Wisconsin Billing Guide 10/31/22

Wisconsin does not currently have an active PHE.

Wisconsin is a non-expansion state with full Medicaid parity (full commercial payment parity is pending until January 1, 2022).

Wisconsin Medicaid is almost entirely managed by Forward Health.

WI Medicaid allows telehealth for any Medicaid-eligible provider and any Medicaid-eligible service.

Originating site facility fees (Q3014) are paid to hospitals, offices, clinics, and skilled nursing facilities.

Medicaid pays FQHCs a PPS rate and covers RPM services.

Wisconsin participates in the following interstate licensure compacts: Medical, eRN, PT, OT, and Psycology.

RECIPROCITY: Physicians must be licensed in Wisconsin to provide telehealth services to a patient in Wisconsin