Arkansas Telemedicine & Telehealth Reimbursement Overview

Provider Reimbursement Eligibility
Consent for Telemedicine Live Video Reimbursement Store & Forward Reimbursement Originating Site & Transmission Fees Eligible Practitioners
State Law

The healthcare professional should follow existing state and federal laws regarding informed consent.

See AR Code 17-80-117(c)

A health plan shall cover telehealth-delivered services on the same basis as it would in-person services.
See AR Code 23-79-1602(c)

Effective 1/1/18
Health plans required to reimburse for Telemedicine, which includes Store & Forward

See AR Code 17-80-117(b)

Effective 1/1/18
A health plan must provide a reasonable facility fee to an originating site if they are licensed to bill the health plan.

See AR Code 23-79-1602

No Reference Found

Medicaid

The healthcare professional should follow existing state and federal laws regarding informed consent.

See AR Code 17-80-117(c)

Medicaid will reimburse  as long as the provider is eligible and is at an eligible originating site.
See AR Code 23-79-1602(c)

Medicaid will not reimburse for Store & Forward because they require Telemedicine to occur in real time for reimbursement.
See AR Provider Manual

Effective 1/1/18
Medicaid must provide a reasonable facility fee to an originating site if they are licensed to bill the health plan.

See AR Code 23-79-1602

To find out if your provider class is eligible for medicaid reimbursement reference the appropriate  medicaid manual for your specialty.
Arkansas Provider Manual

 

Medicare

No Reference Found

Only applicable for rural areas at this time.  See Rural Telehealth Services Document

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).

List of Medicare Approved Practitioners (see page 2)

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

The healthcare professional should follow existing state and federal laws regarding informed consent.

See AR Code 17-80-117(c)

Medicaid

The healthcare professional should follow existing state and federal laws regarding informed consent.

See AR Code 17-80-117(c)

Medicare

No Reference Found

Live Video Reimbursement
State Law

A health plan shall cover telehealth-delivered services on the same basis as it would in-person services.
See AR Code 23-79-1602(c)

Medicaid

Medicaid will reimburse  as long as the provider is eligible and is at an eligible originating site.
See AR Code 23-79-1602(c)

Medicare

Only applicable for rural areas at this time.  See Rural Telehealth Services Document

Store & Forward Reimbursement
State Law

Effective 1/1/18
Health plans required to reimburse for Telemedicine, which includes Store & Forward

See AR Code 17-80-117(b)

Medicaid

Medicaid will not reimburse for Store & Forward because they require Telemedicine to occur in real time for reimbursement.
See AR Provider Manual

Medicare

No Reference Found

Originating Site & Transmission Fees
State Law

Effective 1/1/18
A health plan must provide a reasonable facility fee to an originating site if they are licensed to bill the health plan.

See AR Code 23-79-1602

Medicaid

Effective 1/1/18
Medicaid must provide a reasonable facility fee to an originating site if they are licensed to bill the health plan.

See AR Code 23-79-1602

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.
Arkansas Provider Manual

 

Medicare

List of Medicare Approved Practitioners (see page 2)

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.

Telemedicine CPT Codes

Unique CPT codes do not exist specifically for telemedicine or telehealth. Instead a modifier is applied to existing codes.

  • For interactive audio and video sessions, place a GT modifier in front of the CPT codes you typically use for in person services.
  • For services provided via an asynchronous telecommunication system, simply add a GQ modifier in front of the CPT codes you typically use for in person services.

Telehealth Parity

Yes there is a parity law, but it only applies to Physicians under private insurance, Medicaid, and state employee health plans. The session must also have interactive audio-video.  Arkansas Act 887

Definitions

Telehealth Parity

Telehealth services are equal to in person services and reimbursed at the same rate.

Asynchronous Communication

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.

Distant or Hub Site

The location or site where the practitioner or provider is located while utilizing telemedicine services to meet with patients.

Originating Site

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.

Additional Telemedicine Resources

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: