Arizona Telemedicine Policy, Simplified.

Healthcare legislation is complicated. Let’s clarify a few things.

We strive to keep this information updated and current. It is intended to be an informative guide, and not a comprehensive legal resource. Always consult with your local team of experts and administrators.

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Arizona Telemedicine Policy

updated October 2019

Arizona Telemedicine Policy

A leading center of innovation in the United States, Arizona is on the fast track for improving telemedicine coverage. The Arizona Telemedicine Program at the University of Arizona regularly meets with Arizona legislators to report on enhancements and innovation in telemedicine and discuss potential changes to the state laws.

Arizona is unique because of its partial telemedicine parity law. In other words, the state requires private payers to reimburse for telemedicine, but only for ‘rural’ areas and specific health care services.

New legislation in regards to private payer laws with regards to telemedicine is slated to take affect January 1, 2021. If you practice telemedicine within the state of Arizona, we strongly recommend reviewing the new state statutes (AZ Senate Bill 1089) in its entirety prior to January 1, 2021.

Ready to find out more about Arizona’s telemedicine policy? Keep on reading.

State Policy Overview

Medicaid
Private Payers
Parity

Additional state telemedicine information

  • Parity Laws

    Arizona has a partial telemedicine parity law. The law requires reimbursement through private payers, but only for certain health services delivered to patients in rural areas of Arizona. The law specifically defines a “rural” area as a region or city located in a county of less than nine hundred thousand people.

    Many private payers will still cover telemedicine outside rural areas. Check with your commercial payers on their policy for telemedicine services.

  • Medicaid

    AHCCCS covers medically necessary consultative and/or treatment telemedicine services for all eligible members within the limitations described in this manual, when provided by an appropriate AHCCCS registered provider. With few exceptions, reimbursable consultations must be provided in real-time.

  • Type of Telemedicine Covered

    Arizona Medicaid covers live video, store-and-forward, and home health monitoring telemedicine.

  • Covered Health Services

    Arizona requires private payers to cover the following health services when they are delivered via live telemedicine to patients in rural areas:

    • Trauma
    • Burn
    • Cardiology
    • Infectious disease
    • Mental health disorders
    • Neurologic diseases including strokes
    • Dermatology
    • Pulmonology
    • Pain medicine (starting 2019)
    • Substance abuse (starting 2019)
    • Urology (starting 2020)

    Arizona Medicaid (AHCCCS) will reimburse for medically necessary services provided via live video, including:

    • Cardiology
    • Dermatology
    • Endocrinology
    • Hematology
    • Home Health
    • Infectious diseases
    • Neurology
    • Obstetrics/Gynecology
    • Oncology
    • Ophthalmology
    • Orthopedics
    • Pain clinic
    • Pathology
    • Pediatrics and pediatric sub-specialties
    • Radiology
    • Rheumatology
    • Surgery follow-up and consults
    • Behavioral health services, including:
      • Diagnostic consultation and evaluation
      • Psychotropic medication adjustment and monitoring
      • Individual and family counseling
      • Case management
    • Inpatient consultation
    • Medical Nutrition Therapy
    • Surgery follow-up consultations
    • Pain management
    • Pharmacy management

    For more information, check out pages 45-51 in your Arizona Medicaid Manual.

  • Eligible Healthcare Providers

    Not all healthcare providers can do telemedicine under Arizona Medicaid. Here’s the list of the eligible providers:

    • Physician
    • Registered nurse practitioner
    • Physician assistant
    • Certified nurse midwife
    • Clinical psychologist
    • Licensed clinical social worker
    • Licensed marriage and family therapist
    • Licensed professional counselor

    Providers also must be licensed in Arizona and currently enrolled in the Arizona Medicaid program

  • Online Prescriptions

    Doctors are not allowed to issue a prescription without a physical or mental health examination to establish a relationship with the patient. 

  • Informed Patient Consent

    Arizona requires providers to get a patient’s oral or written consent before a telemedicine visit and note that in the patient’s record. 

    Read our article on informed patient consent to learn more.

  • Cross-State Telemedicine Licensing

    Arizona is part of the Interstate Medical Licensure Compact, an effort to make cross-state licensing easier. 

  • Restrictions on Locations

    According to Arizona’s parity law, private payers are required to provide coverage when the originating site (where the patient is) is located in a rural region, defined as an area or city with a population of less than nine hundred thousand persons.

    Under Medicaid, the provider must be delivering telemedicine at one of the following locations:

    • IHS clinic
    • Tribally-governed 638 facility
    • Urban clinic for Native Americans
    • Office of a physician or other practitioner
    • Hospital
    • Federally qualified health center (FQHC)

  • Reimbursement Rates

    In 2015, Arizona Medicaid started reimbursing for telemedicine services according to the current physician fee schedule amount for that medical service.

    Additionally, Arizona requires private payers to cover live video telemedicine when the patient is in a rural region and is receiving treatment for one of the following conditions:

    • Trauma
    • Burn
    • Cardiology
    • Infectious disease
    • Mental health disorders
    • Neurologic diseases including strokes
    • Dermatology
    • Pulmonology
    • Pain medicine (starting 2019)
    • Substance abuse (starting 2019)
    • Urology (starting 2020)

  • Helpful Resources

    We used the sites below to gather information for this guide. Check them out for more details on your state’s policy!

Additional resources to help you get started.

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