Telehealth guidance by state during COVID-19

Existing state telehealth coverage mandate?
NO

Emergency orders expiration
State of Emergency COVID-19 declaration issued 3/13/20. Public Health Emergency extended to 4/8/20.

Emergency state action on coverage of telehealth services?
Department of Insurance Guidance updated 4/8/20 outlines commercial payers’ coverage policies, including telehealth, during the public health emergency.

State guidance issued 3/13/20 addresses telehealth standards of care.

Yes. On 3/18/20, guidance from the state Medicaid office was issued that allows for telepsychological services to be performed by licensed psychologists.

Emergency licensure waiver?
Yes. Guidance issued by the Alabama Board of Examiners in Psychology allows individuals licensed in another jurisdiction to practice up to 60 days without an Alabama license. Registration is required and out-of-state licensed psychologists must submit the completed Emergency Practice Registration Form within 10 days of practicing in the state.

There is no registration fee.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Per guidance from the Medicaid office, it is unclear whether interns and postdocs are able to perform telehealth services.

Generally, per the Medicaid manual, interns and postdocs’ services are billable for in-person services IF they have a master's degree and (have completed a practicum as part of that) or (have 6 months post master’s experience).

However, the guidance released on 3/18/20 does not specifically name technicians (or interns or postdocs).

Existing state telehealth coverage mandate?
YES for telemental health services provided by commercial health plans using audio and/or video

Alaska Stat. § 21.42.422

Emergency orders expiration
COVID-19 public health emergency order issued 3/13/20. Public Health Emergency ended 6/2/20. Emergency courtesy license for out-of-state psychologists will remain valid until the Governor lifts the state of emergency or 11/15/20, whichever is first.

Emergency state action on coverage of telehealth services?
Bill signed by Governor on 3/16/20 amends Alaska Stat. § 21.42.422 which mandates coverage for telehealth and does not require prior in-person contact. References definition of telehealth under Alaska Stat. § 47.05.270(e)

This amendment expands existing law to include in-network and out-of-network providers and states that new patients are eligible for telehealth services.

Division of Insurance Bulletin 20-07 states that while “AS 21.42.422 does not require health care providers to use a particular technology platform,” health care providers “must use a HIPAA compliant service to protect consumer privacy.”

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 4/2/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Alaska Stat. § 47.05.270(e) defines “telehealth” to include audio-only communications, indicating that telephone calls are permitted.

Division of Insurance Bulletin 20-07 states that while “AS 21.42.422 does not require health care providers to use a particular technology platform,” health care providers “must use a HIPAA compliant service to protect consumer privacy.”

Emergency changes in originating sites requirements?
Division of Insurance Bulletin 20-07 states that the newly enacted statute does not limit the location of services for telehealth. If a health care service is covered when delivered in-person, the service should also be covered when performed via telehealth.

Emergency licensure waiver?
Division of Corporations, Professions and Licensing guidance on Telehealth and Licensing during COVID-19 updated 4/20/20 states that out-of-state licensed psychologists must obtain an emergency courtesy license to provide emergency psychological care to patients in Alaska within their scope of practice and duration of the declared emergency. This emergency courtesy license will remain valid date the Governor lifts the state of emergency or 11/15/20, whichever is first.

Download the Psychologist Emergency Courtesy License Application (PDF, 1.2MB).

Alaska also requires health care providers to apply with the Alaska Telemedicine Business Registry to provide services to Alaska-based clients. This applies to businesses delivering health care services; individual providers only apply for the telemedicine registry if they have a sole proprietorship business license.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are not eligible to perform telehealth services as they are not licensed, and Alaska’s Section 1135 waiver requires all providers to be licensed to perform services.

Existing state telehealth coverage mandate?
YES for all health care services organizations and disability insurers; may limit to in-network providers; excludes audio-only phones

Ariz. Stat. §§ 20-841.09, 20-1057.13, 20-1376.05, 20-1406.05

Emergency orders expiration
Public health state of emergency declared 3/11/20 and is still in effect. Temporary practice expansion/registration for out-of-state psychologists tied to state Public Health Emergency period.

Emergency state action on coverage of telehealth services?
Executive Order 2020-15 dated 3/25/20 expands telemedicine to require insurers to cover telehealth services on the same basis as in-person services. This also applies to Medicaid.

Telemedicine is defined as health care services for mental health disorders. AZ 20-1057.13

Emergency state action on telehealth reimbursement parity?
Executive Order 2020-15 dated 3/25/20 also requires insurers to pay the same reimbursement rate for telehealth services. This also applies to Medicaid.

CMS Section 1135 Medicaid Waiver approved 3/23/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Guidance from the Arizona Board of Psychologist Examiners dated 4/6/20 temporarily waives any restrictions to the delivery of psychology services via electronic means and includes phone only communications.

Emergency changes in originating sites requirements?
Executive Order 2020-15 dated 3/25/20 recognizes the patient’s home as an eligible originating site.

Emergency licensure waiver?
Guidance from the Arizona Board of Psychologist Examiners dated 4/6/20 temporarily expands the 20-day temporary licensure exemption for out-of-state licensed psychologists to a full temporary unrestricted license to practice for the duration of the declared COVID-19 state emergency.

The Board requires all out-of-state licensed psychologists to submit electronically the Temporary registration for independent practice application form.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Guidance from the Arizona Board of Psychologist Examiners dated 4/6/20 temporarily waives any time limitations on telesupervision and telepractice for interns, trainees and post-doctoral candidates for psychologist licensure during the declared state of emergency and for 3 months following.

Any limitations on supervision through telepractice are temporarily waived for the duration of the declared emergency.

At its 4/15/20 meeting, Arizona Board of Psychologist Examiners voted to waive certain licensure requirements specified in A.R.S. §32-2071 (A)(5) and (K) for psychology program graduates with degree completion dates between 8/1/19 and 9/30/20.

In addition, doctoral program psychology students impacted by events such as school closures may elect to submit a psychologist application for exam and/or licensure during the state of emergency while this waiver is in effect, which expires at midnight on the date the Governor of Arizona lifts the state of emergency.

Existing state telehealth coverage mandate?
YES for all policies offered by commercial insurers, self-funded government and church plans, and Medicaid programs; includes reimbursement parity required only for physician services; insurers have discretion to cover audio-only phone, email, or text messaging

Ark. Code §§ 23-79-1601, 1602

Emergency orders expiration
Public health emergency (EO 20-03) issued on 03/11/20, extended for an additional 45 days to 6/19/20.

Emergency state action on coverage of telehealth services?
Executive Order 20-05 dated 3/13/20 suspends the provisions of the Telemedicine Act under Ark. Code Ann. 17-80-401, et seq. and waives the initial in-person or face-to-face examination via audio-video conferencing to establish a professional relationship in order to diagnose or treat a patient via telehealth.

It should be noted that the Arkansas Department of Health has temporarily suspended certain regulations to expand the definition of “physician” to include psychologists per Executive Order No. 20-06.

Guidance by the Board of Psychology states: For 120 days from 3/20/20, licensees will not be required to submit a new Statement of Intent (SOI) to practice Telepsychology in Arkansas. Licensees must comply with APA Telepsychology Guidelines; Arkansas Telemedicine Act, HIPAA, and any other rules, statutes, or orders pursuant to the practice of psychology.

Department of Insurance has published COVID-19 Health Insurance Policy Information, linking to individual commercial payers’ websites for specific coverage information.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 4/2/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Department of Insurance Bulletin No. 13-2020 dated 3/27/20 directs all health insurance carriers (including short-term limited-duration plans) to comply with the telehealth reimbursement parity requirements specified in Ark. Code. Ann. § 23-79-1602(c), (d).

Emergency state action to include audio-only phone?
Executive Order 20-05 temporarily allows audio-only phone to provide telehealth services.

Emergency licensure waiver?
The Arkansas Psychology Board has issued an emergency telepsychology rule for licensees.

The Board is also revising its rules which includes proposed changes to the temporary practice provision (see Section 5.6.D.) – changing from a one-time 60-day temporary practice provision to a 30-day temporary practice provision per calendar year. The out-of-state psychologist would still be required to notify the Board in advance.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Psychology Interns are not included as eligible providers as part of the emergency rule released by the Arkansas Board of Psychology: “All Providers providing care via Telepsychology to a patient/client located within the State of Arkansas shall be licensed to practice psychology in the State of Arkansas.”

Existing state telehealth coverage mandate?
YES for all commercial health plans and Medicaid plans; no restrictions on originating sites; and requires reimbursement parity.

Cal Bus & Prof Code § 2290.5
Cal Health & Safety Code §1374.13, §1374.14
Cal Ins Code § 10123.85, § 10123.855
Cal Wel & Inst Code § 14132.725

Emergency orders expiration
State of emergency declared on 3/4/20. Public Health Emergency still in effect, not yet terminated.

Emergency state action on coverage of telehealth services?
An announcement dated 3/21/20, commercial and Medi-Cal managed care plans were directed to allow members to obtain health care via telehealth.

The California Board of Psychology issued guidance for trainees and supervisors regarding service delivery (using HIPAA compliant video) and face-to-face supervision requirements (using video or phone).

Emergency state action on telehealth reimbursement parity?
Insurance Commissioner guidance dated 3/30/20 directs health insurance companies to provide increased access to telehealth services, including reimbursement parity for telehealth services mirroring rates for equivalent in-person services.

See also DMHC APL 20-013 dated 4/7/20 directing all health plans to allow for reimbursement of telehealth services and establish common billing procedures.

CMS Section 1135 Medicaid Waiver approved 3/23/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Insurance Commissioner guidance dated 3/30/20 directs health insurance companies to provide increased access to telehealth services by allowing network providers to use all available and appropriate technologies, including phone calls to deliver care.

Medi-Cal Information Notice No. 20-09 updated 3/19/20 allows for audio-only phone to deliver services during the declared public health emergency.

Emergency licensure waiver?
Executive Order No. N-39-20 dated 3/30/20 grants authority to the Department of Consumer Affairs to temporarily waive licensing requirements for health care providers during the declared public health emergency.

The order encourages out-of-state providers to register with the California Health Corps to provide non-COVID-19 services to California residents at designated health care sites.

No further information yet available on the California Board of Psychology website.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Per guidance from the board of Psychology, trainees can provide psychological services via telehealth as long as they are properly supervised in doing so and the supervisor is adequately trained and experienced in providing services via telehealth. SPE can be accrued if they meet the requirements set forth in title 16 CCR section 1387.

Existing state telehealth coverage mandate?
YES for commercial health plans, state employee health plans and Medicaid; requires reimbursement parity; includes patient’s home as an eligible originating site.

CRS § 10-16-123
CRS § 25.5-5-320
CRS § 25.5-5-414

Emergency orders expiration
Executive Order No. D2020-20 temporarily suspending any and all limitations to telehealth services was extended through 6/21/20. (This extension also applies to the temporary licensure waiver covered by this order.)

State Insurance Department emergency regulation (20-E-05) requiring reimbursement parity for telehealth services remains in effect through 8/1/20 or as long as the state public health emergency is in effect, whichever is shorter. 

Medicaid guidance allowing audio-only phone and live chat is effective for duration of public health emergency.

Public Health Emergency is still in effect; not yet terminated

Emergency state action on coverage of telehealth services?
Executive Order No. D2020-20 dated 4/1/20 temporarily suspends any and all limitations to telehealth services, including exclusions as to what services are covered and the requirement that only HIPAA-compliant platforms may be used for services to be covered.

This waiver was extended to 6/21/20 by executive order.

Emergency state action on telehealth reimbursement parity?
Colorado Department of Regulatory Agencies – Division of Insurance issued Emergency Regulation 20-E-05 requiring reimbursement parity for telehealth services and suspending any other restrictions to reimbursement. This emergency rule became effective 4/3/20 and remains in effect for 120 days or as long as the Governor’s Emergency Declaration is in effect, whichever is shorter.

CMS Section 1135 Medicaid Waiver approved 3/26/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Guidance issued by the Department of Health Care Policy and Financing allows telephone-only service and live chat for Colorado Health First (Medicaid). However, pediatric behavioral health care providers may not use audio-only phone or live chat with their patients.

Emergency licensure waiver?
Executive Order No. D2020-20 dated 4/1/20 also temporarily suspends the 20-day limitation in the temporary practice provision for mental health providers (C.R.S. § 12-245-217(2)(e)(II)) to allow out-of-state licensed psychologists and other licensed mental health providers to individuals in Colorado.

This waiver was extended to 6/21/20 by executive order.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are not eligible to perform telehealth services as they are not licensed, and Colorado’s Section 1135 waiver requires all providers to be licensed to perform services.

Existing state telehealth coverage mandate?
YES for commercial health plans

CT. Gen. Stat. § § 19a-906, 38a-499a and 38a-526a

Emergency orders expiration
State public health emergency was issued on 3/10/20 and is still in effect; not yet terminated. 

Executive orders allowing audio-only phone services for new and existing Medicaid patients is in effect for the duration of the public health emergency. 

Licensure waivers issued by Dept. of Public Health are in effect through 9/9/20, unless terminated sooner by the governor.

Emergency state action on telehealth reimbursement parity? 
CMS Section 1135 Medicaid Waiver approved 3/27/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Executive Order No. 7F dated 3/18/20 authorizes the Medicaid agency to cover telehealth services provided by audio-only telephone.

Executive Order No. 7G dated 3/19/20 allows enrolled Medicaid providers and network providers for commercial health plans to provide telehealth services to existing patients using audio-only phone.

Executive Order No. 7FF allows for the use of audio-only phone for telehealth services to “new or established patients” who are Medicaid recipients.

Emergency licensure waiver?
Order issued by Dept. of Public Health dated 3/23/20 temporarily suspended licensure requirements for 60 days for professions including psychology. This waiver has been extended through 9/9/20 unless terminated sooner by the Governor.

There are no forms or registration with the Board required.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are not eligible to perform telehealth services as they are not licensed, and Connecticut’s Section 1135 waiver requires all providers to be licensed to perform services.

Existing state telehealth coverage mandate?
YES for commercial health plans; requires reimbursement parity; and allows audio-only phone

Del. Code Title 18, Ch. 33

Emergency orders expiration
Joint agency guidance allowing audio-only phone and patient’s home as eligible originating site is tied to state public health emergency declaration dated 3/13/20, and is still in effect; not yet terminated.

Joint order allowing temporary licensure waivers issued 3/24/20 tied to State of Emergency Order effective 3/13/20.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/27/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Delaware Health & Social Services (DHSS)/Division of Medical Assistance (DMMA) Guidance related to Changes to Telehealth Policies to Respond to COVID-19 revised 4/23/20 provides that audio-only phone services are permissible where interactive telehealth services are unavailable and phone-only is medically permitted for the underlying covered service.

Emergency changes in originating sites requirements?
Delaware Health & Social Services (DHSS)/Division of Medical Assistance (DMMA) Guidance related to Changes to Telehealth Policies to Respond to COVID-19 revised 4/23/20 recognizes the patient’s home or alternate location as eligible originating sites.

Emergency licensure waiver?
A joint order issued 3/24/20 by the Department of Health and Human Services and Emergency Management Agency allows out-of-state mental health providers with an active license to provide in-person and telemedicine mental health services. Further, all mental health providers who held a Delaware license within the last 5 years which is now inactive, expired, or lapsed may provide services.

Online registration form is available.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are not eligible to provide telehealth services as they are not licensed in Delaware (and those performing services from other jurisdictions are required to have an active license elsewhere). Postdoctoral students licensed as Psychology Assistants would be eligible to perform services.

Existing state telehealth coverage mandate?
YES for all commercial health plans and Medicaid

DC Code §§ 31-3861 et seq.

Emergency orders expiration
Mayor’s Order 2020-046 declaring public health emergency effective through 6/8/20. 

DC Medicaid will reimburse for audio-only phone services throughout the public health emergency and for 60 days following termination of emergency declaration. 

Administrative order dated 3/13/20 temporarily waiving licensure requirements tied to Mayor’s public health emergency declaration.

Emergency licensure waiver?
Administrative Order 2020-02 dated 3/20/20 temporarily waives licensing requirements for out-of-state licensed health care professionals (in good standing) providing services (including telehealth) to DC patients in a facility or telehealth services to existing patients who are in DC.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Per the Administrative Order on 3/20/20, trainees are not eligible to perform telehealth services as they are not licensed (in DC or elsewhere). Postdoctoral Students who have a Psychology Associate license would, however, be eligible to provide telehealth services.

Existing state telehealth coverage mandate?
Florida law merely states that for insurers opt to provide telehealth coverage, any provider contract provision that would cause telehealth reimbursement to be different than reimbursement for the same services provided in person must be agreed to and initialed by the provider.

Fla. Stat. §627.42396
Fla. Stat. §641.31(45)

State law also establishes telehealth practice standards and recordkeeping requirements.

Fla. Stat. §456.47

Emergency orders expiration
State public health emergency declaration in effect and set to expire 7/8/20. 

Dept. of Health Emergency Order 20-02 granting temporary licensure waivers for 30 days seems to be tied to EO 20-52 to expire 7/8/20.

Emergency state action on coverage of telehealth services?
n/a

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/16/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency licensure waiver?
Executive Order 20-003 dated 3/20/20 granting 30-day licensure waiver for out-of-state licensed health care providers (in good standing) delivering telehealth services to patients in Florida.

See also Executive Order 20-002 dated 3/16/20

Fla. Stat. §456.47 enacted in 2019 establishes a registration system for out-of-state telehealth providers (licensed in good standing). DOH has established an online system.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are not eligible to perform telehealth services as they are not licensed in Florida or elsewhere (per the Executive Order), and Florida’s Section 1135 waiver requires all providers to be licensed to perform services. Postdoctoral students who have a provisional license (often postdoctoral students) would, however, be eligible to provide telehealth services.

Existing state telehealth coverage mandate?
YES for commercial health plans including state employee health benefit plans; allows for audio-only phone

OGCA §33-24-56.4

Emergency orders expiration
COVID-19 public health emergency declared on 3/14/20 to remain in effect through 6/12/20. 

Medicaid policies temporarily allowing audio-only phone and patient’s home as eligible originating site are in effect for duration of public health emergency.

Emergency state action on coverage of telehealth services?
n/a

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 4/1/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
In the DCH Telehealth Guidance for Medicaid/PeachCare for Kids®/Fee-for-service Providers dated 3/18/20, Georgia Medicaid is temporarily allowing the use of telephones, video cellphone communications, and other audio and video technology to deliver telehealth services during the public health emergency.

Emergency changes in originating sites requirements?
In the DCH Telehealth Guidance to All Providers dated 3/26/20, Georgia Medicaid is temporarily waiving any restrictions on originating sites (where the patient is located) and distant sites (where the provider is located) during the public health emergency.

Qualified providers should continue to follow all applicable licensure rules specific to their profession. Services delivered from distant sites will be billed using the provider billing address associated with the enrolled Medicaid practice or facility. Claims must be billed using the associated procedure code, GT modifier and place of service code 02 to indicate telehealth delivery.

Emergency licensure waiver?
(No. Only physicians and nurses.)

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Emergency Rule amending Board Rule 510-2-.05 allows for supervision of practicum students, interns or post-doctorate fellows to be conducted by telephone and/or videoconferencing for the duration of the COVID-19 state of emergency, and for a period of not more than 120 days thereafter.

Services provided by psychology trainees with (at least) a bachelor’s degree are eligible for reimbursement by Medicaid, so they would be eligible to perform telehealth services as per the DCH guidance.

Existing state telehealth coverage mandate?
YES for commercial health plans and Medicaid; includes reimbursement parity; and no restrictions on eligible originating sites – can include patient’s home or place of work.

HRS §431:10A-116.3
HRS §432:1-601.5
HRS §432D-23.5

Emergency orders expiration
State of emergency issued on 3/4/20 to remain in effect through 6/30/20.

Emergency state action on coverage of telehealth services?
n/a

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/26/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Services performed by trainees are not eligible for Medicaid reimbursement because Medicaid requires all providers to be enrolled as Qualified Mental Health Providers (QMHP). Being under supervision precludes one from becoming a QMHP.

Additionally, Trainees are not eligible to perform telehealth services as they are not licensed, and Hawaii’s Section 1135 waiver requires all providers to be licensed to perform services.

Existing state telehealth coverage mandate?
NO

Emergency orders expiration
Governor declared state of emergency on 3/11/20 and remains in effect through 6/11/20. 

Insurance commissioner bulletin requiring telehealth coverage by private payers and allowing audio-only phone is tied to the public health emergency declaration.

Emergency state action on coverage of telehealth services?
Insurance Commissioner Bulletin No. 20-03 dated 4/6/20 temporarily requires health insurance carriers offering individual or employer sponsored group major medical health insurance policies to cover telehealth services provided by in-network providers.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/26/20 allows for reimbursement of payable claims by out-of-state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Insurance Commissioner Bulletin No. 20-03 dated 4/6/20 temporarily allows in-network providers to use non-HIPAA compliant communication platforms (such as Skype, Facebook Messenger, or Apple Facetime) as well as audio-only phone to provide patient care.

Emergency licensure waiver?
No. Executive Order dated 3/23/20 waives regulations for several professions, but NOT psychologists or other mental health providers.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are not eligible to perform telehealth services as they are not licensed, and Idaho’s Section 1135 waiver requires all providers to be licensed to perform services.

Existing state telehealth coverage mandate?
If an insurer chooses to provide telehealth coverage, then it must not impose additional requirements for the insured to access telehealth services.

IL Comp. Stat. Ann. §5/356z.22

Emergency orders expiration
Executive orders requiring coverage of telehealth services, allowing audio-only phone services and removing limitations to where patients can receive services expired 5/29/20. 

Temporary licensure waiver for out-of-state providers to continue seeing an existing patient in IL via telehealth is tied to the state public health emergency declaration.

Emergency state action on coverage of telehealth services?
Executive Order 2020-09 dated 3/19/20 requires coverage for telehealth services provided by in-network providers.

Executive Order 2020-33 reissues and extends a number of executive orders including EO 2020-09 through 05/29/20.

Emergency state action on telehealth reimbursement parity?
According to Executive Order 2020-09, insurers are required to cover the costs of all telehealth services and may not impose cost-sharing for services rendered by in-network providers.

CMS Section 1135 Medicaid Waiver approved 3/23/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Executive Order 2020-09 dated 3/19/20 allows audio or video communication technology to provide telehealth services.

While providers are allowed to use any non-public remote communications technology during this public health emergency, they are still encouraged to use encryption and privacy protections for telehealth. Public facing video communication applications like Facebook Live, Twitch, or TikTok are not allowed.

FAQ dated 3/30/20 allows Medicaid providers to use audio-only phones to deliver services during the public health emergency.

Emergency changes in originating sites requirements?
Executive Order 2020-09 removes any limitations to the patient’s location for receiving telehealth services. See Section 1

FAQ dated 3/30/20 allows removes any restrictions on the patient’s location and the provider’s location when delivering telehealth services during this public health emergency.

Emergency licensure waiver?
IL DFPR Guidance dated 3/30/20 interprets Executive Order 2020-09 to permit an out-of-state health care provider not licensed in Illinois to continue to provide health care services to an existing patient in Illinois via telehealth where there is a previously established provider/patient relationship for the duration of the declared public health emergency.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Services provided by interns and postdocs to Medicaid and commercial Blue Cross Blue Shield-enrolled patients are reimbursed, and would be eligible for telehealth reimbursement because of IL Comp. Stat. Ann. §5/356z.22.

Existing state telehealth coverage mandate?
YES for commercial health plans

Ind. Code Ann. §§ 27-8-34, 27-13-1-34, 27-13-7-22

Emergency orders expiration
Public health emergency declared on 3/6/20 and set to expire on 6/4/20. 

Executive Orders allowing telemental health, allowing audio-only phone services, and expanding Medicaid coverage of telehealth services are in effect for the duration of the public health emergency. 

Executive Orders 20-05, 20-13 temporarily allow out-of-state providers to register in Indiana to practice and are tied to the public health emergency declaration.

Emergency state action on coverage of telehealth services?
Executive Order No. 20-05 dated 3/19/20 allows mental health professionals to practice via telehealth.

Executive Order No. 20-13 dated 3/30/20 authorizes the state Family and Social Services Administration to suspend restrictions to expanded telehealth services under Medicaid; instructs the state Department of Insurance to request health insurers to provide coverage for expanded telehealth services during the public health emergency.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/25/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Executive Order No. 20-13 dated 3/30/20 allows audio-only phone to provide telehealth services.

Emergency licensure waiver?
Executive Order No. 20-05, No. 20-13 allows out-of-state providers to practice in Indiana if they are licensed in good standing elsewhere. Out-of-state licensed providers must register with the Indiana Professional Licensing Agency via its website.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Because services performed by interns are currently reimbursed by Medicaid at 50% of supervisor rate if they are employed at a CMHC, these services would continue to be reimbursed consistent with Executive Order No. 20-05.

Existing state telehealth coverage mandate?
YES for commercial health plans; coverage and reimbursement parity for Medicaid

Iowa Code. Ann § 514C.32
Iowa Admin. Code §441-78.55(249A)

Emergency orders expiration
Governor issued a state public health emergency declaration dated 3/22/20 with an expiration date of 4/16/20. 

Public health emergency and the interstate practice waivers remain in effect through 6/25/20. 

Medicaid policy waivers allowing for audio-only phone and patient’s home as an eligible originating site seem to be tied to the public health emergency declaration. It is unclear when those will be lifted post-pandemic.

Emergency state action on coverage of telehealth services?
n/a

Emergency state action to include audio-only phone?
Iowa Medicaid COVID-19 Provider Toolkit allows for the use of audio-only phone during the public health emergency.

Emergency changes in originating sites requirements?
Iowa Medicaid COVID-19 Provider Toolkit allows for patients to receive telehealth services in any location.

Emergency licensure waiver?
Governor’s Proclamation of Disaster Emergency (Section 15) dated 3/22/20 temporarily suspends state licensing requirements for out-of-state licensed mental health care providers, including psychologists, in good standing to provide services to patients in Iowa via telephone or other electronic means.

