| Provider Reimbursement Eligibility | |||||
|---|---|---|---|---|---|
| Consent for Telemedicine | Live Video Reimbursement | Store & Forward Reimbursement | Originating Site & Transmission Fees | Eligible Practitioners | |
| State Law |
No Reference Found |
Live video telehealth is reimbursable. See MI Compiled Law Services 500.3476 |
There is no reimbursement for Store & Forward due to Michigan’s definition of telehealth. |
No Reference Found |
No Reference Found |
| Medicaid |
No Reference Found |
Michigan Medicaid reimburses for several live video telehealth cases. For a full list: |
Store & Forward is not included in Michigan’s telemedicine policy. |
Originiating site may bill for a facility fee. |
To find out if your provider class is eligible for medicaid reimbursement reference the appropriate medicaid manual for your specialty. |
| Medicare |
No Reference Found |
Only applicable for rural areas at this time. See Rural Telehealth Services Document. Medicare does offer new telehealth reimbursement opportunities for chronic care management and behavioral health integration. This initiative removes previous face-to-face requirements and geographic restrictions. Download the FREE guides for Primary Ca |
No Reference Found |
Medicare will pay 80% of the lesser of the actual charge of $25.10 per live video session to the originating site(patient location). |
|
| Private Payors |
Private payors are actively exploring telemedicine and telehealth, but each provider is different. If you are in network with a specific provider, call and request documentation of their policy related to telehealth. |
||||
| Self Pay |
There are no limitations for self pay patients/clients, and providing telehealth services is a great way to increase revenue with patients that are selfpay or value premium services. |
||||
| Provider Reimbursement Eligibility | |||||
|---|---|---|---|---|---|
| Consent for Telemedicine | |||||
| State Law |
No Reference Found |
||||
| Medicaid |
No Reference Found |
||||
| Medicare |
No Reference Found |
||||
| Live Video Reimbursement | |||||
| State Law |
Live video telehealth is reimbursable. See MI Compiled Law Services 500.3476 |
||||
| Medicaid |
Michigan Medicaid reimburses for several live video telehealth cases. For a full list: |
||||
| Medicare |
Only applicable for rural areas at this time. See Rural Telehealth Services Document. Medicare does offer new telehealth reimbursement opportunities for chronic care management and behavioral health integration. This initiative removes previous face-to-face requirements and geographic restrictions. Download the FREE guides for Primary Ca |
||||
| Store & Forward Reimbursement | |||||
| State Law |
There is no reimbursement for Store & Forward due to Michigan’s definition of telehealth. |
||||
| Medicaid |
Store & Forward is not included in Michigan’s telemedicine policy. |
||||
| Medicare |
No Reference Found |
||||
| Originating Site & Transmission Fees | |||||
| State Law |
No Reference Found |
||||
| Medicaid |
Originiating site may bill for a facility fee. |
||||
| Medicare |
Medicare will pay 80% of the lesser of the actual charge of $25.10 per live video session to the originating site(patient location). |
||||
| Eligible Practitioners | |||||
| State Law |
No Reference Found |
||||
| Medicaid |
To find out if your provider class is eligible for medicaid reimbursement reference the appropriate medicaid manual for your specialty. |
||||
| Medicare | |||||
| Private Payors |
Private payors are actively exploring telemedicine and telehealth, but each provider is different. If you are in network with a specific provider, call and request documentation of their policy related to telehealth. |
||||
| Self Pay |
There are no limitations for self pay patients/clients, and providing telehealth services is a great way to increase revenue with patients that are selfpay or value premium services. |
||||
Unique CPT codes do not exist specifically for telemedicine or telehealth. Instead a modifier is applied to existing codes.
In 2016, Michigan passed SB 753 providing parity for telehealth services.
Telehealth services are equal to in person services and reimbursed at the same rate.
The exchange of messages, such as among the hosts on a network or devices in a computer, by reading and responding as schedules permit rather than according to some clock that is synchronized for both the sender and receiver or in real time. Email, chat and text messaging are primary examples of asynchronous communication.
The location or site where the practitioner or provider is located while utilizing telemedicine services to meet with patients.
The location of the patient at the time services are provided. An originating site can be the client's home or a public facility like a rural hospital or physician's office. Many payors will reimburse for an originating site fee if it meets specific requirements. Rural use cases provide an applicable example for an eligible originating site fee where the patient will go to a local medical facility like a primary care physician's office and meet with a specialist located in distant urban health facility.
Telehealth and telemedicine are fast growing and changing segments. Both state licensure and state legislation are changing rapidly along with federal legislation and for this reason the information provided cannot be considered legal advice. We make every attempt to keep state specific information up to date, but encourage you to validate this information through the following sites:
