- More states are covering remote patient monitoring but the conditions for payment in each state vary, with some states limiting RPM coverage to patients with specific conditions or diseases, according to the American Telemedicine Association's 2019 State of the States Report: Coverage and Reimbursement issued on Thursday.
- The report identified the eight most common telehealth providers: physician, physician assistant, nurse practitioner, licensed mental health professional, psychologist, physical therapist, occupational therapist and dentist.
- The ATA, whose leaders include top officials at Cerner and providers like the Mayo Clinic, also found barriers remain hindering broader use, including state requirements governing distance and staffing.
For homebound patients, those that lack access to transportation or those living in areas with few healthcare providers, telehealth services can expand access to much-needed care.
While states take a variety of approaches to reimbursement and coverage of telehealth services, the report said states' recognition and utilization of telehealth have been on the rise since 2017.
Forty states and the District of Columbia have adopted substantive policies or received awards to expand telehealth coverage and reimbursement since 2017, according to the ATA report. And most states don't restrict coverage and reimbursement to particular categories of providers. Meanwhile, 36 states and D.C. have parity policies for private payer coverage for telehealth services.
Kentucky, Maine, Massachusetts, New Jersey, Oregon, Utah and D.C. have adopted or substantively updated policies on telehealth modalities since 2017, the study said. Twenty-two states and D.C. cover RPM, while 29 states and D.C. cover store and forward transfer, in which clinical information is collected and sent electronically to another location to be evaluated.
Alaska, Maine, New Jersey and Oregon are going beyond reimbursing for just traditional telehealth services to include reimbursing for audio-only technology services, the study said.
Even so, the lobbying group noted gaps, including distance restrictions and limitations on eligible settings in many states as well as requiring staff be immediately available. For example, North Carolina, Ohio and Montana have distance restrictions on telehealth services, while Alabama, South Carolina and Virginia require staff to be immediately available during a telehealth session. And Iowa, West Virginia and Virginia have the fewest eligible settings, the study said.
And even though most states have adopted policies in their Medicaid programs to treat telehealth and in-person services the same for coverage and payment purposes, 19 states lacking parity policies for telehealth. States are more likely to regulate coverage and payment policies of private payers than their Medicaid programs, the study said, with 36 states and D.C. having coverage parity and only 13 states lacking private payer parity policies.
And while 13 states use integrated care for Medicare-Medicaid dual eligible beneficiaries, only three states — New York, Rhode Island and Virginia — offer telehealth, the report said.
"It’s clear that more states are adopting telehealth solutions, but some lack the authority or resources needed to fully deploy telehealth across the state," Ann Mond Johnson, ATA's CEO said in a statement.