Medi-Cal considers telemedicine to be the “use of medical information exchanged…using interactive telecommunication equipment that includes, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and physician or practitioner.”
Medi-Cal reimburses for live video telemedicine (use the billing modifiers GT or 95), and store-and-forward services for dermatology, dentistry, and ophthalmology.
Center for Connected Health Policy
As of August 2019 Medi-Cal is now allowing providers in fee-for-service to decide what modality, live video or store-and-forward, will be used to deliver eligible services to a Medi-Cal enrollee as long as the service is covered by Medi-Cal and meets all other Medi-Cal guidelines and policies, can be properly provided via telehealth and meets the procedural and definition components of the appropriate CPT or HCPCS code. Additionally, Medi-Cal specifically allows the home to be an originating site and they will reimburse for one specific code for e-consult (as a sub-set of store-and-forward).
Other programs that have updated policies as of August 2019 include:
- Indian Health Services, Memorandum of Agreement (IHS-MOAs)
- Family Plan, Access, Care and Treatment (Family PACT)
- Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).
- Local Education Agency
- Vision Care