The governor issued a proclamation extending the declaration through 4/30/20.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Per Iowa Board of Psychology Guidance from 3/27/20, for individuals who are currently participating in the supervised professional experience, the requirement to meet “face to face” can be satisfied using electronic means. In addition, the requirement for the supervisor to work in the same physical setting as the supervisee is waived to the extent that the supervisor and supervisee may be working remotely during this emergency.

Existing state telehealth coverage mandate?
YES for commercial health plans and Medicaid

Kan. Stat. Ann. §§ 40-2.211, 40-2.213

Emergency orders expiration
State public health emergency was declared on 3/12/20. 

Medicaid policies related to COVID-19 waivers are in effect through 6/30/20.

Emergency state action on coverage of telehealth services?
See Insurance Commissioner bulletin dated 3/23/20 encouraging providers to check with each insurer for its coverage/billing policies.

Are health insurers covering telehealth services due to COVID-19?
The Commissioner of Insurance does not have the authority to mandate expansion of telehealth services or modifications in reimbursement amounts. However, we know many health insurers, but not all, are voluntarily making changes to allow telehealth services and to modify their payment practices to reimburse those services at the same level as in-person services. We encourage everyone to check with their health insurer regarding the coverage of telehealth services.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/24/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Kansas Medicaid Bulletin 20045: Telemedicine Reimbursement Update states that reimbursement for telehealth services must be equivalent to in-person services during the emergency declaration period.

Kansas Medicaid Bulletin No. 20046: UPDATED - Telemedicine Updates in Response to COVID-19 Emergency outlines the coding requirements for eligible telemental health services.

Emergency state action to include audio-only phone?
Kansas Medicaid Bulletin No. 20046: UPDATED - Telemedicine Updates in Response to COVID-19 Emergency temporarily allows for use of phones to provide telehealth services.

Emergency changes in originating sites requirements?
Kansas Medicaid Bulletin 20045: Telemedicine Reimbursement Update allows for patients to receive telehealth services in their homes during the emergency declaration period.

Emergency licensure waiver?
Note while Executive Order No. 20-08 (3/20/20) temporarily waives licensing requirements for out-of-state licensed physicians and other professions regulated by the KS Board of Healing Arts; however, this does not include the Kansas Behavioral Sciences Board under which psychology is housed.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are not eligible to perform telehealth services.

Existing state telehealth coverage mandate?
YES for commercial health plans (including self-insured plans as permitted by ERISA) and Medicaid; includes reimbursement parity; and patient’s home or office as an eligible originating site.

Ky Rev Stat § 304.17A-138
Ky Rev Stat § 304.17A-005

Emergency orders expiration
State of emergency declared on 3/6/20 and is still in effect; not yet terminated. 

Temporary COVID-19 policies for Medicaid and private insurance are tied to the state public health emergency declaration. 

Senate Bill 150 signed by the Governor on 3/3/20 temporarily allowing out-of-state licensed providers to provide health care services via telehealth so long as they register with the appropriate board and requiring insurers to cover said services will expire immediately upon termination of the public health emergency.

Emergency state action on coverage of telehealth services?
Insurance Commissioner issued guidance dated 3/18/20 stating that insurers cannot require that the patient have a prior relationship with the provider in order to have services delivered through telehealth, if the provider determines that telehealth would be medically appropriate.

See Kentucky’s Telehealth Program for more information about telehealth coverage and reimbursement policies for both Medicaid and private insurance.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/25/20 allows for reimbursement of payable claims by out-of-state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Insurance Commissioner issued guidance dated 3/18/20 temporarily waiving state requirements for HIPAA compliance consistent with the OCR guidance so long as providers use telehealth such as non-public facing audio or video communication products in good faith.

Emergency licensure waiver?
No, guidance from the Kentucky Board of Examiners of Psychology dated 3/13/20 provides that out-of-state licensed psychologists must comply with existing temporary non-resident registration process to provide services, including telehealth, in Kentucky. The Board has temporarily waived the registration fee.

Board memorandum dated 3/25/20 allows out-of-state licensed psychologists employed by the state to provide services immediately upon written notification to the Board and verification of holding an IPC, CPQ or ABPP board certification; out-of-state licensed psychologists to practice temporarily pursuant to the ARC-APA disaster response network upon notification to the Board; and encourages licensees to use telehealth to provide services including electronic supervision to supervisees.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Postdocs who hold the Psychological Associate license would be eligible to perform telehealth services to Medicaid beneficiaries. Interns and other trainees would not.

Board memorandum dated 3/25/20 states supervision shall not be required to be face-to-face or by direct observation until the state of emergency is lifted. Licensees are not required during this time to seek Board permission for electronic supervision.

Existing state telehealth coverage mandate?
The law provides that reimbursement for telehealth shall not be denied for the physician at the originating site and shall not be less than 50% of the normal rate of an in-person office visit. No mention of the distant site physician or inclusion of other health care providers.

La. Rev. Stat. Ann. § 22:1821(F)

Emergency orders expiration
State public health emergency declared on 3/11/20 and set to expire on 6/5/20. 

Department of Insurance Emergency Rule 37 (adopted 3/23/20) waiving telehealth coverage restrictions and allowing audio-only phone remained in effect until 5/12/20. 

Medicaid policies expanding access to telehealth services remain in effect for duration of public health emergency.

Department of Health order dated 3/22/20 requiring all health care providers to transition to telehealth for non-emergent care expired on 4/30/20. 

Amended and updated guidance dated 4/22/20 advised providers to continue telehealth services if possible and to follow CDC guidance for needed in-person services effective 4/27/20.

Emergency state action on coverage of telehealth services?
Department of Insurance’s Emergency Rule 37 temporarily requires all health insurers to waive any coverage limitations restricting telemedicine access to providers included within a plan’s telemedicine network as well as any requirement that the patient and provider have a prior relationship in order to have services delivered through telemedicine.

Specifically, mental health services must be covered to the same extent as in-person services.

This emergency rule is in effect through 5/12/20.

Executive Order No. JBE 2020-32 dated 3/19/20 compels all licensing boards to promulgate any rules necessary to promote and facilitate use of telehealth in delivering health care services.

Louisiana Department of Health’s Health Plan Advisory 20-8 dated 3/25/20 instructs Medicaid managed care organizations to cover assessments/evaluations and psychological testing conducted via telehealth based on the clinical judgment of the psychologist or psychiatrist.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Waiver approved 3/23/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.

Emergency state action to include audio-only phone?
Emergency Rule 37 temporarily waives any limitation on the use of audio-only phone consultations to provide telemedicine services, including the use of personal devices, as outlined in the guidance from HHS’s Office of Civil Rights.

Medicaid Director issued a provider update dated 3/17/20 allowing for the use of audio-only phone to deliver telehealth services when an interactive audio/video system is not available.

Emergency changes in originating sites requirements?
Louisiana Department of Health’s Health Plan Advisory 20-8 dated 3/25/20 advises that Medicaid has no originating site limitations.

Emergency licensure waiver?
Executive Order No. 25 JBE 2020 dated 3/11/20 grants authority to Department of Health to take any and all actions during the public health emergency but no mention of emergency licensure waivers for out-of-state providers.

Louisiana State Board of Examiners of Psychologists has established an online application process for out-of-state licensed psychologists to apply for emergency temporary registration to provide temporary services, including telepsychology. The Board will waive the requirement that the temporary practice request be associated with an organized relief effort.

Louisiana Department of Health Notice #2020-COVID19-ALL-006 dated 3/21/20 requires all health care providers to postpone all in-person services for 30 days and transition to telehealth services where appropriate.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Telesupervision is permitted after supervisors register with Board of Psychology via the Application for Authorization to Provide Tele-Supervision to Psychology Trainees/Unlicensed Assistants to Psychologists form and pay a $25 fee per supervisee.

Existing state telehealth coverage mandate?
YES for all commercial health plans and Medicaid; includes reimbursement parity

24-A Me. Rev. Stat. § 4316

Emergency orders expiration
State of public health emergency issued 3/15/20 and remains in effect through 6/11/20. 

Executive Order dated 4/7/20 allowing audio-only phone is tied to the public health emergency declaration.

Executive Order dated 4/7/20 also temporarily allows out-of-state psychologists to obtain a temporary license valid up to 60 days after the state public health emergency ends.

Emergency state action on coverage of telehealth services?
State guidance dated 3/12/20 from Maine Bureau of Insurance emphasizes existing state law mandates coverage of telehealth services.

Emergency state action to include audio-only phone?
Under the existing state mandate, audio-only phone would be permitted only if the scheduled telehealth service is not technologically available at the time of service.

Executive Order No. 35 FY19/20 dated 4/6/20 allows all Maine licensed psychologists and psychological examiners can provide services through all video and audio, and audio-only, electronic media for the duration of the public health emergency.

MaineCare guidance dated 3/16/20 states audio-only phone is permitted for telehealth services.

Emergency changes in originating sites requirements?
There are no restrictions on where the patient must be to receive telehealth services.

Emergency licensure waiver?
Executive Order No. 35 FY19/20 dated 4/6/20 allows for the following:

Any licensed psychologist who has held an active Maine license within the past three years and was in good standing, can have his/her Maine license immediately reactivated upon request. The license will remain valid for 60 days after the state of emergency ends.

Any out-of-state licensed psychologist in good standing (no disciplinary action in the past ten years) may apply for a temporary Maine license valid until 60 days after the end of the state of emergency. Services can be provided either in-person or using telehealth.

Also, Maine psychology licenses set to expire during the state of emergency shall be extended until 30 days following the end of the emergency.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Maine does not permit Medicaid reimbursement for trainee services.

Existing state telehealth coverage mandate?
YES for commercial health plans and Medicaid; reimbursement parity is required.

Md. Code Ann. Ins. § 15-139
Md. Code Ann. Health Gen. §15-105.2
COMAR 10.09.49

Emergency orders expiration
On 3/5/20, a state public health emergency was issued and is still in effect; not yet terminated. 

Executive orders allowing Medicaid reimbursement of audio-only phone health services and allowing asynchronous telehealth services are tied to the public health emergency. 

Omnibus health care order dated 3/16/20 allowing interstate practice reciprocity (but still requiring temporary license) remains in effect for duration of public health emergency.

Emergency state action on coverage of telehealth services?
DOH guidance states that behavioral health providers must contact the Medicaid behavioral health managed care organization with questions regarding prior authorization requirements for telehealth services.

Medicaid Memorandum regarding Provider Enrollment COVID-19 Temporary Changes dated 3/25/20 advises that Maryland Medicaid will not suspend any providers whose licenses about to expire and will allow enrollment for a provider with an expired Maryland license or out-of-state license, as long as there is no apparent Board sanction during the state of emergency.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/26/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency. **

Emergency state action to include audio-only phone?
Executive Order No. 20-04-01-01 further authorizes additional telehealth services by temporarily allowing the use of audio-only phones to deliver health care services during the public health emergency.

Executive Order No. 20-03-20-01 dated 3/20/20 expressly allows for reimbursement of audio-only health care services under Medicaid.

Maryland Department of Health guidance dated 3/25/20 allows for notebook computers, smartphones, or audio-only phones for Medicaid telehealth services during the public health emergency.

If Medicaid participants cannot access cellphone based video technology, audio-only telephone calls are permitted.

Emergency changes in originating sites requirements?
DOH guidance dated 3/21/20 (and previous guidance dated 2/12/20) allows temporary expansion of Medicaid (FFS and managed care) originating sites to include the patient’s home

Emergency licensure waiver?
Executive order dated 3/16/20 temporarily waives licensure requirements for out-of-state licensed health care providers for those working at a MD health care facility.

Otherwise, seek a temporary health care license; boards are ordered to expedite processing during the public emergency period.

Maryland Board of Psychology guidance dated 4/3/20 advises that out-of-state licensed psychologists (in good standing) must apply for a Temporary Exception to Practice in order to treat current patients located in Maryland via telehealth. There is a $100 application fee. The exception is valid for 30 days and eligible for extension upon request.

It is important to note that the Temporary Exception to Practice is only available to licensed psychologists, not psychology associates or interns.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Maryland does not permit Medicaid reimbursement for trainee services and the board specifically says via guidance on 4/3/20 that the waiver of licensure does not apply to interns or psychology associates.

Existing state telehealth coverage mandate?
The law is permissive, meaning that an insurer is not required to provide coverage for telehealth services. But if an insurer chooses to provide coverage for telehealth services, it may limit coverage to in-network providers and coverage shall be consistent with in-person services.

Mass. Gen. Laws. Ann. Ch. 175 §47BB

Medicaid does provide coverage and reimbursement parity for telehealth.

Emergency orders expiration
State of emergency declared on 3/10/20 and is not yet terminated.

Executive Order dated 3/15/20 requiring coverage of all in-network telehealth services, reimbursement parity for in-network telehealth services, and allowing for audio-only phone remains in effect until the state of emergency is terminated. 

Medicaid waivers allowing audio-only phone and requiring reimbursement parity are tied to the public health emergency. 

Executive Order dated 3/17/20 allowing certain out-of-state providers like psychologists to provide telehealth services in Massachusetts is tied to the state public health emergency declaration.

Emergency state action on coverage of telehealth services?
Executive Order dated 3/15/20 mandates all commercial insurers including BCBS and HMOs to cover in-network telehealth services.

Department of Insurance Bulletin No. 2020-04 dated 3/16/20 waives any preauthorization requirements for telehealth services by in-network providers. Commercial health plans must also reimburse for telehealth services at the same rate as paid for the same services when delivered in-person. (But this does not include facility fees for distant or originating sites.)

MassHealth Provider Bulletin 289 dated March 2020 confirms that telehealth services will be covered for both FFS and managed care Medicaid plans.

Emergency state action on telehealth reimbursement parity?
Executive Order dated 3/15/20 requires that reimbursement for telehealth services must be the same as in-person.

CMS Section 1135 Medicaid Waiver approved 3/26/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

MassHealth Provider Bulletin 289 dated March 2020 specifies that the reimbursement rates for telehealth services will be the same as in-person rates and outlines the telehealth billing policies including telephone assessment codes.

Emergency state action to include audio-only phone?
Executive Order dated 3/15/20 cannot impose specific requirements on telehealth technologies used so audio-only phone is allowed.

MassHealth FAQ: COVID-19 and Behavioral Health Providers dated 4/10/20 confirms that behavioral health providers may deliver telehealth services using audio-only phone.

Emergency changes in originating sites requirements?
MassHealth (Medicaid) does not have any limitations on originating sites.

Emergency licensure waiver?
Executive Order (Rescinding and Replacing the March 29, 2020 Order of the Commissioner of Public Health) dated 4/3/20 temporarily allowing out-of-state licensed health care providers including psychologists (in good standing) to provide services both in-person and across State lines into Massachusetts using telemedicine where appropriate.

This order also allows previously licensed Massachusetts health care providers within past 10 years to renew or reactivate their licenses without meeting state requirements and said license would be valid for 90 days beyond the end of the public health declaration. Any relevant fees shall be waived.

The Mental Health Practitioner Emergency Temporary Licensure Application is available online. There is no application fee.

The Emergency Temporary License Reinstatement Application is available online.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Medicaid reimburses for supervised trainee services which are eligible to be performed through telehealth means.

MassHealth FAQ: COVID-19 and Behavioral Health Providers dated 4/10/20 confirms that a licensed supervisor may use telehealth technology to provide clinical supervision of an unlicensed behavioral clinician providing face-to-face, telephonic or telehealth services to Medicaid patients.

Existing state telehealth coverage mandate?
YES for commercial health plans

MCLS § 500.3476
MCLS § 550.1401k

Emergency orders expiration
State of emergency (Executive Order 2020-04) was declared on 3/10/20 and is in effect through 6/19/20. 

Medicaid guidance issued 3/20/20 expanding telehealth policy expansions such as audio-only phone, patient’s home as originating site remain in effect for 30 days after the end of the public health emergency, or on the first of the following month, whichever is later.

Emergency state action on coverage of telehealth services?
Michigan Medicaid listed the codes and coverage changes for the COVID-19 response that are in effect for 30 days following the termination of Governor Whitmer’s Declaration of a State of Emergency Order (2020-04, COVID-19), or on the first of the following month, whichever is later.

Emergency state action to include audio-only phone?
The existing state law mandating telehealth coverage already allows for audio-only phone.

Emergency changes in originating sites requirements?
Executive order dated 3/12/20 allows Medicaid patients to receive telehealth services at home.

Emergency licensure waiver?
Executive Order 2020-13 grants additional flexibility to LARA/DHHS regarding decisions about licensing, registration, and workflow requirements

Executive Order 2020-30 temporarily waives state licensure requirements and allows out-of-state licensed providers in good standing to practice in Michigan for the duration of the public health emergency.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Interns and postdoc supervised services are reimbursed by Medicaid and eligible to be performed via telehealth.

Existing state telehealth coverage mandate?
YES for commercial health plans and Medicaid; includes reimbursement parity

Minn. Rev. Stat. § 62A.672
Minn. Rev. Stat. § 256B.0625

Emergency orders expiration
Executive Order 20-01 dated 3/13/20 declared a peacetime emergency in response to COVID-19 and is in effect through 6/12/20. 

Medicaid waivers pursuant to Executive Order 20-12 dated 3/20/20 allowing audio or video visits tied to the peacetime emergency declaration. 

2020 SF 4334 signed into law on 3/17/20 allowing patient’s home as eligible originating site expires 2/1/21. 

Executive Order 20-28 issued 4/6/20 allowing out-of-state mental health providers to deliver telehealth services is tied to the peacetime emergency declaration.

Emergency state action on coverage of telehealth services?

Joint DOI-DOH Memorandum to Health Insurance Carriers Related to COVID-19 dated 3/13/20 advises health plans to take the necessary steps to eliminate any barriers to telehealth services consistent with state law.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/27/20 allows for reimbursement of payable claims by out-of-state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Medicaid CV16 implementing Executive Order 20-12, MinnesotaCare allows for audio-only phone to deliver health care services.

It also allows providers to treat new patients via audio-only phone, allows CHIP and Medicaid beneficiaries to have more than three telemedicine visits per week, and requires managed care plans to follow these policies.

Emergency changes in originating sites requirements?
2020 SF 4334 signed into law on 3/17/20 adds patient’s home to list of eligible originating sites for telehealth.

This provision became effective on 3/18/20 and expires 2/1/21.

Emergency licensure waiver?
Emergency Executive Order 20-28 temporarily allows out-of-state licensed mental health care providers (including psychologists) in good standing to provide telehealth services to individuals in Minnesota during the state of emergency.

Providers must register with the appropriate Minnesota licensing board which includes submitting a copy of their current license and obtain the board’s acknowledgement of receipt of registration.

Existing state telehealth coverage mandate?
YES for all commercial health plans including state employee benefit plans and Medicaid but may limit coverage to services from in-network providers

Miss. Code Ann. §§ 83-9-351, 83-9-353

Emergency orders expiration
State of emergency declared on 3/14/20 and is still in effect; not yet terminated.

Medicaid recognition of patient’s home as an eligible originating site is effective for the duration of the state of emergency.

Medicaid’s emergency telehealth policy allowing audio-only phone, certain services not typically allowed for telehealth, and certain providers not typically eligible to deliver telehealth services is in effect through 6/30/20.

Insurance Commissioner Bulletin 20-09 extended Bulletin 20-01 directing insurers to remove any barriers to telehealth and allowing audio-only phone to remain in effect through 6/30/20.

MS Board of Psychology guidance dated 3/17/20 temporarily waiving the 30-day limit on temporary practice for out-of-state licensed psychologists remains in effect for the duration of the public health emergency.

Emergency state action on coverage of telehealth services?
Mississippi Insurance Department Bulletin 2020-1 dated 3/16/20 temporarily suspends any health plan’s requirement limiting coverage of telehealth services to providers in the plan’s telehealth network. The bulletin advises that coverage of telehealth services should be the same as in-person services.

Medicaid’s Emergency Telehealth Policy dated 4/10/20 outlines the telehealth billing policies and approved billing codes.

Mississippi Insurance Department Bulletin No. 2020-9 dated 4/24/20 extends its previous bulletin on use of telemedicine during the COVID-19 crisis (Bulletin 2020-1) through 6/30/20.

Emergency state action on telehealth reimbursement parity?

CMS Section 1135 Medicaid Waiver approved 3/23/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?

Mississippi Insurance Department Bulletin 2020-1 dated 3/16/20 temporarily allows the use of audio-only phones to deliver telehealth services. This is effective through 4/30/20.

Medicaid’s Emergency Telehealth Policy dated 4/10/20 temporarily allows use of audio-only phone to deliver telehealth services.

Emergency changes in originating sites requirements?
Medicaid’s Emergency Telehealth Policy dated 4/10/20 temporarily recognizes the patient’s home as an eligible originating site to receive telehealth services. (See page 3.) This policy is effective through 5/31/20.

Emergency licensure waiver?
MS Board of Psychology issued guidance dated 3/17/20 temporarily waiving the 30-day limit on temporary practice for out-of-state licensed psychologists during public health emergency period. But must still apply for Temporary Practice Certificate from the Board which will expedite review/approval process.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are not eligible to perform telehealth services.

Existing state telehealth coverage mandate?
YES for all commercial health plans including state employee and retiree health benefit plans and Medicaid/MOHealthNet; includes reimbursement parity; BUT may restrict coverage to services from in-network providers

R.S.Mo. § 376.1900
R.S.Mo. § 208.670

Emergency orders expiration
Governor issued emergency declaration on 3/13/20 and is in effect through 6/15/20.

Medicaid temporarily expanded telehealth guidance allowing audio-only phone and allowing flexibility for the provider’s distant site location appear to be tied to the emergency declaration.

Executive Order 20-04/Missouri Department of Insurance bulletin dated 3/20/20 temporarily waiving licensing requirements for out-of-state licensed providers during the COVID-19 public health crisis remained in effect through 5/15/20.

Executive Order No. 20-10 dated 5/4/20 extends previously issued EO 20-04 through 6/15/20.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/25/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
MO HealthNet Division (Medicaid) in its telehealth guidance revised 3/26/20 is temporarily allowing the use of telephone for telehealth services.

Emergency changes in originating sites requirements?
In addition to already allowing the patient’s home as an originating site, MO HealthNet Division (Medicaid) in its telehealth guidance revised 3/26/20 is temporarily allowing quarantined providers and/or providers working from alternate sites or facilities to provide and bill for telehealth services. These services should be billed as distant site services using the provider number.

Emergency licensure waiver?
Pursuant to Executive Order 20-04, Missouri Department of Insurance bulletin dated 3/20/20 temporarily waives licensing requirements for out-of-state licensed providers during the COVID-19 public health crisis.

MO HealthNet Division (Medicaid) in its telehealth guidance revised 3/26/20 is temporarily allowing out-of-state licensed providers to deliver telehealth services.

Executive Order No. 20-10 dated 5/4/20 extends previously issued EO 20-04 through 06/15/20.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees can perform telehealth services if the trainee is being supervised by a Missouri licensed psychologist and that licensed psychologist supervisor knows the services are being delivered in such a manner (per guidance from Committee of Psychologists).

Existing state telehealth coverage mandate?
YES for commercial health plans; includes reimbursement parity

Mont. Code Ann. § 33-22-138

Emergency orders expiration
Public health emergency declared (Executive Order 2-2020) on 3/12/20 and to remain in effect through the national public health emergency.

Temporary changes in Medicaid allowing audio-only phone and patient’s home as originating site appear to be effective for the duration of the public health emergency.

Executive order temporarily waiving restrictions on the types of technology allowed for telehealth (including audio-only phone), expanding what constitutes eligible originating sites and distant sites to include homes of the patient and the provider, and emphasizing reimbursement parity for telehealth services is in effect for the duration of the national public health emergency.

Emergency state action on coverage of telehealth services?
No but Insurance Commissioner’s press release dated 3/19/20 lists those health plans that have voluntarily expanded telehealth coverage during the public health emergency.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/30/20 allows for reimbursement of payable claims by out-of-state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Executive order dated 3/20/20 allows for use of audio-only phone in providing telehealth services.

Medicaid Director guidance recognizes audio-only phone and secure messaging for telehealth services during public health emergency period.

Emergency changes in originating sites requirements?
Medicaid Director guidance recognizes patient’s home as eligible originating site to receive telehealth services.

Emergency licensure waiver?
Montana has developed an interstate licensure registration system for out-of-state licensed providers for the duration of the public health emergency.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Montana does not permit Medicaid reimbursement for trainee services (1135 waiver says only licensed practitioners). No mention of telesupervision changes on their board website.

Existing state telehealth coverage mandate?
YES for commercial health plans including self-funded employee benefit plans (not preempted by ERISA)

Neb. Rev. Stat. § 44-7, 107
Neb. Rev. Stat. § 44-312

Emergency orders expiration
State public health emergency declaration issued on 3/13/20 and is still in effect; not yet terminated.

Executive Order No. 20-12 dated 3/31/20 requiring published guidance for payment of Medicaid telehealth services remains in effect for 30 days following the end of the public health emergency.

Executive Order No. 20-10 dated 3/27/20 temporarily allowing out-of-state health care providers to provide telehealth services will remain in effective for 30 days after the public health emergency declaration is lifted.

Emergency state action on coverage of telehealth services?
Department of Insurance published Telehealth Questions and Responses dated 4/9/20 summarizing telehealth coverage and billing policies for commercial health plans in the state.

Executive Order No. 20-12 dated 3/31/20 instructs the Department of Health and Human Services to provide guidance for health care providers regarding the use of telehealth by licensed practitioners and guidance for the payment of Medicaid services provided via telehealth.

Medicaid Provider Bulletin 20-06 dated 3/17/20 advises that telephone evaluation and management services will be covered during the public health emergency.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 4/2/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Medicaid and Long-Term Care COVID-19 FAQ dated 3/23/20 temporarily allows audio-only phone when telehealth is unavailable.

Emergency changes in originating sites requirements?
Nebraska Department of Insurance Telehealth Questions and Responses confirm that patients may receive telehealth services at home during the COVID-19 public health emergency.

Emergency licensure waiver?
Executive Order No. 20-10 temporarily waives state licensing requirements and allows out-of-state licensed health care providers to work in Nebraska during the state of emergency so long as they are in good standing and free from disciplinary action in the states where they are licensed.

Telehealth FAQ revised 4/1/20 allows those out-of-state licensed providers permitted to practice pursuant to Executive Order 20-10 to use telehealth.

Executive Order No. 20-10 temporarily allows out-of-state health care providers (actively licensed in good standing free from disciplinary action) to use telehealth to practice in Nebraska without a Nebraska license. This will remain in effective for 30 days after the public health emergency declaration is lifted.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Interns are not eligible to perform telehealth services as they are not licensed (and Nebraska’s section 1135 waiver requires all providers to be licensed) but postdocs enrolled in Medicaid as psychological assistants would be eligible to perform services via telehealth.

Existing state telehealth coverage mandate?
YES for commercial health plans including small employer health benefit plans and industrial insurance and Medicaid

Nev. Rev. Stat. Ann. §§ 689A.0463, 6898.0369, 689C.195, 616C.730, 695A.265, 695B.1904, 695C.1708, 695D.216, 695G.162

Emergency orders expiration
State of emergency declared on 3/12/20 and is still in effect; not yet terminated.

Medicaid temporary waivers allowing audio-only phone. Allowing group therapy via telehealth and recognizing patient’s home as eligible site are in effect during the public health emergency.

Declaration of Emergency Directive 011 dated 4/1/20 temporarily allowing out-of-state licensed health care to provide services is in effect for duration of the public health emergency.

Emergency state action on coverage of telehealth services?
Department of Insurance emergency regulation dated 3/5/20 prohibiting insurers from charging out-of-pocket costs for preventative visits related to COVID-19 and requiring insurers to notify patients and network providers about available benefits including telehealth services.

Check specific commercial insurer for individual guidance.

Nevada Telehealth Resource Guide dated 3/18/20 outlines Medicaid’s coverage and billing policies for telehealth services.

In the Nevada Telehealth Memo updated 3/19/20, Medicaid lifted restrictions on use of telehealth for group therapy.

In the Nevada Telehealth Memo dated 3/27/20, Medicaid advised certain ABA services provided via telehealth will be covered during the public health emergency.

Emergency state action to include audio-only phone?
Nevada Telehealth Memo dated 3/17/20 temporarily allows audio-only phone for delivering services to Medicaid beneficiaries.

Emergency changes in originating sites requirements?
COVID-19 FAQ for Medicaid Providers dated 3/18/20 states that patients may receive telehealth services in their home.

Emergency licensure waiver?
Declaration of Emergency Directive 011 temporarily suspends state licensure requirements for out-of-state licensed health care providers (in good standing) to provide services in Nevada during the public health emergency. Providers must notify the applicable Nevada professional licensing board to confirm home state licensing status.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are eligible to perform telehealth services for Medicaid reimbursement.

Existing state telehealth coverage mandate?
YES for commercial health plans including state employee health benefit plans, and Medicaid

RSA 415-J:1 et seq.

Emergency orders expiration
Executive Order 20-04 dated 3/13/20 declared a public health emergency and is in effect through 6/5/20.

Emergency Order No. 8 (EO 20-04) dated 3/18/20 requiring coverage and reimbursement of in-network telehealth services, allowing for all types of technologies including audio-only phone for telehealth, and recognizing the patient’s home as an originating site is in effect for the duration of the public health emergency.

Emergency Order No. 15 (EO 20-04) dated 3/23/20 temporarily allowing out-of-state providers to deliver telehealth services is in effect for duration of public health emergency.

Emergency state action on coverage of telehealth services?
Emergency Order #8 requires all health insurers, health benefit plans and Medicaid (including managed care plans) to allow in-network providers to provider telehealth services during the state of emergency.

Emergency state action on telehealth reimbursement parity?
Emergency Order #8 requires reimbursement parity for telehealth services but waives any cost-sharing for medically necessary treatment delivered via telehealth related to COVID-19.

CMS Section 1135 Medicaid Waiver approved 3/23/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Emergency Order #8 allows all modes of telehealth, including video and audio, audio- only, or other electronic media.

NH Medicaid Guidance dated 3/18/20 allows for Medicaid providers to use audio-only phones to deliver services for the duration of the public health emergency.

Emergency changes in originating sites requirements?
Emergency Order #8 expansively defines “originating site” to include patients’ homes, schools and clinical settings.

NH Medicaid Guidance dated 3/18/20 affirms that there are no restrictions on originating sites for the duration of the public health emergency.

Emergency licensure waiver?
Executive Order #15 allows for temporary authorization for out-of-state providers to provide medically necessary services and provide services through telehealth including NH students enrolled in schools within or outside of the state.

Emergency Rule PLC 802.01 describes the application process for an emergency license pursuant to Executive Order #15.

The application is available online.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
New Hampshire does not permit Medicaid reimbursement for trainee services (1135 waiver says only licensed practitioners). No mention of telesupervision changes on their board website.

Board of Psychologists Standing Order dated 4/3/20 temporarily waives the face-to-face requirement for intern and postdoctoral supervision for the duration of the public health emergency.

Existing state telehealth coverage mandate?
YES for commercial health plans including state employee health benefit plans and school employee health benefit plans, and Medicaid/NJ FamilyCare programs; includes reimbursement parity; but allows insurers to limit coverage to services provided by in-network providers

N.J. Stat. § 45:1-6
N.J. Stat. § 26:2S-29
N.J. Stat. § 52:14-17.29w
N.J. Stat. § 52:14-17.46.6h
N.J. Stat. § 30:4D-6k

Emergency orders expiration
State public health emergency is in effect through 6/5/20.

Emergency guidance from Department of Insurance (Bulletin 20-07) requiring coverage of in-network telehealth services, granting in-network exceptions for out-of-network care when appropriate, and allowing all forms of technology including audio-only phone remains in effect for the duration of the COVID-19 public health emergency.

Emergency legislation (A3860) enacted on 3/19/20 temporarily removing all restrictions to coverage and reimbursement of telehealth services including the patient’s home as an eligible originating site is in effect during the COVID-19 public health emergency.

Emergency legislation (A3860) allows for all licensed providers to deliver telehealth services including out-of-state providers seeing established patients who are in New Jersey. This remains in effect for the duration of the COVID-19 state of emergency.

Emergency legislation (A3862) established temporary emergency licensing for out-of-state individuals, waiving certain requirements, such as a criminal history background check and payment of certain licensing fees. for the duration of any declared state of emergency.

Emergency state action on coverage of telehealth services?
Insurance Commissioner bulletin 20-07 dated 3/22/20 requires insurers to review plans for network adequacy; to grant any requested in-plan exceptions for individuals to access out-of-network telehealth providers if network telehealth providers are not available; and to encourage in-network providers to use telehealth whenever possible and clinically appropriate.

Emergency state action on telehealth reimbursement parity?
Insurance Commissioner bulletin 20-07 dated 3/22/20 requires insurers to waive any cost-sharing for telehealth service; and to ensure reimbursement parity for telehealth services.

It also prohibits insurers from imposing any restriction on telehealth reimbursement that requires the provider who is delivering the services to be licensed in a particular state, so long as the provider is in compliance with recently enacted A3860 and A3862 and this guidance.

CMS Section 1135 Medicaid Waiver approved 3/23/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Effective immediately, emergency legislation (A3860) allows for the use of telephone to deliver telehealth services during the COVID-19 public health emergency.

Insurance Commissioner bulletin 20-07 dated 3/22/20 requires insurers to update their policies to allow for telephone-only services within the definition of telehealth and to not impose any specific requirements on the technologies used to deliver telemedicine and/or telehealth services (including any limitations on audio-only or live video technologies) during the state of emergency and public health emergency declared pursuant to EO 103.

Emergency changes in originating sites requirements?
NJ Department of Banking and Insurance issued COVID-19: Telehealth and Telemedicine FAQs which confirm patients may receive telehealth services in their homes.

Emergency licensure waiver?
Effective immediately, emergency legislation (A3860) allows out-of-state licensed providers in good standing to deliver telehealth services to patients in NJ (subject to certain conditions) during the COVID-19 public health emergency.

Under this emergency legislation, an out-of-state provider may only provide telehealth services and bill for the encounter if it involves an existing patient or the screening, diagnosis, or treatment of COVID-19.

Emergency legislation (A3682) orders NJ Division of Consumer Affairs to expedite licensing for out-of-state individuals and to waive certain requirements, such as a criminal history record background check of an individual and payment of certain fees for the license, certificate of registration or certification.

There is an online application process for accelerated temporary licensure for out-of-state licensed health care professionals to provide services via telehealth or in-person.

Executive Order No. 112 grants immunity from civil liability for out-of-state providers practicing via telehealth in New Jersey via temporary license for acts or omissions done in good faith as result of providing services in support of COVID-19 response during the public health emergency.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Services provided by interns in “Independent Clinic-Mental Health or Independent Clinic Drug/Alcohol setting” are reimbursed by Medicaid and are eligible to be performed via telehealth.

Existing state telehealth coverage mandate?
YES for all commercial health plans including state employee health benefit plans and any form of self- insurance, and Medicaid (FFS and managed care) plans; includes reimbursement parity

N.M. Stat. Ann. §13-7-14
N.M. Stat. Ann. §59A-22-49.3
N.M. Stat. Ann. §59A-23-7.12
N.M. Stat. Ann. §59A-46-50.3
NMAC §§ 8.310.2.12(M), 8.308.9.18

Emergency orders expiration
Executive Order 2020-04 dated 3/11/20 established a public health emergency, which is in effect through 6/30/20.

Medicaid guidance allowing coverage of telehealth services provided by phone, telephone assessment and management services, and e-visit services remains in effect for the duration of the public health emergency.

Emergency state action on coverage of telehealth services?
NM Department of Insurance issued guidance dated 3/6/20 state that insurers should encourage network providers to utilize telehealth services and take other proactive measures.

NM Medicaid Special COVID-19 Supplement #3 – Guidance for NM Medicaid Providers dated 4/6/20 states in addition to existing psychotherapy codes, ABA services provided by phone, telephone assessment and management services, and e-visit services will be covered for the duration of the public health emergency.

Emergency state action on telehealth reimbursement parity?
NM State Medicaid Program and Superintendent of Insurance issued new requirement dated 3/20/20 calling for reimbursement parity for telehealth services.

CMS Section 1135 Medicaid Waiver approved 3/23/20 allows for reimbursement of payable claims by out-of-state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Superintendent of Insurance Bulletin 2020-05 confirms that there must be reimbursement parity between telehealth and comparable in-person services.

Emergency state action to include audio-only phone?
NM State Medicaid Program and Superintendent of Insurance issued new requirement dated 3/20/20 allowing for phone or computer video to deliver telehealth services.

NM Medicaid Letter of Direction #30 dated 3/30/20 instructs all Medicaid managed care organizations on new COVID-19 billing policies including the use of audio-only phone.

The companion document - NM Medicaid Special COVID-19 Supplement #3 – Guidance for NM Medicaid Providers dated 4/6/20 outlines the list of accepted behavioral services that may temporarily be provided by phone.

Emergency changes in originating sites requirements?
There are no restrictions on eligible originating sites (where the patient is to receive telehealth services) under existing state law.

Emergency licensure waiver?
Executive Order 2020-004 compels the Department of Health et al to credential out-of-state professionals during the declared public emergency (see NMSA §12-10-11).

No specific guidance on DOH explaining credentialing process.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Interns and postdocs would be eligible to provide services via telehealth to Medicaid beneficiaries.

Existing state telehealth coverage mandate?
YES for commercial health plans and Medicaid

NY CLS Ins Law §3217-h
NY CLS Ins Law § 4306-g
NY CLS Pub Health § 2999-dd NY CLS Pub Health § 4406-g
NY CLS Soc Serv § 367-u(2)

Emergency orders expiration
State disaster emergency declaration (#202) was issued on 3/7/20 and to remain in effect through 9/7/20.

Medicaid waivers allowing audio-only phone and the patient’s home as an originating site are in effect for duration of public health emergency.

Executive Order 202.27 dated 5/5/20 temporarily allowing out-of-state health care providers to practice in New York up to 30 days remains effective through 6/04/20.

Executive Order 202.32 dated 5/21/20 extends EO 20.27 through 6/20/20.

Emergency state action on telehealth reimbursement parity?
NY Department of Financial Services Emergency Insurance Regulation 62 waives cost-sharing for all in-network telehealth services during the declared state of emergency.

CMS Section 1135 Medicaid Waiver approved 3/26/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
NY Office of the Professions has existing guidance recognizing audio-only phone, email, chat and videoconferencing for telepractice.

NY Office of Mental Health has issued supplemental guidance dated 3/17/20 allowing use of phone and/or commonly available video apps for delivery of telehealth services to Medicaid patients during the public health emergency period.

NY Medicaid Bulletin Vol. 36, No. 5 dated 3/23/20 allows audio-only phone to deliver services during the public health emergency.

Emergency changes in originating sites requirements?
NY Medicaid Bulletin Vol. 36, No. 5 dated 3/23/20 removes any limitations on the originating sites (where the patient is) and distant sites (where the provider is) when delivering telehealth services for the duration of the public health emergency.

Emergency licensure waiver?
Recent executive orders temporarily waive state licensing requirements for certain medical providers; however, NYSED Office of the Professions emphasize that all other licensed professionals must have a NYS license to provide services.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
New York does not permit Medicaid reimbursement for trainee services (1135 waiver says only licensed practitioners).

Existing state telehealth coverage mandate?
NO

Emergency orders expiration
Executive Order 116 established a state of emergency effective 3/10/20. The Public Health Emergency is still in effect; not yet terminated.

Executive Order No. 130 dated 4/8/20 temporarily waiving state licensing requirements for out-of-state licensed providers remains in effect through 6/7/20.

Emergency state action on coverage of telehealth services?
Insurance Commissioner advisory bulletin No. 20-B-05 dated 3/12/20 compels insurers to remove all barriers to care, including ensuring their telehealth programs with participating providers are robust and will be able to meet any increased demand.

The NC Department of Insurance includes links to major health plans for information about telehealth coverage and billing policies.

NC Medicaid Summary of NC Payers COVID-19 Telehealth Policies outlines the general coverage policies for each NC payer serving Medicaid patients.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/23/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency changes in originating sites requirements?
Medicaid Special Bulletin COVID-19 #34 confirms that there are no restrictions on originating sites for receiving telehealth services. There are also no restrictions on distant sites (where the treating provider is located).

Emergency licensure waiver?
Executive Order No. 130 dated 4/8/20 temporarily waives state licensing requirements for out-of-state licensed providers (in good standing) including psychologists to provide services either via telehealth in person.

This order is in effect through 6/7/20.

North Carolina Psychology Board COVID-19 FAQ #5 advises that out-of-state psychologists must notify the Board in advance and provide the following information:

• Intent to provide psychological services to someone located in North Carolina and under exemption they are eligible for emergency temporary practice
• Name of the state(s) in which they are currently licensed, if applicable
• The identity and contact information of the NC psychologist in who will provide the required supervision, if applicable
• The name of the organization under which they are volunteering, if applicable
• Any other required information or documentation

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Postdocs licensed as psychology associates are eligible to perform services for Medicaid beneficiaries via telehealth, but interns and other trainees are not.

The Board references a statement including information about face to face supervision by electronic means: As long as a licensee is practicing in a manner consistent with his/her training and experience, and is receiving supervision as is appropriate, the medium for doing so is not at issue.

Existing state telehealth coverage mandate?
YES for commercial health plans including public employee health benefit plans; requires for negotiations between insurers and providers to be conducted in same manner for telehealth as for in-person services

N.D. Cent. Code §26.1-36-09.15

Emergency orders expiration
State of emergency was declared on 3/13/20 and is still in effect; not yet terminated.

Executive Order 2020-05.1 dated 3/20/20 amending EO 2020-05 to include telehealth and also temporarily allowing audio-only services for telehealth remains in effect for the duration of the public health emergency.

Executive Order 2020-05 dated 3/19/20 temporarily waiving licensing requirements for out-of-state providers remains in effect for duration of public health emergency.

Emergency state action on coverage of telehealth services?
Executive Order 2020-05.1 dated 3/20/20 specifies that insurers shall cover virtual check-ins and e-visits for established patients and shall not subject telehealth (including virtual check-ins and e-visits) to any cost-sharing requirements for established patients.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/24/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Executive Order 2020-05.1 dated 3/20/20 also allows for audio-only phone to provide telehealth services, prohibits insurers from imposing any specific requirements on telehealth technologies used, and expands state’s “secured connection” requirement to be consistent OCR’s guidance.

Emergency changes in originating sites requirements?
Existing state law does not appear to impose any restrictions on eligible originating sites.

Emergency licensure waiver?
Executive Order 2020-05.1 dated 3/19/20 temporarily suspends licensing requirements for out-of-state licensed health care professionals (in good standing) to provide health care services, including telehealth, to ND residents.

ND Department of Health has set up an online emergency licensure application process.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
North Dakota does not permit Medicaid reimbursement for trainee services (1135 waiver says only licensed practitioners).

Existing state telehealth coverage mandate?
YES for commercial health plans but limited to telehealth services provided by physicians, nurse practitioners and physician assistants; includes reimbursement parity

Ohio Rev. Stat. Ann. § 3902.30 (effective 1/121)

Emergency orders expiration
Executive Order 2020-1D dated 3/9/20 established the public health emergency which is still in effect; not yet terminated.

Executive Order 2020-5D dated 3/19/20 allowed emergency rulemaking to expand health care access via telehealth for Medicaid beneficiaries. The rules remain in effect through 4/19/20 (120 days from effective date of emergency rules) or until adopted through normal rulemaking process, whichever is sooner.

Medicaid emergency rule 5160-1-21 effective 3/20/20 allowing telehealth services, including behavioral health, to new and established patients and audio-only phone remains in effect through 4/19/20.

Medicaid temporary waiver removing any restrictions to eligible originating sites remains in effect during the public health emergency.

Emergency state action on coverage of telehealth services?
Insurance Commissioner bulletin 2020-02 dated 3/11/20 encourages insurers to implement early adoption of Ohio’s telehealth coverage mandate law that goes into effect as of 1/1/21.

It is important to note that the coverage mandate is limited to services provided by physicians, nurse practitioners and physician assistants.

Medicaid’s Telehealth Billing Guidelines During COVID-19 State of Emergency outlines all of the services/billing codes that can be delivered via telehealth during the public health emergency.

Emergency state action on telehealth reimbursement parity?
Insurance Commissioner bulletin 2020-02 dated 3/11/20 reminds insurers that the coverage mandate includes reimbursement parity for telehealth services.

Emergency state action to include audio-only phone?
Departments of Health and Medicaid announced emergency orders (3/14/20) reducing restrictions on telehealth, ensuring that every Ohioan has access to behavioral health care via telehealth services by landline or cell phone as authorized by Executive Order 2020-05D dated 3/19/20

Medicaid emergency rule No. 5160-1-21 dated 3/20/20 temporarily allows audio-only phone and other video technologies consistent with recent OCR guidance.

Ohio Board of Psychology issued advisory guidance dated 3/11/20 stating that under the current COVID-19 public health emergency, Ohio-licensed psychologists may use their professional judgment, on a case-by-case basis, to use audio-only phone to ensure client welfare and continuity of care when the client and psychologist are prohibited from meeting in-person because of efforts to contain COVID-19.

This bulletin also confirms that telecommunications may be used for psychological work and training supervision.

Emergency changes in originating sites requirements?
Medicaid’s Telehealth Billing Guidelines During COVID-19 State of Emergency provides that Medicaid patients may access telehealth services wherever they are located, including their homes.

Emergency licensure waiver?
Ohio Board of Psychology issued follow-up guidance dated 3/20/20 confirming that licensing requirements have NOT been waived.

However, out-of-state licensed psychologists (and independently practicing master’s level psychology providers) may apply for a Non-Resident Temporary Permit to practice in Ohio in-person or via telehealth. The time limit has been temporarily extended to 90 days/calendar year. This also may be extended to supervisees practicing psychology under supervision.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Interns and postdocs services are eligible for reimbursement when performed via telehealth for Medicaid beneficiaries.

With regard to telesupervision, at the supervising psychologist's discretion, supervisees may provide services to patients living in Ohio. Supervisees must practice under supervision of the authorized psychologist in their home state.

Existing state telehealth coverage mandate?
YES for commercial health plans, disability insurer programs, workers compensation programs, and Medicaid (FFS) programs

36 Okla. St. Ann. §§ 6802, 6803

Emergency orders expiration
Amended Executive Order 2020-07 (dated 3/17/20) established a state of emergency effective through 5/1/20.

Temporary waiver of existing provider-patient relationship requirement for telehealth and Medicaid waiver allowing audio-only phone are effective for the duration of the declared emergency.

Emergency state action on coverage of telehealth services?
Amended Executive Order No. 2020-07 temporarily waives the preexisting provider-patient requirement for telehealth during the declared public health emergency.

Oklahoma Health Care Authority has expanded use of telehealth to include coverage of telephone assessment services. This is effective through 4/30/20.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/24/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Oklahoma SoonerCare (Medicaid) allows for audio-only phone to deliver telehealth services during the declared public health emergency.

Supervised Trainee Telehealth Services – Telesupervision and Medicaid Reimbursement
Guidance by the Oklahoma State Board of Examiners of Psychologists advises that formal, face-to-face supervision for trainees may be conducted via HIPAA-compliant videoconferencing in the event of social distancing or mandated site closure until the conclusion of the COVID-19 emergency as declared by the Oklahoma Governor or 12/31/20, whichever is sooner.

The trainee should clearly indicate this on the weekly log and the primary supervisor should verify this information.

The Telehealth Registration Form for out-of-state providers is available online.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Interns and postdoc supervised services are reimbursed by Medicaid and commercial insurance and eligible to be performed via telehealth.

Existing state telehealth coverage mandate?
YES for commercial health plans including public health benefit plans and school employees benefit plans

Or. Rev. Stat. §§ 743A.058, 743A.185

For Medicaid telehealth coverage, see Or. Admin. Code §§ 410-123-1265, 410-172-0850

Emergency orders expiration
Executive Order 20-03 issued a state of emergency on 3/9/20 in effect through 7/6/20.

It appears that joint agency guidance for commercial health plans and Medicaid calling for reimbursement parity, allowing for audio-only phone, and removing restrictions for originating sites is tied to the public health emergency declaration.

Board of Psychology temporary rule amendment (OBP 4-2020) temporarily allowing out-of-state psychologists to provide telemental health services remains in effect through 9/26/20.

Emergency state action on coverage of telehealth services?
Guidance jointly issued by the Oregon Health Authority (OHA) and the Department of Business and Consumer Services (DCBS) requires commercial and Medicaid health plans to cover all telehealth services provided by network providers whenever possible and clinically appropriate; to allow telehealth access for existing and new patients; to ensure provider networks to ensure robust telehealth services are available; and to ensure patients maintain access to behavioral health services for the duration of the COVID-19 outbreak.

Emergency state action on telehealth reimbursement parity?
Joint OHA-DCBS guidance encourages reimbursement rates for telehealth services to mirror payment rates for an equivalent office visit or that providers and health plans quickly agree on applicable reimbursement rates.

CMS Section 1135 Medicaid Waiver approved 3/25/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Joint OHA-DCBS guidance requires commercial and Medicaid health plans to waive encryption requirements and to allow all modes of telehealth delivery including synchronous video, telephone-based service delivery, and other appropriate methods (e.g., Google Hangouts, FaceTime, and Skype pursuant to recent OCR guidance) for the duration of the COVID-19 outbreak.

Oregon Health Plan (Medicaid) issued guidance dated 3/20/20 confirming certain telephone services will now be covered:

• 99441-99443 for providers who can provide evaluation and management services;
• 98966-98968 for other types of providers, including nonphysician behavioral health providers

Oregon Health Authority guidance dated 3/23/20 expanding telehealth to include telephone services provided by IHS/Tribal providers, FQHCs and Rural Health Clinics during the public health crisis.

Emergency changes in originating sites requirements?
Joint OHA-DCBS guidance instructs insurers to remove related to originating sites to allow patients to receive services at home, in a nursing home, or where they are physically present and can receive the service; and to enable providers to deliver telehealth service from their own home.

Emergency licensure waiver?
The Oregon Board of Psychology filed a temporary rule amendment (OBP 4-2020) allowing an out-of-state psychologist licensed in good standing to temporarily provide telemental health services in Oregon.

The out-of-state psychologist must obtain the permit before providing services.

There is an online application for the emergency visitor’s permit.

This temporary rule is effective from 3/3/20 to 9/26/20.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Interns and residents are eligible to perform telehealth services under Medicaid through Coordinated Care Organizations.

The Oregon Board of Psychology has posted guidance indicating that residents may receive supervision via electronic means if in-person meetings are prohibited due to COVID-19.

Existing state telehealth coverage mandate?
NO

Emergency orders expiration
State emergency proclamation was issued on 3/6/20 and is still in effect; not yet terminated.

Medicaid temporary policy waivers allowing for audio-only phone and patient’s home as eligible originating site are in effect for the duration of the emergency disaster declaration.

State waiver dated 3/18/20 allowing out-of-state providers to deliver telehealth services during the coronavirus emergency without obtaining a license is in effect for the duration of the emergency.

Emergency state action on coverage of telehealth services?
Department of Human Services Provider Quick Tip #242 dated 4/9/20 outlines what kinds of telehealth care services are covered Medicaid Fee-For-Service.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/27/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
DHS-Office of Mental Health and Substance Abuse Services Issued Telehealth Guidelines Related to COVID-19 dated 3/15/20 allowing Medicaid providers to use phone-based video technology such as FaceTime or Skype to provide services and if video is unavailable, phone only services.

The policy will remain in effect for 90 days or while a valid emergency disaster declaration related to the COVID-19 virus remains in effect, whichever is earlier.

Emergency changes in originating sites requirements?
Department of Human Services Provider Quick Tip #242 dated 4/9/20 allows Medicaid patients to receive telehealth services in their homes.

Emergency licensure waiver?
Department of State's Bureau of Professional and Occupational Affairs (BPOA) issued guidance dated 3/18/20 that temporarily expands the existing 14-day temporary practice provision, allowing out-of-state licensed health care professionals to deliver services to Pennsylvania patients via telemedicine during the coronavirus emergency.

Out-of-state providers must notify the appropriate Pennsylvania board prior to practicing telehealth into the state.

Department of State issued guidance dated 3/22/20 temporarily suspending certain licensing requirements for supervision, allowing the use of electronic means, preferably on a HIPAA-compliant platform, but if that is not possible, then by online methods such as Skype or Facetime to conduct the required weekly in-person meetings with psychology residents.

Department of State issued an additional temporary waiver dated 3/26/20 that allows certain mental health trainees (including psychology) who are receiving clinical supervision for experience qualifications for licensure may provide teletherapy services so long as they are receiving supervision from a supervisor who complies with all required state regulatory requirements.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are not eligible to perform telehealth services under Medicaid.

Department of State issued a temporary waiver dated 3/26/20 allowing psychology post-doctoral trainees to provide teletherapy services so long as they are being supervised by a supervisor who complies with all required regulatory requirements.

Department of State issued a temporary waiver dated 3/22/20 temporarily allowing psychology trainees to receive individual supervision via electronic means using a HIPAA-compliant platform, if available.

Existing state telehealth coverage mandate?
YES for commercial health plans; allows for the patient’s home as an originating site “where medically appropriate”

R.I. Gen. Laws §§ 27-81-1 et seq.

Emergency orders expiration
Executive Order 20-02 dated 3/9/20 established disaster emergency declaration effective through 6/5/20.

Executive Order 20-06 dated 3/18/20 expanding telehealth access (temporarily allowing audio-only phone and patient’s home for private plans and Medicaid and requiring reimbursement parity for in-network services) was in effect for 30 days through 4/17/20.

Emergency state action on coverage of telehealth services?
Yes. Executive Order No. 20-06 dated 3/18/20 mandates telehealth services.

This Executive Order will remain in effect until 4/17/20 unless renewed, modified, or terminated by subsequent executive order.

Executive Order No. 20-28 dated 4/17/20 extends Executive Order No. 20-06 to 5/8/20.

Emergency state action on telehealth reimbursement parity?
Yes — Executive Order No. 20-06 dated 3/18/20 requires reimbursement parity for telehealth services provided by in-network providers.

CMS Section 1135 Medicaid Waiver approved 3/25/20 allows for reimbursement of payable claims by out-of-state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Yes — Executive Order No. 20-06 dated 3/18/20 allows for audio-only phone.

Department of Health Guidance confirms that audio-only phone is available for patients with private insurance as well as Medicaid beneficiaries during the public health emergency.

Emergency changes in originating sites requirements?
Yes — Executive Order No. 20-06 dated 3/18/20 waives the patient site requirement and allows patients to receive telehealth services in any location.

Emergency licensure waiver?
Announcement by Governor and Department of Health dated 3/18/20 expands the existing temporary practice provision (up to 10 days/year and not more than 5 consecutive days), allowing out-of-state licensed providers (in good standing) to obtain a 90-day temporary license subject to a one-time renewal.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are not eligible to perform telehealth services under Medicaid.

Emergency state action on coverage of telehealth services?

Department of Insurance COVID-19 resource page summarizes the COVID-19 telehealth coverage/billing policies for private health insurance plans with links to each plan’s website.

Department of Health and Human Services issued FAQs dated 4/13/20 outlining its telehealth Medicaid coverage policies for services during the state of emergency.

The list of telehealth services that may be provided to new Medicaid patients is available online.

Emergency orders expiration
Executive Order 20-08 dated 3/13/20 establishes a state of emergency effective through 6/11/20.

Medicaid waiver temporarily allowing for audio-only phone service and reimbursement parity is in effect for the duration of the current declared public health emergency, unless Medicaid office determines they should sunset at an earlier date.

Emergency state action on telehealth reimbursement parity?

CMS Section 1135 Medicaid Waiver approved 3/31/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

The Department of Health and Human Services posted its Medicaid telehealth billing requirements and indicated that telehealth services will be paid at the same rate as in-person services.

Emergency state action to include audio-only phone?
Guidance issued by SC Medicaid Office dated 3/19/20 allows for telehealth and telephone only care for established patients who need check-ins subject to the following limitations:

These codes should not be billed if the telephonic encounter originates from a related E/M service provided within the preceding seven days nor if it leads to an E/M service or procedure within the subsequent 24 hours. Up to three encounters will be allowed every 30 days, and services may be provided regardless of the Medicaid member's location.

Telephone crisis management continues to be available through the community mental health, LIP, and rehabilitative behavioral health services benefits. Medical necessity requirements related to the provision of crisis management continue to apply.

Emergency licensure waiver?
Guidance issued by the Board of Psychology stating that it will suspend enforcement of South Carolina licensing provisions for psychologists who are licensed out-of-state, who have an established client relationship with an individual now in South Carolina, to allow continuity of care by means of telecommunication for the duration of the public health emergency.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are eligible to perform telehealth services under Medicaid to both patients with an existing client relationship and new patients, though services available to new patients are limited by the list in this Department of Health and Human guidance.

Existing state telehealth coverage mandate?
YES for commercial health plans

S.D. Codified Laws §§ 58-17-167 to 58-17-170

Emergency orders expiration
Executive Order 20-04 established a state of emergency effective 3/13/20 through 12/30/20.

Executive Order 20-07 dated 3/23/20 temporarily waiving limitations on Medicaid telehealth services remains in effect for the duration of the state of emergency.

Executive Order 20-16 dated 4/15/20 temporarily lifting existing provider-patient relationship requirement and allowing audio-only phone service is in effect for the duration of the state of emergency.

EO 20-07 dated 3/23/20 temporarily allowing out-of-state psychologists licensed in other EMAC states to provide services remains in effect during state of emergency.

Emergency state action on coverage of telehealth services?
Executive Order No. 2020-07 dated 3/23/20 temporarily suspends any limitations to Medicaid telehealth services.

Executive Order No. 2020-16 dated 4/15/20 temporarily waives the prior provider-patient relationship requirement mandated by the state telehealth health practice act.

Emergency changes in originating sites requirements?
South Dakota Medicaid Telemedicine Provider Manual updated May 2020 allows for the patient’s home to be an eligible originating site if primarily telehealth is primarily used to reduce risk of exposure to COVID-19.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/24/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?

Executive Order No. 2020-16 dated 4/15/20 temporarily waives limitations established by the state telehealth practice act, allowing providers to deliver telehealth services using audio-only phone.

Emergency licensure waiver?

Executive Order No. 2020-07 dated 3/23/20 temporarily waives state licensing requirements, allowing out-of-state psychologists who are licensed in member states of the Emergency Management Assistance Compact (EMAC) to deliver services in South Dakota during the state of emergency.

Executive Order No. 2020-15 extended the state of emergency through 5/31/20.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are not eligible to perform telehealth services under Medicaid as they are not licensed (and South Dakota’s section 1135 waiver requires all providers to be licensed).

Existing state telehealth coverage mandate?
YES for commercial health plans and Medicaid managed care plans; incudes reimbursement parity

Tenn. Code Ann. §56-7-1002

Emergency orders expiration
Executive Order 20-14 dated 3/12/20 established a state of emergency effective through 5/11/20.

Executive Order 20-15 dated 3/19/20 superseding EO 20-14 and temporarily lifting restrictions on technology including audio-only phone, provider’s network status to provide telehealth services, and eligible originating sites to include patient’s home to remain in effect through 6/30/20.

Executive Order 20-20 dated 3/26/20 temporarily removing restrictions to allow any licensed TN health care provider to deliver telehealth services is in effect through 6/30/20.

Executive Order 20-15 dated 3/19/20 also temporarily allows out-of-state providers to deliver telehealth services during state of emergency.

Emergency state action on coverage of telehealth services?
Executive Order No. 20-20 dated 3/26/20 temporarily waives Tenn. Code Ann. § 63-1-155(a)(1) allowing any TN licensed health care provide to deliver services using telehealth.

Executive Order No. 20-15 dated 3/19/20 encourages insurers to cover telehealth services irrespective of a provider’s network status. See Section 38.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/31/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Executive Order No. 20-15 dated 3/19/20 encourages providers to follow recent CMS guidance regarding the use of equipment and everyday communications technologies that may be used for the provision of telemedicine services. See Section 38.

TennCare Provider Memo dated 3/25/20 temporarily allows for audio-only phones to deliver behavioral health care services during the public health emergency.

Emergency changes in originating sites requirements?
Executive Order No. 20-15 dated 3/19/20 encourages insurers to cover telehealth services irrespective of originating site. See Section 38.

Emergency licensure waiver?
Executive Order No. 20-15 dated 3/19/20 temporarily waiving licensing requirements for out-of-state licensed health care professionals to provide telehealth services. See subsection 38.

Executive Order No. 20-24 dated 4/3/20 temporarily allows unlicensed individuals with mental health training (at masters or doctoral level) individuals to provide telemental health services under the supervision of a licensed psychologist or other licensed mental health provider.

This temporary practice authorization is valid through 5/18/20.

There is an online application for non-licensed behavioral health provider.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are not eligible to perform telehealth services under Medicaid as they are not licensed (and Tennessee’s section 1135 waiver requires all providers to be licensed).

Existing state telehealth coverage mandate?
YES for commercial plans including self-insured plans (to extent permitted by ERISA)

Tex. Ins. Code §§ 1455.001 to 1455.006

Emergency orders expiration
State of emergency was declared on 3/13/20 and is still in effect; not yet terminated.

Insurance Department Emergency Rule 2020-6287 dated 3/17/20 temporarily requiring reimbursement and documentation parity and lifting restrictions on what technologies are used for telehealth services is in effect for 120 days, with the possibility for a 60-day extension (7/16/20).

Emergency state action on telehealth reimbursement parity?
Texas Department of Insurance Emergency Rule 2020-6287 dated 3/17/20 temporarily establishes reimbursement and documentation parity for in-person services.

This emergency rule may not be in effect for longer than 120 days, with the possibility for a 60-day extension.

CMS Section 1135 Medicaid Waiver approved 3/30/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Texas Department of Insurance Emergency Rule 2020-6287 dated 3/17/20 temporarily prohibits insurers from limiting, denying or reducing for telehealth services based on the health professional's choice of platform for delivering the service or procedure.

This emergency rule may not be in effect for longer than 120 days, with the possibility for a 60-day extension.

Texas Health & Human Services Guidance for Behavioral Health Services Providers temporarily allows audio-only phone to deliver health care services to Medicaid beneficiaries during the public health emergency.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are eligible to perform telehealth services under Medicaid.

Guidance from the Texas State Board of Examiners of Psychologists dated 4/6/20 advises the governor’s suspension of Rule 465.2(a)(7)(C) to allow for supervision of trainees to be done through remote or electronic means.

This means any face-to-face or in-person supervision requirements may be satisfied using remote or electronic means during the pendency of the suspension.

Trainees may also provide supervised services via telehealth, if appropriate, for a particular patient or situation.

This waiver will remain in effect until terminated by the Office of the Governor or until the 3/13/20 disaster declaration is lifted or expires.

Existing state telehealth coverage mandate?
YES for commercially health plans (expanded to include telepsychological services as recognized by CMS effective 1/1/21)

Utah Code Ann. § 31A-22-649
Utah Code Ann. § 31A-22-649.5
Utah Code Ann. § 36-60-102
Utah Code Ann. § 36-60-103

Emergency orders expiration
Governor issued state of emergency on 3/6/20 (Executive Order 2020-01), which is still in effect; not yet terminated.

Executive Order 2020-07 dated 3/25/20 temporarily allowing non-HIPAA compliant technologies is in effect for the duration of the emergency (EO 2020-01).

Time-limited emergency licenses allowed under state law are valid for 180 days from issuance, 30 days from the end of the declared emergency, or upon 10 days’ notice from the state Division of Occupational and Professional Licensing.

Emergency state action on coverage of telehealth services?
Yes. Department of Commerce Division of Occupational and Professional Licensing Guidance permits the provision of telehealth services in accordance with HHS’s guidance.

Utah Department of Health COVID-19 Telehealth Resource Center lists the telehealth the technical billing and reimbursement guidance from private health insurance payers and Medicaid.

Emergency state action on telehealth reimbursement parity?
Utah Medicaid Guidance affirms reimbursement parity for Medicaid telehealth services.

Emergency state action to include audio-only phone?
Executive Order 2020-07 dated 3/25/20 temporarily waives state law requirements that health care providers must use HIPAA-compliant platforms to deliver telehealth services during the state of emergency.

