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The general telemedicine policy for Connecticut covers all necessary medical care. Medicaid is required to pay for most health care services, but the state commissioner must first approve them. The state’s Medicaid policy manuals don’t discuss telemedicine, except for behavioral health care, so coverage is a developing situation. While there is a parity law in place, it only deals with coverage.
|Reimbursement for: Interactive audio and video. No coverage for fax, audio telephones, email, or texting.||Reimbursement for: Interactive audio and video. No coverage for fax, audio telephones, email, or texting.||Coverage is required for telehealth services that would be covered during in-person appointments|
Connecticut doesn’t have a reimbursement parity law. This means that although Connecticut parity law states that telemedicine coverage is allowed by private payers and Medicaid, it doesn’t determine or set forth regulations regarding how much you’ll be reimbursed for using these services.
There is no mention in the parity law about the types of telehealth services, such as live video, store-and-forward, and remote patient monitoring. As noted, these rules have been amended temporarily, and further provisions have been made regarding out-of-state-providers offering treatment to Connecticut residents.
Eligible Health Care Providers
The only health care providers covered under Connecticut Medicaid’s original plan documents are those who provide case management for patients aged 18 and under who are receiving behavioral treatment. These providers can bill for live video telehealth psychotherapy services and psychiatric diagnostic evaluations that they provide.
Connecticut also specifically lists health care workers permitted to provide medication-assisted treatment and medication management services.
The following providers are covered under Medicaid to provide services to out-of-state surgery and homebound patients:
Due to state waivers, most providers of health care services that can be practiced via telehealth are eligible.
Telehealth physicians and nurse practitioners can prescribe non-controlled medications and Schedule IV or V substances. Connecticut allows doctors to prescribe Schedule II and III drugs used in medication-assisted treatment for substance abuse.
Treatment via telehealth is still coming into its own in Connecticut, and the state will likely continue to expand its coverage of telemedicine services. Should you decide to seek help from an online doctor in Connecticut, consider the following factors:
Research credentials: Before scheduling an appointment with an online doctor, make sure to verify their professional certifications and licensure. You may want to inquire about the technology they utilize for telemedical services to ensure that your privacy is protected. You can verify medical licensure in Connecticut via the Connecticut Department of Public Health website.
Determine your cost: It’s always a good idea to discuss costs with your clinic or doctor’s office before confirming an appointment. Ask about additional fees, such as monthly subscriptions, that providers may charge for telemedicine, as these fees are often not covered by Medicaid and private insurance.
Read online doctor reviews: Online reviews can help you to determine if a provider is right for your telehealth needs. Perform a web search and check on social media platforms to find reviews and see what other patients are saying about a doctor’s telemedicine services. Hearing about other people’s experiences can help you understand what to expect during your own appointments.
Like many states, telemedicine is expected to expand in Connecticut over the next few years. Stay up-to-date with rules and regulations regarding telemedicine, as well as available Medicaid coverage by visiting the following resources: