Ohio 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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Ohio Telemedicine Policy

updated October 2019

Ohio Telemedicine Policy

Ohio has a comprehensive telemedicine outlook that includes behavioral health services, school-based speech therapy and pharmacological management. Though their parity law has yet to be enacted, the state is making strides in other areas.

In 2019 Ohio Medicaid included the patient’s home as an originating site.

For example, though Ohio is not yet part of the Interstate Medical Licensure Compact, the state has some of the least-restrictive policies for out-of-state physicians. Ohio offers a special telemedicine permit rather than requiring full state licensure for practicing physicians.

Find out more about Ohio telemedicine policy below!

State Policy Overview

Medicaid
Private Payers
Parity

Additional state telemedicine policy

  • Parity Laws

    Ohio proposed a parity law for private insurance and Medicaid a few years ago, but it failed to pass. However, many private insurance companies will still cover telehealth policies even when it’s not required. Call your payers and check back for updates!

  • Medicaid

    Ohio’s Medicaid program covers a range of evaluative and management services or psychiatric services, including behavioral health and speech therapy, when delivered via live video telemedicine. Currently, the program doesn’t reimburse for not store-and-forward or remote patient monitoring solutions. Medicaid also places a few limitations on eligible providers and the location of the patient at the time of care.

  • Type of Telemedicine Covered

    Ohio’s Medicaid program defines telemedicine only as interactive, real-time care. Reimbursement is only covered for live video telemedicine, not store-and-forward, home health monitoring, or email/phone/fax.

  • Covered Health Services

    Telemedicine health services that are covered by Ohio Medicaid include:

    • Consultations by physicians
    • School-based speech therapy
    • Behavioral health counseling and therapy
    • Mental health assessment
    • Pharmacological management
    • Community psychiatric supportive treatment service

  • Eligible Healthcare Providers

    Ohio Medicaid will reimburse the following providers for telemedicine:

    • Physicians (MD, DO)
    • Psychologists
    • Federally Qualified Health Center (medical and mental health)

  • Online Prescriptions

    Ohio regulation states that physicians can’t prescribe any medication to a patient without doing a physical exam.

     However, physicians may sometimes prescribe non-controlled substances based on a telemedicine visit, as long as they meet this list of requirements:

    • Establish the patient’s identity and physical location
    • Obtain the patient’s informed consent
    • Forward medical record to patient’s primary care provider
    • Conduct an appropriate evaluation
    • Establish or confirm a diagnosis and treatment plan
    • Document information in patient’s medical record
    • Provide appropriate follow-up care
    • Make medical record of the visit available to patient
    • Use appropriate technology sufficient to conduct all steps

  • Informed Patient Consent

    Ohio requires providers to get a patient’s informed consent for a telemedicine visit.

  • Cross-State Telemedicine Licensing

    Great news! Qualifying out-of-state physicians don’t need to have a full license to practice telemedicine in Ohio.

    They also have the option to apply for a telemedicine permit to practice in the state.

  • Restrictions on Locations

    In order to bill for telemedicine through Ohio Medicaid, the patient needs to be at an eligible originating site, and that site needs to be more than five miles away from the telehealth provider.

    Here are the list of eligible originating sites:

    • The offices of a:
      • Physician;
      • Psychologist;
      • Physician assistant;
      • Clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner; or
      • Licensed independent social worker, licensed independent chemical dependency counselor, licensed independent marriage and family therapist, or licensed professional clinical counselor
    • The patient’s home
    • School
    • Inpatient hospital
    • Outpatient hospital
    • Nursing facility
    • Intermediate care facility for individuals with an intellectual disability (ICF/IID)

     

  • Billing Codes

    Luckily, Ohio Medicaid has a handy telemedicine billing cheatsheet ready for you. Here are the list of appropriate HCPCS codes:

    • 99201-99215
    • 99241-99245
    • 99251-99255
    • 90791-90792
    • 90832-90838
    • 90863

    Use the relevant code along with the GT modifier to indicate 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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