Mississippi 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

Mississippi Medicaid and private payers are required to provide coverage for live video consultations.

See MS Code Sec. 83-9-351

Private payers, MS Medicaid and employee benefit plans are required to provide coverage at the same level as in-person consultation for store-and-forward telemedicine services.

See MS Code Sec. 83-9-351

The originating site is eligible to receive a facility fee.

See MS Code Sec. 83-9-351

No Reference Found

Medicaid

No Reference Found

Medicaid covers medically necessary health services via telehealth when coverage is provided in person and is live, interactive and audiovisual.

See State of Mississippi. State Plan Under Title XIX of the Social Security Act. Medical Assistance Program. Attachment 3.1A.

There is reimbursement for tele-radiology services; however, there is no reference to reimbursing for other specialties.

See MS Div. of Medicaid, Radiology Services Provider Reference Guide, pg. 4-5

Facility fee provided.

See State of Mississippi. State Plan Under Title XIX of the Social Security Act. Medical Assistance Program. Attachment 4.19-B.

One of 19 States that does not specify the type of healthcare provider allowed to practice telemedicine.  Offering the most flexibility.

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

Mississippi Medicaid and private payers are required to provide coverage for live video consultations.

See MS Code Sec. 83-9-351

Medicaid

Medicaid covers medically necessary health services via telehealth when coverage is provided in person and is live, interactive and audiovisual.

See State of Mississippi. State Plan Under Title XIX of the Social Security Act. Medical Assistance Program. Attachment 3.1A.

Medicare

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

Store & Forward Reimbursement
State Law

Private payers, MS Medicaid and employee benefit plans are required to provide coverage at the same level as in-person consultation for store-and-forward telemedicine services.

See MS Code Sec. 83-9-351

Medicaid

There is reimbursement for tele-radiology services; however, there is no reference to reimbursing for other specialties.

See MS Div. of Medicaid, Radiology Services Provider Reference Guide, pg. 4-5

Medicare

No Reference Found

Originating Site & Transmission Fees
State Law

The originating site is eligible to receive a facility fee.

See MS Code Sec. 83-9-351

Medicaid

Facility fee provided.

See State of Mississippi. State Plan Under Title XIX of the Social Security Act. Medical Assistance Program. Attachment 4.19-B.

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

One of 19 States that does not specify the type of healthcare provider allowed to practice telemedicine.  Offering the most flexibility.

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

MS’s parity law was enacted in 2013. The law requires parity for telemedicine under private insurance, state employee health plans, and public assistance. In 2014, lawmakers passed a law requiring insurance plans to cover and reimburse for services via store-and-forward as well as remote patient monitoring for chronic disease management.

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: