care. Reimbursement is only covered for live video telemedicine, not store-and-forward, home health monitoring, or email/phone/fax.

Covered Health Services

Telemedicine health services that are covered by Ohio Medicaid include:

 

  • Consultations by physicians
  • School-based speech therapy
  • Behavioral health counseling and therapy
  • Mental health assessment
  • Pharmacological management
  • Community psychiatric supportive treatment service

 

Eligible Healthcare Providers

Ohio Medicaid will reimburse the following providers for telemedicine:

 

  • Physicians (MD, DO)
  • Psychologists
  • Federally Qualified Health Center (medical and mental health)

 

Online Prescriptions

Ohio regulation states that physicians can’t prescribe any medication to a patient without doing a physical exam.

 

 However, physicians may sometimes prescribe non-controlled substances based on a telemedicine visit, as long as they meet this list of requirements:

  • Establish the patient’s identity and physical location
  • Obtain the patient’s informed consent
  • Forward medical record to patient’s primary care provider
  • Conduct an appropriate evaluation
  • Establish or confirm a diagnosis and treatment plan
  • Document information in patient’s medical record
  • Provide appropriate follow-up care
  • Make medical record of the visit available to patient
  • Use appropriate technology sufficient to conduct all steps

 

Informed Patient Consent

Ohio requires providers to get a patient’s informed consent for a telemedicine visit.

Cross-State Telemedicine Licensing

Qualifying out-of-state physicians don’t need to have a full license to practice telemedicine in Ohio.

They also have the option to apply for a telemedicine permit to practice in the state.

Restrictions On Locations

In order to bill for telemedicine through Ohio Medicaid, the patient needs to be at an eligible originating site, and that site needs to be more than five miles away from the telehealth provider.

Here is the list of eligible originating sites:

 

  • Primary Care Clinic
  • Outpatient Hospital
  • Rural Health Clinic (Medical)
  • Federally Qualified Health Clinic (Medical)
  • Physician
  • Professional Medical Group
  • Podiatrist
  • Optometrist

 

Unfortunately, the patient’s home does not qualify as an originating site for Medicaid.

 

Billing Codes

Luckily, Ohio Medicaid has a handy telemedicine billing cheatsheet ready for you. Here is the list of appropriate HCPCS codes:

  • 99201-99215
  • 99241-99245
  • 99251-99255
  • 90791-90792
  • 90832-90838
  • 90863
 

Use the relevant code along with the GT modifier to indicate telemedicine.

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