West Virginia 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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West Virginia Telemedicine Information

updated October 2019

West Virginia Telemedicine Policy

West Virginia does not yet have a parity law in place that would require private payers to cover telemedicine the same way as in-person services. However, there are still benefits to practicing telemedicine in the Mountain State, especially for providers looking to reach patients in rural areas. Learn more about West Virginia’s policies below!

State Policy Overview

Medicaid
Private Payers
Parity

Additional state telemedicine information

  • Parity Laws

     A state telemedicine parity law requires private payers to reimburse telemedicine services in the same way as in-person services.  Many states have passed telemedicine parity laws.

    Unfortunately, West Virginia does not currently have a telemedicine parity law in place and has not yet proposed one. However, private payers may still reimburse for telemedicine services in West Virginia – check with your payers! 

  • Medicaid

    West Virginia’s Medicaid program encourages providers to use real-time, video telemedicine to extend access to care to many of the state’s rural regions. The program reimburses for a limited number of medical services delivered via live video, including mental health care.

  • Type of Telemedicine Covered

    West Virginia Medicaid currently covers live video telemedicine, with no reimbursement for store-and-forward or remote patient monitoring.

  • Covered Health Services

    West Virginia Medicaid reimburses for medical consultations (initial follow-up, consultation in hospitals, outpatient facilities, or medical offices), nutrition and exercise services, and behavioral health consultations, all when offered through live video technology. 

  • Eligible Healthcare Providers

    West Virginia Medicaid restricts telemedicine reimbursement to the following healthcare providers:

    • Physicians
    • Physician Assistants (PA)
    • Advanced Practice Registered Nurses (APRN)/Nurse Practitioners (NP)
    • APRN/Certified Nurse Midwife (CNM)
    • APRN/Clinical Nurse Specialists (CNS)
    • Licensed Psychologists (LP)
    • Licensed Independent Clinical Social Worker (LICSW)

  • Online Prescriptions

    Providers in West Virginia must establish an ongoing physician-patient relationship in order to issue a prescription. However, West Virginia law also says that telemedicine can be used to establish this relationship! 

  • Informed Patient Consent

    West Virginia requires providers to get a patient’s informed consent before doing a telemedicine visit. We recommend this anyway as a telemedicine best practice. 

  • Cross-State Telemedicine Licensing

    West Virginia joined the Interstate Medical Licensing Compact in 2015. The compact makes it easier to practice telehealth across state lines.

  • Restrictions on Locations

    West Virginia Medicaid requires patients to receive telemedicine at particular “originating sites.” Here is the full list of those locations:

    • Offices of physicians or practitioners
    • Private Psychological Practices
    • Hospitals
    • Rural Health Clinics (RHCs)
    • Federally Qualified Health Centers (FQHCs)
    • Hospital-based or CAH-based Renal Dialysis Centers (including satellites)
    • Skilled Nursing Facilities (SNF)
    • Community Mental Health Centers (CMHC).

  • Billing Codes

    West Virginia Medicaid, like many other states, requires you to bill the appropriate CPT code along with the GT (telemedicine) modifier. Here are a few of the included CPT codes:

    • 99241-99245
    • 99251-9925
    • 99261-99263
    • 99271-99275

  • 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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