South Dakota 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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South Dakota Telemedicine Policy

updated October 2019

South Dakota Telemedicine Policy

South Dakota’s telemedicine policies have volleyed back and forth, but the state’s lawmakers are still making progress. The state does set some restrictions on patient settings (at the time of the visit) and types of telemedicine that can receive Medicaid coverage.

However, South Dakota has joined the Interstate Medical Licensure Compact and has implemented several telehealth programs to provide substance abuse treatment to rural areas of the state. Also, although the state does not yet have a telehealth parity law, one has been proposed. Check this page for updates!

State Policy Overview

Medicaid
   Private Payers
  Parity

Additional state telemedicine information

  • Parity Laws

    Unfortunately, South Dakota doesn’t have a parity law at the moment, but one is proposed for legislation.

    Health insurers cannot exclude a service for coverage solely because the service is provided through telehealth and not provided through in-person consultation or contact between a health care professional and a patient. 

    Telehealth parity laws require private payers to cover telemedicine services, often at the same rate as in-person care. However, many private payers still include telehealth in their policies even when it’s not legally mandated by the state. Check with your private insurance companies to see what their policies are. 

  • Medicaid

    South Dakota Medicaid defines telemedicine as occurring in “real time,” which means the program covers live video telehealth, but not store-and-forward applications. Medicaid covers a limited number of medical services, including pharmacological management, at the same rate as in-person services. See the Medicaid Manual for the complete list of covered services and the corresponding billing codes.

    South Dakota does also offer some coverage for remote patient monitoring reimbursement, specifically through the Office of Adult Service and Aging for patients who need in-home support.

  • Type of Telemedicine Covered

    South Dakota’s Medicaid program defines telemedicine as “real time,” so store-and-forward technology isn’t covered, but two-way interactive video is. Additionally, The Office of Adult Services and Aging offers reimbursement for remote patient monitoring. 

  • Covered Health Services

    South Dakota Medicaid covers the following medical services delivered via telehealth:

    • Psychotherapy
    • Psychiatric diagnostic evaluation
    • End-stage renal disease
    • Health and behavior assessment and intervention
    • Patient office consultation
    • Inpatient hospital consultation
    • Nursing facility visits
    • Pharmacologic management
    • Office or other outpatient visits
    • Diabetes outpatient self-management education services

    Additionally, Medicaid will cover an individual’s home monitoring services if:

    • The individual is residing at home
    • The individual is age 60 or older or is age 18 or older with a disability
    • The individual is not eligible for other programs which provide the same type of services.

  • Eligible Healthcare Providers

    South Dakota does not specify the type of healthcare provider allowed to practice telemedicine. This offers better flexibility for practicing telemedicine in the Mount Rushmore State.

  • Online Prescriptions

    South Dakota does not have any regulations currently for prescribing medication via telehealth. 

  • Informed Patient Consent

    The state does not have any telemedicine-specific rules on getting informed patient consent. However, we always recommend obtaining consent as a telemedicine best practice. 

    Learn more about that here.

  • Cross-State Telemedicine Licensing

    South Dakota is now a member of the Interstate Medical Licensure Compact, which helps out-of-state healthcare providers get licensed in the state. Additionally, South Dakota allows licensing reciprocity to out-of-state providers as long as they are licensed and in good standing in another state.

  • Restrictions on Locations

    South Dakota Medicaid does unfortunately place some restrictions on the patient’s location at the time of the telehealth visit. In order to access these services, patients need to be at one of the following locations:

    • Office of a physician or practitioner
    • Outpatient hospital
    • Critical Access Hospital
    • Rural Health Clinic
    • Federally Qualified Health Center
    • Indian Health Services Clinic
    • Community Mental Health Center
    • Nursing facilities

  • Reimbursement Rates

    While South Dakota does not yet have a telehealth parity law, many payers reimburses telemedicine at similar rates to in-person services. The state’s Medicaid, for example, pays at the same rate as the comparable traditional service.

  • Billing Codes

    Need help billing for telemedicine? Your South Dakota Medicaid manual has all the billing codes you need. Here are a few that are included:

    • 99241 – 99245 Patient office consultation
    • 99251 – 99255 Inpatient hospital consultation
    • 99211 – 99215 Established patient office or other outpatient visit
    • G0108 Diabetes outpatient self-management education services, individual
    • G0109 Diabetes outpatient self-management education services, group

    Don’t forget to include your GT modifier to indicate the visit was completed via 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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