Minnesota Telemedicine & Telehealth Reimbursement Overview

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

No Reference Found

Covered under state statutes chapter 256B medical assistance for needy persons.

MN Statute 256B.0625 Subd 3b.d

 

It is additionally provided under Chapter 62A concerning accident and health insurance.

Section 62A.671 subd.9

 

And under

 

Chapter 147 Section147.033

Store & Forward is included under the definition of telemedicine.

MN Statute 256B.0625 Subd 3b.d

And under

Section 62A.671 subd.9

Chapter 147 Section147.033

No Reference Found

Minnesota Statutes Concerning Telemedicine Coverage reference specific providers related to accident & health insurance.

See Chapter 62A Section 62A.671 that references related chapter and sections concerning Board of Medical Practice.

Medicaid

No Reference Found

Eligible providers can be reimbursed for eligible services. A list of eligible providers and services can be found in the Medicaid Manual.
See MN Medicaid Manual

Medicaid reimburses Store & Forward for one reading of a diagnostic test. They will not reimburse for the sending of materials to other providers, patients, or families.
See MN Medicaid Manual

No Reference Found

To find out if your provider class is eligible for medicaid reimbursement reference the appropriate medicaid manual for your specialty.
Minnesota Medicaid 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

No Reference Found

Medicaid

No Reference Found

Medicare

No Reference Found

Live Video Reimbursement
State Law

Covered under state statutes chapter 256B medical assistance for needy persons.

MN Statute 256B.0625 Subd 3b.d

 

It is additionally provided under Chapter 62A concerning accident and health insurance.

Section 62A.671 subd.9

 

And under

 

Chapter 147 Section147.033

Medicaid

Eligible providers can be reimbursed for eligible services. A list of eligible providers and services can be found in the Medicaid Manual.
See MN Medicaid Manual

Medicare

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

Store & Forward Reimbursement
State Law

Store & Forward is included under the definition of telemedicine.

MN Statute 256B.0625 Subd 3b.d

And under

Section 62A.671 subd.9

Chapter 147 Section147.033

Medicaid

Medicaid reimburses Store & Forward for one reading of a diagnostic test. They will not reimburse for the sending of materials to other providers, patients, or families.
See MN Medicaid Manual

Medicare

No Reference Found

Originating Site & Transmission Fees
State Law

No Reference Found

Medicaid

No Reference Found

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

Minnesota Statutes Concerning Telemedicine Coverage reference specific providers related to accident & health insurance.

See Chapter 62A Section 62A.671 that references related chapter and sections concerning Board of Medical Practice.

Medicaid

To find out if your provider class is eligible for medicaid reimbursement reference the appropriate medicaid manual for your specialty.
Minnesota Medicaid 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

Telemedicine consults shall be paid at the same rate as in-person services under statute covering medical assistance for needy persons. . See MN Statute Section 256B.0625 Subd. 3b. 

Additional state statute covering accident and health insurance states that a health carrier shall not exclude telemedicine services and must reimburse at the same rate as in person visits.  See MN Statute Section 62A.672 Subd. 2 & 3.

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: