State Telemedicine Policy Information
Healthcare Legislation Is Complex, We Can Help.
Illinois Telemedicine Policy
Illinois Telemedicine Policy
Illinois still has some work to do to expand access to telehealth. While the state introduced legislation in 2016 to gain full parity for both medical and mental health telemedicine, the bills failed to pass.
One innovative feature of Illinois coverage of telehealth includes coverage for services provided by local schools and podiatrists. Hopefully, the state will expand forward-thinking policies like these in the near future.
State Policy Overview
Medicaid
Yes
Private Payer
No
Parity
No
Additional State Telemedicine Info
Parity Laws
Telemedicine parity laws require private payers to pay for telemedicine services the same way they would in-person services. Unfortunately, Illinois does not have a private payer parity law yet, so coverage by private payers isn’t mandated. However, that doesn’t mean private payers won’t cover telemedicine.
Medicaid
Illinois’ Medicaid program defines telehealth as “the use of a telecommunication system to provide medical services between places of lesser and greater medical capability and/or expertise, for the purpose of evaluation and treatment. Medical data exchanged can take the form of multiple formats: text, graphics, still images, audio and video. The information or data exchanged can occur in real time (synchronous) through interactive video or multimedia collaborative environments or in near real time (asynchronous) through “store and forward” applications.”
The program reimburses for live video, store-and-forward, and remote patient monitoring telemedicine under specific conditions. Medicaid does not reimburse for email, phone calls, or FAX.
Type Of Telemedicine Covered
Illinois Medicaid covers live-video telemedicine for both medical and mental health services, as well as store-and-forward telemedicine services for dermatology. The state also covers remote patient monitoring, but only for home uterine monitoring and for elderly patients.
Covered Health Services
Under Illinois telehealth expansion bill, covered services include those provided by:
- Physicians
- Advanced practice nurses
- Podiatrists
- Federally Qualified Health Centers (FQHCs)
- Rural Health Clinics
- Encounter Rate Clinics
- Telepsychiatry is also covered under the bill.
Eligible Healthcare Providers
Eligible telemedicine practitioners in Illinois include:
- Physicians
- Physician Assistants
- Podiatrists
- Advanced practice nurses
- Local health departments
- Community mental health centers
- Outpatient hospitals
- Federally Qualified Health Centers
- Rural Health Clinics
- Encounter Rate Clinics
- Mental Health professionals
Online Prescriptions
Illinois does not have any specific regulations on providing online prescriptions through telemedicine.
Informed Patient Consent
Illinois does not currently have any requirements for getting a patient’s informed consent prior to a telemedicine visit.
Cross-State Telemedicine Licensing
Illinois has elected to join the Interstate Medical Licensure Compact. This means the application process for out-of-state providers will be easier (expedited processing, discounted licensing fee, less paperwork), but still requires providers to follow all the state’s rules and standards.
Restrictions On Locations
Illinois Medicaid requires the patient to be at one of the following locations to receive telehealth services:
- Physician office
- Podiatrist office
- Local health departments
- Community mental health centers
- Outpatient hospitals
- Rural health clinics
- Encounter Rate Clinics
- Federally Qualified Health Centers
Reimbursement Rates
Illinois Medicaid reimburses telemedicine services at the same rate as the comparable in-person service.
Billing Codes
To bill for your telemedicine services, Illinois Medicaid requires the relevant CPT code and the GT (telemedicine) modifier. You can find billing examples on the Illinois Medicaid website.