Colorado 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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Colorado Telemedicine Information

updated October 2019

Telemedicine in Colorado: Policies

Colorado has made great strides in improving availability and access to telemedicine in the centennial state. Prior to 2017, Colorado had a partial telemedicine parity law, which mandated coverage for telemedicine in rural areas. Legislation passed in 2017 removed that location restriction and now mandates telemedicine coverage across the entire state, not just rural locations.

In 2019 the Colorado legislature passed a law requiring Medicaid to reimburse at the same rate for telemedicine as if it were an in-person visit. They also added a patient’s home as an originating site.

State Policy Overview

Medicaid
Private Payers
Parity

Additional state telemedicine information

  • Parity Laws

    When a state passes a telemedicine parity law, it means private payers are required to reimburse live telemedicine the same way as in-person visits. Colorado used to only mandate telemedicine reimbursement for services delivered in rural areas of the state. Since January 2017, Colorado now has a full parity law, requiring reimbursement across the entire state.

  • Medicaid

    Telemedicine is defined as a means to deliver medical services, diagnosis, consultation, or treatment using interactive audio, video, or data communication.

    According to Health First Colorado, “Telemedicine is not considered a unique service, but rather, a means to provide services approved by Health First Colorado through live, interactive audio and video telecommunications.” Telehealth also includes home health monitoring services by the member’s home health agency.

  • Type of Telemedicine Covered

    Colorado Medicaid covers reimbursements for live video telemedicine for both medical and mental health services. The program also reimburses for Remote Patient Monitoring, but only for chronic disease management as a flat fee under specific conditions.

    Colorado Medicaid does not reimburse for store-and-forward technology telehealth services.

  • Covered Health Services

    Colorado Medicaid reimburses for live video telemedicine for both medical and mental/behavioral health services, as well as speech therapy and obstetric ultrasound services. The program also covers remote patient monitoring for certain home health patients. 

  • Eligible Healthcare Providers

    Here’s the list of healthcare providers who are eligible to get reimbursed for telemedicine in Colorado:

     

    • Physician
    • Clinic
    • Osteopath
    • FQHC
    • Psychologist
    • MA Psychologist
    • Physician Assistant
    • Nurse Practitioner
    • Rural Health Clinic

  • Online Prescriptions

    Colorado does not allow physicians to prescribe patients controlled substances and dangerous drugs based only on an internet-based questionnaire, online consult, or a telephone consultation.

  • Informed Patient Consent

    Colorado state law requires providers to get all first-time patients’ written consent before a telemedicine visit. We recommend this as a telemedicine best practice in any event! Additionally, Colorado Medicaid says that a face-to-face encounter between provider and patient “may be waived prior to treating the member through telemedicine for the first time.” 

  • Cross-State Telemedicine Licensing

    Colorado joined the FSMB’s Interstate Medical Licensure Compact in 2016. This compact offers physicians an expedited license to practice in multiple states.

  • Restrictions on Locations

    Good news! Colorado enacted laws removing the restriction of telemedicine coverage to rural areas. The  laws went into effect in 2017. Additionally, Colorado Medicaid allows the originating site (where the patient is) to be the patient’s home. 

  • Reimbursement Rates

    Colorado Medicaid reimburses telemedicine services with the same physician fee schedule amount for that medical service. Rates for a telemedicine service are the same as the comparable in-person medical service.

    Other Reimbursable Fees: In addition to the billing for the actual medical service, if the patient is doing the visit from a hosting (originating site), that site can charge a facility fee. Lookup HCPCS code Q3014 for details.

  • Billing Codes

    Need a list of the eligible Colorado Medicaid codes for telemedicine? We’ve got you covered:

    • Evaluation & Management
    • 99201 Office or other outpatient visit, new patient, 10 minutes
    • 99202 Office or other outpatient visit, new patient, 20 minutes
    • 99203 Office or other outpatient visit, new patient, 30 minutes
    • 99204 Office or other outpatient visit, new patient, 45 minutes
    • 99205 Office or other outpatient visit, new patient, 60 minutes
    • 99211 Office or other outpatient visit, established patient, 5 minutes
    • 99212 Office or other outpatient visit, established patient, 10 minutes
    • 99213 Office or other outpatient visit, established patient, 15 minutes
    • 99214 Office or other outpatient visit, established patient, 25 minutes
    • 99215 Office or other outpatient visit, established patient, 40 minutes

     

    • Outpatient Mental Health
    • 90791 Diagnostic evaluation. If interactive complexity then report with add on code 90785
    • 90832 Psychotherapy, 30 min (actual time can be 16-37 min. If interactive complexity then report with add on code 90785
    • 90833 Add on Psychotherapy 30 min (actual time can be 16-37 min) Use in conjunction with appropriate E/M codeIf interactive complexity then report with add on code 90785
    • 90834 Psychotherapy 45 min (actual time can be 38-52 min)If interactive complexity then report with add on code 90785
    • 90836 Add on Psychotherapy 45 min (actual time can be 38-52 min) Use in conjunction with appropriate E/M code. If interactive complexity then report with add on code 90785
    • 90837 Psychotherapy 60 min (actual time can be 53+) Medicare crossover only
    • 90838 Add on Psychotherapy 60 min (actual time can be 53+ Use in conjunction with appropriate E/M code). Medicare crossover only
    • 90863 Add on Pharmacologic management code can be added to primary psychotherapy code
    • 90846 Family therapy – patient not present
    • 90847 Family therapy – patient present

    Don’t forget your GT modifier! Providers should also use the GT modifier with the relevant code to note telemedicine.

    For additional billing codes for Speech Therapy and Obstetrical services, check out the Colorado Medicaid Telemedicine Handbook.

  • 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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