Pennsylvania reimbursement for telemedicine PDF Print E-mail

Pennsylvania Medicaid will reimburse for specialty consultations using HIPAA-compliant live video.  Secure Telehealth Video Software meets the requirements.  

Gateway Health Managed Medicaid plan

The Gateway Health Managed Medicaid plan pays for telehealth Specialty Consults.  Read more. This plan is available in the following (40) PA counties: Adams, Allegheny, Armstrong, Beaver, Bedford, Berks, Blair, Butler, Cambria, Cameron, Clarion, Clearfield, Crawford, Cumberland, Dauphin, Elk, Erie, Fayette, Forest, Franklin, Fulton, Greene, Huntingdon, Indiana, Jefferson, Lancaster, Lawrence, Lebanon, Lehigh, McKean, Mercer, Northampton, Perry, Potter, Somerset, Venango, Warren, Washington, Westmoreland and York

April 2014 - PA approves use of telepsychiatry in FQHCs and RHCs

"Telepsych Encounter (applicable only to Behavioral Health Managed Care delivery system claims; telepsych encounters are not payable under the fee-for-service delivery system): An encounter between a psychiatrist or a psychologist licensed by the Commonwealth of Pennsylvania and a patient, in which mental health services are provided through the use of approved electronic communication and information technologies to provide or support clinical psychiatric care at a distance. Qualifying telepsych services utilize real-time, two-way interactive audio-video transmission, and do not include a telephone conversation, electronic mail message, or facsimile transmission between a health care practitioner and a service recipient, or a consultation between two healthcare practitioners, although these activities may support the delivery of telepsych services. Telepsych services require service providers to have a service description approved by the Office of Mental Health and Substance Abuse Services (OMHSAS) and deliverable through the managed care option"

             - Excerpt from, Guidelines, Procedures and Standards for Federally Qualified Health Centers (FQHCs)/Rural Health Clinics (RHCs), April 2014

Originitating site may bill for facility fee - Accroding to Center for Connected Health Policy, "Fifty State Medicaid report" 9/2014




Last Updated on Tuesday, 15 August 2017 14:23