Georgia 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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Georgia Telemedicine Policy

updated October 2019

GeorgiaTelemedicine Policy

Like many other U.S. states, Georgia is on the road to better coverage for telemedicine. Georgia has a telemedicine parity law in place, which requires private payers to cover telemedicine services. Georgia’s Medicaid program also covers a wide range of medical services delivered via live-video.

However, there’s still room for Georgia to grow! Similar to Medicare’s telemedicine regulations, Georgia Medicaid places some restrictions on the location of patient and provider at the time of the telemedicine visit. Georgia also does not cover other forms of telemedicine, like store-and-forward or remote patient monitoring solutions.

State Policy Overview

Medicaid
Private Payers
Parity

Additional state telemedicine information

  • Parity Laws

    Beginning January 1, 2020, Georgia will have a service and payment parity law in place pertaining to private payers. A telemedicine parity law requires private payers to reimburse telemedicine services in the same way as in-person services.

  • Medicaid

    Georgia’s Medicaid program defines telemedicine as “the use of two-way, real time interactive communication equipment to exchange the patient information from one site to another via an electronic communication system.” This means Georgia Medicaid covers live video telemedicine, but not remote monitoring or store-and-forward.

  • Type of Telemedicine Covered

    Live video is a go! Private payers and state Medicaid will both reimburse for telemedicine visits done over video. However, there’s currently no coverage for store-and-forward, remote patient monitoring, or other electronic communication (like email, phone or fax).

  • Covered Health Services

    Georgia Medicaid reimburses for live video telemedicine, as long as the service is considered medically necessary and appropriate for the patient. Here’s what’s covered:

    • Office visits
    • Pharmacologic management
    • Limited office psychiatric services
    • Limited radiological services
    • A limited number of other physician fee schedule services

  • Eligible Healthcare Providers

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

    • Physicians
    • Nurse Practitioners
    • Physician Assistants
    • Nurse-midwives
    • Clinical Nurses specialists
    • Nurse anesthetists
    • Dentists and dental hygienists
    • Clinical Psychologists and clinical social workers
    • Speech language pathologists
    • Audiologists
    • Dietitians or Nutrition Professionals

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

  • Online Prescriptions

    Georgia does not allow physicians to prescribe patients controlled substances and dangerous drugs based only on a virtual telemedicine visit.

  • Informed Patient Consent

    Georgia’s Medicaid program requires providers to get a patient’s written consent before a telemedicine visit. We recommend this anyway as a telemedicine best practice. 

  • Cross-State Telemedicine Licensing

    Georgia has recently introduced legislation to join the Interstate Medical Licensure Compact, which would expedite the licensing process for out-of-state providers. Providers engaging in telemedicine in Georgia at this time need to have a Georgia medical license.

  • Restrictions on Locations

    Like with Medicare, Georgia’s Medicaid program restricts where the patient and provider can be located during the telemedicine visit. Here are the eligible originating and distant sites under Georgia Medicaid:

    • Provider Offices
    • Hospitals
    • CAH based renal Dialysis Centers
    • Rural Health Clinics (RHC)
    • Federally Qualified Health Centers (FQHC)
    • Skilled nursing facilities
    • Emergency Medical Services Ambulances
    • School-based clinics
    • Pharmacies
    • County Boards of Health

    That means both the patient and provider will need to be at one of the eligible sites during the visit for GA Medicaid to cover it.

  • Reimbursement Rates

    Good news! Georgia Medicaid reimburses telemedicine services according to the current physician fee schedule amount for that medical service.

    Other Reimbursable Fees: The originating site can bill a facility fee  using the Q3014 HCPCS code. Any claims need to be submitted with revenue code 780 (telemedicine) and type of bill 130.

  • Billing Codes

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

    • 99201-99205: Office or Other Outpatient Visit, New patient
    • 99211-99215: Office or Other Outpatient Visit, Established patient
    • G0425-G0427: Initial Inpatient telehealth consultations (30, 50, 70 minutes)
    • G0406-G0408: Follow-up telehealth consultations furnished to members in hospitals or SNFs (15, 25, 35 minutes)
    • 99231-99233: Subsequent Hospital care
    • 99307-99309: Subsequent Nursing facility care Subsequent hospital care services are limited to one telehealth visit every 3 days
    • 90801: Psychiatric diagnostic interview examination
    • 90804-90809: Individual psychotherapy (office or outpatient facility)
    • 90816-90818: Individual psychotherapy (inpatient hospital)
    • 90862: Pharmacologic management (reimbursable by MD only)
    • H0039: Assertive Community Treatment
    • Q3014: Telemedicine originating site facility fee.

    Don’t forget your GT modifier!

    Providers should also use the GT modifier with the relevant code to note telemedicine.

  • 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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