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Minnesota

States

Medicaid Policies

TELEHEALTH DEFINITION: “The delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site.”

SERVICE PARITY: “A health carrier shall not exclude a service for coverage solely because the service is provided via telemedicine and is not provided through in-person consultation or contact between a licensed health care provider and a patient.”

PAYMENT PARITY: “A health carrier shall reimburse the distant site licensed health care provider for covered services delivered via telemedicine on the same basis and at the same rate as the health carrier would apply to those services if the services had been delivered in person by the distant site licensed health care provider.”

ORIGINATING SITES: Office of physician or practitioner, Hospital (inpatient or outpatient), CAHs, RHCs, FFQHCs, Hospital-based or CAH-based renal dialysis center (including satellites), SNFs, ESRD facilities, Community mental health center, Dental clinic, Residential settings (such as a group home, assisted living, shelter or temporary lodging), Home (a licensed or certified health care provider may need to be present to facilitate the delivery of telemedicine services provided in a private home), School, Correctional facility-based office, Mobile stroke unit

ELIGIBLE PROVIDERS: Physician, NP, PA, Nurse midwife, clinical nurse specialist, RD/nutrition professional, dentist/hygienist/therapist, mental health professional, pharmacists, certified genetic counselor, podiatrist, ST, OT, PT, audiologist, public health nursing organization 

PREREQUISITES TO TELEHEALTH: Providers must complete the Provider Assurance Statement for Telemedicine

PROVIDER REQUIREMENTS: Providers must document “the provider's basis for determining that telemedicine is an appropriate and effective means for delivering service to the recipient” 

NON-COVERED SERVICES: Connections using non-HIPAA compliant technology, Prescription renewals, Scheduling a test or appointment, Clarification of issues from a previous visit, Reporting test results, Non-clinical communication, Communication via telephone, email or fax, Day treatment, Partial hospitalization programs, Residential treatment services, Case management face-to-face contact

FQHCs & RHCs:

  • PROSPECTIVE PAYMENT SYSTEM (PPS) REIMBURSEMENT STRUCTURE
  • Most in-person services can be provided via telehealth and are reimbursed at the PPS/encounter rate

OTHER MN MEDICAID POLICIES:

MHCP reimburses for interactive audio/visual communications & asynchronous store-and-forward (to send information to a reviewing physician)

Payment for telemedicine services is limited to three per week for an MHCP member

Physician services may be delivered by telemedicine to provide intensive residential treatment services

Tele-home care is covered under the Elderly Waiver (EW) and Alternative Care (AC) Programs

Telemedicine delivery of mental health services:

  • NON-COVERED SERVICES: Children’s day treatment, Partial hospitalization programs, Mental health residential treatment services, Case management services delivered to children
  • ELIGIBLE PROVIDERS: Mental health professionals who are qualified under Minnesota Statute 245.462 Subd. 18 (qualified in psychiatric nursing, clinical social work, psychology, psychiatry, marriage and family therapy, licensed professional counseling, or allied fields)

Teledentistry: “Reimbursement for teledentistry is the same as face-to-face encounters. The distant site can bill for the services provided by a licensed dentist.”

Early intensive developmental and behavioral intervention: MHCP does not reimburse for connection charges or origination, set-up, or site fees

Additional originating sites for SUD treatment services: Drug court office, Correctional facility-based office (including jails), Substance abuse disorder treatment facility (residential or outpatient), Withdrawal management facility

Medication therapy management services: Available for members more than 20 miles from MHCP MTMS provider;  Both originating and distant sites must be pharmacy/clinic/hospital/ambulatory care site;  Connection must be audio/visual

Temporary COVID-19 Policies (MN Medicaid)

NEWLY ELIGIBLE SERVICES: Audio-only connection

WAIVED REQUIREMENTS: The first interaction with a provider no longer needs to be in person, limit of 3 visits per weeks is ended

TEMPORARILY ELIGIBLE PROVIDERS: Community Health Worker, Public Health Nurse Clinic, Doula (pre and postnatal care only), Physician extenders, Licensed Alcohol and Drug Counselors, Alcohol and Drug Counselors, Alcohol and Drug Counselor – Temps Recovery, Peers and student interns in SUD programs licensed under chapter 245G, Pharmacists enrolled to perform medication therapy management, mental health works across a variety of practice areas

FQHCs and RHCs: 

  • Any service that, when provided face-to-face that would generate an encounter if performed in person, will continue to generate an encounter if provided via audio-visual telemedicine

OTHER TEMPORARY MN MEDICAID POLICIES:

COVID-19 telemedicine services are exempt from cost-sharing

Billing for tele-Targeted Case Management is the same as for in-person services

Temporary coverage of telemedicine visits for SUD/mental health providers

  • Billing for SUD treatment is the same as in person
  • Additional SUD providers who can practice telemedicine: Licensed Alcohol and Drug Counselors, Alcohol and Drug Counselors, Alcohol and Drug Counselor - Temps Recovery, Recovery peers and student interns in SUD programs licensed under chapter 245G

FQHCs & RHCs temporary:

  • Telephone billing codes have been added
  • FQHCs can bill for telehealth evaluation and management
  • Not billing POS 02, just modifier 95
  • There is a new provider assurance statement (6806) for telephone (audio-only) services


Commercial Payer Policies

TELEHEALTH DEFINITION: “The delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site… provided by means of real-time two-way, interactive audio and visual communications.”

SERVICE PARITY: “A health carrier shall not exclude a service for coverage solely because the service is provided via telemedicine and is not provided through in-person consultation or contact between a licensed health care provider and a patient.”

PAYMENT PARITY: “A health carrier shall reimburse the distant site licensed health care provider for covered services delivered via telemedicine on the same basis and at the same rate as the health carrier would apply to those services if the services had been delivered in person by the distant site licensed health care provider… the deductible, co-payment, or coinsurance [must not be in] addition to, and [must] not exceed, the deductible, co-payment, or coinsurance applicable if the same services were provided through in-person contact”

Temporary COVID-19 Policies (MN Commercial Payers)

A patient’s residence may constitute an originating site (expiration date 2/1/21)

  • The health carrier cannot exclude/reduce coverage for telemedicine visits where the originating site is the patient’s residence

Applicable during a peactetime emergency: An insurer cannot deny/limit reimbursement for telemedicine-delivered services

Applicable during a peactetime emergency: The definition of a “licensed health care provider” in Section 62A.671 (Minnesota Telemedicine Act) is expanded to include mental health practitioners & respiratory therapists


Medical Board Policies

TELEMEDICINE DEFINITION: “The delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site” provided via real-time two-way interactive audio and visual communications. Telemedicine does not include telephone, email, or fax.

LICENSED PROVIDERS FROM THE MN TELEMEDICINE ACT:  MD (147), PA (147A), Chiropractors (148), Nurses (148.171) Speech Language Pathologists (148.511), Optometrists (148.52), Dieticians/Nutritionists (148.621), OT/OTA (148.6401), PT/PTA (148.65), Athletic Trainers (148.7801), Psychologists (148.79), Doulas (148.995), Marriage and Family counselors, Licensed Professional Counseling, (148B), Social Work (148E), Alcohol and Drug Counselors (148F), Dentistry (150A), Podiatry (153)

  • INELIGIBLE PROVIDERS: Pharmacists, Respiratory Therapists, and Genetic Counselors

Physician-patient relationship may be established via telemedicine

A physician licensed from another state may provide interstate telemedicine services to a patient in MN if they are licensed without restrictions in their home state, does not meet with or open an office in MN, and registers with the MN Board

Telemedicine abortions are allowed

Minnesota Professional Licensure Compacts

Interstate Medical Licensure Compact

Temporary COVID-19 Policies (MN Medical Board)

As stipulated in MN Statutes 12.42, during a declared emergency, a person with a license/certificate/permit in another state, including mental health practitioners, can render aid in MN via telehealth

Out-of-state providers can provide care in MN, including via telehealth, during the COVID-19 public health emergency

For substance use disorders:

  • The requirement for examination prior to prescribing can be met by telemedicine (expires 60 days after peacetime emergency is ended)


Mid-Level Providers

LICENSED PROVIDERS FROM THE MN TELEMEDICINE ACT: MD (147), PA (147A), Chiropractors (148), Nurses (148.171), Speech Language Pathologists (148.511), Optometrists (148.52), Dieticians/Nutritionists (148.621), OT/OTA (148.6401), PT/PTA (148.65), Athletic Trainers (148.7801), Psychologists (148.79), Doulas (148.995), Marriage and Family counselors, Licensed Professional Counseling, (148B), Social Work (148E), Alcohol and Drug Counselors (148F), Dentistry (150A), Podiatry (153)

  • Service parity: Health carriers cannot exclude a service from coverage solely because it is provided via telemedicine and not through in-person consultation or contact between a licensed health care provider and a patient
  • Payment parity: Health carriers must reimburse distant site licensed providers for telehealth services on the same basis and at the same rate as they would for the same services delivered in-person

Minnesota Mid-Levels Professional Licensure Compacts

Pending Enhanced Nurse Licensure Compact

Temporary COVID-19 Policies (MN Mid-Levels)

Nurses can practice telemedicine in MN without a MN license if they are associated with a healthcare system or provider in MN

The examination requirement for prescribing certain drugs can be met via telemedicine (this section expires 60 days after peacetime emergency end)

  • (controlled substance drugs listed in section 152.02, subdivisions 3 to 5; drugs defined by the Board of Pharmacy as controlled substances under section 152.02, subdivisions 7, 8, and 12; muscle relaxants; centrally acting analgesics with opioid activity; drugs containing butalbital; phosphodiesterase type 5 inhibitors when used to treat erectile dysfunction)
  • Nurses and PAs can administer these drugs: “A licensed practitioner in the course of professional practice only, may prescribe, administer, and dispense a legend drug, and may cause the same to be administered by a nurse, a physician assistant, or medical student or resident under the practitioner's direction and supervision”


Behavioral Health Providers

LICENSED PROVIDERS FROM THE MN TELEMEDICINE ACT: Licensed under chapter 147, 147A, 148 (psychologists), 148B (marriage and family therapists, licensed professional counselors), 148E, 148F (alcohol and drug counselors), 150A, or 153; a mental health professional as defined under section 245.462, subdivision 18, or 245.4871, subdivision 27

  • INELIGIBLE PROVIDERS: Pharmacists, Respiratory Therapists, and Genetic Counselors
  • Service parity: Health carriers cannot exclude a service from coverage solely because it is provided via telemedicine and not through in-person consultation or contact between a licensed health care provider and a patient
  • Payment parity: Health carriers must reimburse distant site licensed providers for telehealth services on the same basis and at the same rate as they would for the same services delivered in-person

Psychologists must demonstrate competency in order to practice, including via telehealth

Minnesota Mental Health Professional Licensure Compacts

Psychology Interjurisdictional Compact - legislation pending

Temporary COVID-19 Policies (MN Mental Health Providers)

Out-of-state mental health practitioners can provide telehealth services in MN. This applies only only to providers who would otherwise be required to obtain a license from one or more of the following Minnesota health-related licensing boards: Psychology, Social Work, Marriage and Family Therapy, and Behavioral Health and Therapy.

During a peacetime emergency, the definition of “licensed health care provider” from 62A.671 (Minnesota Telemedicine Act) is expanded to include mental health practitioners & respiratory therapists

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