State Telemedicine Policy Information
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Washington Telemedicine Policy
Washington Telemedicine Policy
Things are heating up for telemedicine in Washington! Updates to the state’s telemedicine parity law in 2017 expanded coverage to even more varied telehealth services. Washington also recently joined the Interstate Medical Licensure Compact, making it easier for providers all over the country to practice telemedicine in the Evergreen State.
State Policy Overview
Additional State Telemedicine Info
Washington’s parity law mandates payment for telemedicine services at the same rates as in-person care under private insurance, state employee health plans, and Medicaid managed care. The law applies to both live video and store-and-forward telemedicine.
Washington Medicaid reimburses for telehealth services through both their fee-for-service and managed care programs. While most coverage applies to live video telemedicine, Medicaid also reimburses for teledermatology (store-and-forward), and remote patient monitoring for patients with unstable conditions.
Type Of Telemedicine Covered
As of January 1, 2017, all insurers are required to cover live video and store-and-forward telemedicine, including private payers, employee health plans and Medicaid Managed Care. Washington Medicaid also covers remote patient monitoring for patients with an unstable condition, who are at risk for hospitalization.
Covered Health Services
When provided over live video, WA Medicaid reimburses for medically necessary services. The program also covers prenatal genetic counseling, behavior analysis and autism treatment, teledentistry, teledermatology and remote patient monitoring for those at-risk of hospitalization.
Eligible Healthcare Providers
Washington does not identify a specific list of healthcare providers who can bill for telemedicine.
Washington providers who prescribe medications via a telehealth encounter have to follow the same guidelines as for in-person care. This means conducting a patient evaluation, gathering their history and any other information needed to make a diagnosis.
Informed Patient Consent
Providers are only required to get patient informed consent specifically for telemedicine when using a store-and-forward solution.
Cross-State Telemedicine Licensing
Washington recently joined the Interstate Medical Licensure Compact which makes it easier for licensed out-of-state physicians to provide telemedicine to Washington patients.
Restrictions On Locations
Some states place restrictions on where the patient can receive virtual care. Washington Medicaid does limit where the patient can be at the time of care, but offers more flexibility by including the patient’s home. Here’s the full list of eligible patient locations:
- Community mental health/chemical dependency settings
- Dental offices
- Federally qualified health center (FQHC)
- Home or any location determined appropriate by the individual receiving service
- Hospitals (inpatient and outpatient)
- Neurodevelopmental centers
- Physician or other health professional’s office
- Rural health clinics (RHC)
- Skilled nursing facilities
Reimbursement rates for a telemedicine service should be equivalent to the rates of the same service in-person.
Billing for telemedicine services usually means billing the appropriate CPT/HCPCS code along with the GT or 95 modifiers to indicate live video telemedicine. (Use GQ for a store-and-forward solution.) Washington Medicaid follows these guidelines, and also requires the place of service (POS) 02 code. For more details on billing, see your Medicaid Manual.