Utah Medicaid Guidance temporarily allows the use of audio-only phones to deliver health care services during the public health emergency.

Emergency changes in originating sites requirements?
Existing state law does not have limitations on eligible originating sites.

Emergency licensure waiver?
Department of Commerce Division of Occupational and Professional Licensing (DOPL) Guidance states that out-of-state licensed mental health professionals may work in Utah within their scope of practice without restrictions or conditions may practice in Utah for the duration of the declared emergency by obtaining a DOPL Time-limited Emergency License. See Practice Exemptions During Declared Emergency - Mental Health.

This emergency license expires upon the earlier of 180 days, 30 days from the end of the declared emergency, or upon 10 days’ notice from DOPL.

The emergency license application is available online.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are able to perform telehealth services under Medicaid.

Department of Occupation and Professional Licensing guidance advises that trainee supervision may be conducted using real-time electronic means. Supervisors must protect the security of electronic, confidential data and information.

Existing state telehealth coverage mandate?
YES for all commercial health plans including self-funded or publicly funded plans and Medicaid; may limit coverage to telehealth services delivered by in-network providers; originating site is defined to include the patient’s home and the patient’s workplace

8 V.S.A. § 4100k

Emergency orders expiration
On 3/13/20, the Governor issued Executive Order 01-20 declaring a state of emergency in effect through 6/15/20.

Medicaid policy issued 3/13/20 temporarily allowing audio-only phone and G-codes are in effect for the duration of the COVID-19 emergency.

Department of Financial Regulation Emergency Rule H-2020-02-E dated 3/30/20 specifying coverage and reimbursement for telehealth services and allowing audio-only phone is in effect for duration of state of emergency.

Emergency legislation (Act No. 91) signed into law on 3/30/20 granting expedited temporary licensure to out-of-state health care providers to provide telehealth services in Vermont is in effect for the duration of the COVID-19 state of emergency.

Emergency state action on coverage of telehealth services?
Department of Financial Regulation issued Emergency Rule H-2020-02-E dated 3/30/20 specifies coverage and reimbursement for telehealth services, including telephone triage services (code G2012) and requires mental health parity compliance.

This emergency rule is in effect for the duration of the state of emergency.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/30/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Vermont Medicaid Provider Memorandum dated 4/8/20 temporarily allows for audio-only phone to deliver services to Medicaid patients.

The memorandum also specifies billing requirements for certain codes/services provided via telephone.

Department of Financial Regulation issued Emergency Rule H-2020-02-E dated 3/30/20 governing coverage of telehealth services to allow use of audio-only phone to deliver telehealth services.

This emergency rule is in effect for the duration of the state of emergency.

Emergency changes in originating sites requirements?
Existing law recognizes the patient’s home as an eligible originating site.

Emergency licensure waiver?
The Office of Professional Regulation issued guidance about the emergency legislation signed into law on 3/30/20, which temporarily allows out-of-state providers licensed in good standing to provide telehealth services in Vermont during the COVID-19 public emergency. (See pp. 12-14)

You only need to submit your information to OPR if you are providing services in a Vermont facility.

The emergency legislation also allows licensing boards to issue temporary licenses to graduates of an approved professional program who are unable to take the required exam due to COVID-19. The temporary license is valid for 90 days, or until termination of the declared state of emergency, whichever occurs first, as long as provided the licensee remains in good standing. The board may reissue the temporary license if the declared state of emergency continues longer than 90 days. (See pp. 10-11)

Fees for the temporary license are waived.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are able to perform telehealth services under Medicaid.

Existing state telehealth coverage mandate?
YES for commercial health plans; reimbursement parity included

Va. Code Ann. § 38.2-3418

Emergency orders expiration
State public health emergency declaration 3/12/20 still in effect; not yet terminated.

All tied to public health emergency:

• Medicaid audio only
• Medicaid telehealth reimbursement parity
• Medicaid telehealth coverage
• Home as originating site

Emergency state action on coverage of telehealth services?
Medicaid Director Memo dated 3/19/20 states that DMAS will reimburse for Medicaid-covered services delivered via telehealth where the following conditions are met:

To the extent feasible under the circumstances, providers must assure the same rights to confidentiality and security as provided in face-to-face services. Providers must ensure the patient’s informed consent to the use of telehealth and advise members of any relevant privacy considerations.

Emergency state action on telehealth reimbursement parity?
Medicaid Director Memo dated 3/19/20 states that DMAS will reimburse for telehealth services at the same rate as the analogous service provided face-to-face.

For behavioral health services, providers delivering services via telehealth (including phone communications) shall simply bill and submit a claim as they normally would in their regular practice. The Place of Service (POS) that the provider usually bills should remain the same and no modifiers shall be necessary.

Providers shall maintain appropriate documentation to indicate the mode of delivery and to support medical necessity for the ongoing delivery of the service through that model of care.

Emergency state action to include audio-only phone?
DMAS will allow for telehealth (including telephonic) delivery of all behavioral health services with several exceptions. Services that will be allowable via telehealth include:

• Care coordination, case management, and peer services
• Service needs assessments (including the Comprehensive Needs Assessment and the IACCT assessment in mental health and the Multidimensional Assessment in ARTS) and all treatment planning activities
• Outpatient psychiatric services
• Community mental health and rehabilitation services
• Addiction recovery and treatment services

Emergency changes in originating sites requirements?
DMAS Guidance to Allow Home as Originating Site:

During the current emergency, DMAS will allow the home as the originating site. This is particularly important for members who are quarantined, those who are diagnosed with or demonstrating symptoms of COVID-19, or those who are at high risk of serious illness from COVID-19.

Clinicians shall use clinical judgment when determining the appropriate use of home as the originating site. No originating site fee shall be paid for telehealth in the home.

Executive Order No. 57 (Section 4) dated 4/17/20 temporarily allows health care providers to use non-public facing audio or remote communication product that is available to communicate with patients to provide telehealth services.

The executive order remains in effect until 6/10/20 unless otherwise modified by executive order.

Emergency licensure waiver?
Executive Order No. 57 (Section 2) dated 4/17/20 provides that an out-of-state psychologist licensed in good standing may obtain a temporary license by endorsement to provide services. The out-of-state provider must submit an application to the Virginia Board of Psychology that includes verification of an active license in good standing and no current reports in the HHS National Practitioner Databank.

The temporary license expires 90 days after the state of emergency ends.

Application for the Temporary License is available online.

Executive Order No. 57 (Section 3) dated 4/17/20 also allows out-of-state providers with an active license issued by another state to provide continuity of care to their current patients who are Virginia residents through telehealth services.

For new patients, the out-of-state psychologist must have a temporary license.

The executive order remains in effect until 6/10/20 unless otherwise modified by executive order.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are not able to perform telehealth services. Board of Psychology guidance requires full licensure for telepractice in Virginia.

Existing state telehealth coverage mandate?
YES for commercial health plans BUT only if the plan covers the comparable in-person service; the telehealth service is medically necessary; the telehealth service is recognized as an essential health benefit as defined by PPACA; the service is determined to be provided safely and effectively via telehealth according to generally accepted health care practices and standards.

2020 SB 5385 amending Wash. Rev. Code § 48.43.735 will require reimbursement parity for telehealth services for commercial health plans beginning 1/1/21.

Emergency orders expiration
State public health emergency declaration 2/29/20 is still in effect; not yet terminated.

On 5/22/20, Insurance commissioner extended audio only telehealth until 6/21/20.

On 5/29/20, Governor extended reimbursement parity for telehealth services until the public health emergency ends or 6/17/20 whichever happens first.

Emergency state action on telehealth reimbursement parity?
Executive Order 20-29 on Telemedicine (Amending Proclamation 20-05) temporarily suspends and waives the 1/1/21 implementation date for the newly enacted 2020 SB 5385 and requires that health plans to institute reimbursement parity immediately. This waiver will remain in effect until 4/24/20.

CMS Section 1135 Medicaid Waiver approved 3/19/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
Insurance Commissioner Emergency Order No. 20-02 recognizes audio-only phone for delivering telehealth services during the public health emergency.

This shall remain in effect through 5/23/20 unless further extended by order of the insurance commissioner.

Emergency changes in originating sites requirements?
Existing state law mandating telehealth coverage already recognizes the patient’s home as an eligible originating site.

Emergency licensure waiver?
Washington has enabled its emergency volunteer health care practitioners program which allows out of state providers to practice in Washington with restrictions around compensation. It requires an application.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are not able to perform telehealth services under Medicaid in Washington state.

Existing state telehealth coverage mandate?
2020 HB 4003 was enacted on 3/7/20 creating a new state law requiring coverage of telehealth services for health plans beginning 7/1/20.

Emergency orders expiration
In the Week 1 phase of reopenings (4/30/20-5/3/20), outpatient health care operations were allowed to resume for facilities regulated by Licensing Boards contained in WV Code Chapter 30, including psychologists. 

Temporary telepsychology and telesupervision guidelines expire on 5/31/20, at which time the board will decide whether to extend them.

Emergency state action on coverage of telehealth services?
Medicaid Commissioner memorandum dated 3/12/20 allows for psychological testing in Medicaid through the “Telehealth Modality” for procedure codes 96130, 96131, 96136, 96137, 96132, 96113 and 96146 through 5/31/20. (Bureau of Medical Services will reevaluate after that)

The other services the state is allowing appear to be all E&M services.

West Virginia Insurance Commission Bulletin No. 20-03 encourages health plans to implement telehealth policies as described in the newly enacted 2020 HB 4003 as quickly as possible to meet the access needs during the public health emergency.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/30/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency state action to include audio-only phone?
DHHR Letter COVID-19 dated 3/26/20 encourages the use of phone or video communications to provide telehealth services where clinically appropriate during the state of emergency.

Emergency changes in originating sites requirements?
Although not effective until 7/1/20, the newly enacted state telehealth coverage mandate has no restrictions on originating sites and includes the patient’s home.

Emergency licensure waiver?
WV Board of Examiners of Psychology issued Guidance to allow telepsychology if HIPAA compliant, and allow temporary practice of 10 days or 80 hours.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
West Virginia does not allow interns to bill under Medicaid, though postdocs are allowed. However, the licensing board put out updated guidance on 3/27/20 which states that telesupervision is now permissible.

Existing state telehealth coverage mandate?
NO

Emergency orders expiration
Audio-only phone exception expired 5/13/20.

Emergency orders related to temporary licensure expired 5/13/20.

Emergency state action on coverage of telehealth services?
No – Insurance Commissioner Bulletin dated 3/6/20 states: Health Plan Issuers are reminded to review provisions in current policies regarding the delivery of health care services via telehealth and ensure their telehealth programs with participating providers are robust and will be able to meet any increased demand.

In addition to permanently allowable telehealth services for Medicaid, Department of Health Services Guidance No. 2020-12 outlines those services, such as mental health screenings, that are temporarily allowed to be delivered via telehealth during the public health emergency.

Emergency state action to include audio-only phone?
Department of Health Services Guidance No. 2020-12 advises that beginning 3/12/20, the use of audio-only phone to deliver telehealth services is temporarily allowed for Medicaid for the duration of the public health emergency.

Emergency changes in originating sites requirements?
Department of Health Services Guidance No. 2020-09 allows telehealth services to be provided to Medicaid patients at any originating sites.

Department of Health Services Guidance No. 2020-12 advises that there are no restrictions on distant sites (where the provider is located when delivering telehealth services) for Medicaid.

Emergency licensure waiver?
Emergency Order No. 16 dated 3/27/20 allows any temporary licenses issued for out-of-state licensed health care providers shall remain valid for 30 days beyond the termination of the public health emergency declaration.

Emergency Order No. 20 modifies Emergency Order No. 16 to retroactively include temporary or otherwise valid licenses that were current before the public health emergency declaration on 3/12/20 in Executive Order #72 but have since expired.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are eligible to perform telehealth services under Medicaid.

Existing state telehealth coverage mandate?
NO

Emergency orders expiration
State public health emergency declaration 3/13/20 is still in effect; not yet terminated.

Board will revisit their telehealth guidance (that says telehealth is not specifically prohibited in the practice act and therefore they may use it as appropriate) before 7/1/20 to determine whether the Board should rescind, amend, or promulgate portions.

Emergency state action on coverage of telehealth services?
Insurance Commissioner Bulletin No. 20-01 encourages health insurers to liberalize telehealth benefits during the public health emergency and to allow consumers to access telehealth benefits through their current health care providers.

Emergency state action on telehealth reimbursement parity?
CMS Section 1135 Medicaid Waiver approved 3/27/20 allows for reimbursement of payable claims by out of state licensed providers not enrolled in the state Medicaid program subject to certain conditions for the duration of the public health emergency.**

Emergency licensure waiver?
No — Wyoming Board of Psychology guidance dated 3/25/20 is that since the Practice Act does not specifically prohibit telepsychology, it may be provided where appropriate. One must be licensed in WY in order to treat a client located in WY.

Supervised trainee telehealth services – Telesupervision and Medicaid reimbursement
Trainees are eligible to provide telehealth services under Medicaid.