State Telemedicine Policy Information

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South Dakota Telemedicine Policy

South Dakota Telemedicine Policy

South Dakota’s telemedicine policies have volleyed back and forth, but the state’s lawmakers are still making progress. The state does set some restrictions on patient settings (at the time of the visit) and types of telemedicine that can receive Medicaid coverage.

However, South Dakota has joined the Interstate Medical Licensure Compact and has implemented several telehealth programs to provide substance abuse treatment to rural areas of the state. Also, although the state does not yet have a telehealth parity law, one has been proposed. 

State Policy Overview

Medicaid

Yes

Private Payer

No

Parity

No

Additional State Telemedicine Info

Parity Laws

Unfortunately, South Dakota doesn’t have a parity law at the moment, but one is proposed for legislation. Telehealth parity laws require private payers to cover telemedicine services, often at the same rate as in-person care. However, many private payers still include telehealth in their policies even when it’s not legally mandated by the state.

Medicaid

South Dakota Medicaid defines telemedicine as occurring in “real time,” which means the program covers live video telehealth, but not store-and-forward applications. Medicaid covers a limited number of medical services, including pharmacological management, at the same rate as in-person services. See the Medicaid Manual for the complete list of covered services and the corresponding billing codes.

South Dakota does also offer some coverage for remote patient monitoring reimbursement, specifically through the Office of Adult Service and Aging for patients who need in-home support.

Type Of Telemedicine Covered

South Dakota’s Medicaid program defines telemedicine as “real time,” so store-and-forward technology isn’t covered, but two-way interactive video is. Additionally, The Office of Adult Services and Aging offers reimbursement for remote patient monitoring. 

Covered Health Services

South Dakota Medicaid covers the following medical services delivered via telehealth:

 

  • Psychotherapy
  • Psychiatric diagnostic evaluation
  • End-stage renal disease
  • Health and behavior assessment and intervention
  • Patient office consultation
  • Inpatient hospital consultation
  • Nursing facility visits
  • Pharmacologic management
  • Office or other outpatient visits
  • Diabetes outpatient self-management education services

 

Additionally, Medicaid will cover an individual’s home monitoring services if:

 

  • The individual is residing at home
  • The individual is age 60 or older or is age 18 or older with a disability
  • The individual is not eligible for other programs which provide the same type of services.

 

Eligible Healthcare Providers

South Dakota is 1 of just 19 states that does not specify the type of healthcare provider allowed to practice telemedicine. This offers better flexibility for practicing telemedicine in the Mount Rushmore State.

Online Prescriptions

South Dakota does not have any regulations currently for prescribing medication via telehealth. 

Informed Patient Consent

The state does not have any telemedicine-specific rules on getting informed patient consent. However, we always recommend obtaining consent as a telemedicine best practice. 

Cross-State Telemedicine Licensing

South Dakota is now a member of the Interstate Medical Licensure Compact, which helps out-of-state healthcare providers get licensed in the state. Additionally, South Dakota allows licensing reciprocity to out-of-state providers as long as they are licensed and in good standing in another state.

Restrictions On Locations

South Dakota Medicaid does unfortunately place some restrictions on the patient’s location at the time of the telehealth visit. In order to access these services, patients need to be at one of the following locations:

  • Office of a physician or practitioner
  • Outpatient hospital
  • Critical Access Hospital
  • Rural Health Clinic
  • Federally Qualified Health Center
  • Indian Health Services Clinic
  • Community Mental Health Center
  • Nursing facilities

Reimbursement Rates

While South Dakota does not yet have a telehealth parity law, many payers reimburse telemedicine at similar rates to in-person services. The state’s Medicaid, for example, pays at the same rate as the comparable traditional service.

Billing Codes

Need help billing for telemedicine? Your South Dakota Medicaid manual has all the billing codes you need. Here are a few that are included:

  • 99241 – 99245 Patient office consultation
  • 99251 – 99255 Inpatient hospital consultation
  • 99211 – 99215 Established patient office or another outpatient visit
  • G0108 Diabetes outpatient self-management education services, individual
  • G0109 Diabetes outpatient self-management education services, group

 

Don’t forget to include your GT modifier to indicate the visit was completed via telemedicine.

 

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