Only certain types of telemedicine are reimbursed through Florida’s Medicaid program. For private payers, payment rates are established through mutually agreed contracts between health insurers and telehealth providers. Many private insurers are choosing to reimburse telemedicine services that replace in-person visits as a result of COVID-19.
|Reimbursement for: Live, real-time, two-way interactive video.||Reimbursement for services determined by health insurers and telehealth providers.||No parity law|
There are no parity laws in Florida, which means that Medicaid and private payers aren’t required to cover telehealth services at the same rate as in-person medical visits. Reimbursement for some services is possible. However, for private payers, there are no regulations regarding what these services are or the copay amount. Telehealth providers and patients should make sure they fully understand the compensation amounts before starting a service.
Eligible Health Care Providers
For patients on Medicaid, only physicians who provide telemedicine services through secure live video are eligible for reimbursement. All providers enrolled in the Florida Medicaid Program can practice telehealth in the area they’re licensed to practice.
Reimbursement is available to providers of Child Protective Team (CPT) services in rural and remote areas of Florida.
The following providers are able to conduct CPT telemedicine services:
There’s no information provided regarding store-and-forward telemedicine services or remote patient monitoring.
Medications may only be prescribed after a thorough patient evaluation. Telehealth providers can only prescribe controlled substances to treat:
Telehealth providers are required to research a patient’s medical history before determining treatment.
Because the rules and regulations regarding telemedicine are still in the making, you should conduct comprehensive research before choosing a provider. The lack of a parity law doesn’t ensure payment by your insurance carrier. Before making an appointment, you should consider the following factors:
Research Credentials: You always want to do a little background research on your doctor, regardless of whether it’s an online or in-person appointment. Many states provide a website where you can verify state licenses, as well as other credentials. Visit the Florida Department of Health online to make sure your online doctor has up-to-date licensure. You can search by name, specialty, and city.
Determine your cost: Due to the lack of parity laws, it’s difficult to know how much telemedicine services will cost. Always talk to your insurance provider and telemedicine service provider before agreeing to treatment. There may also be subscription or additional service fees that Florida Medicaid or private payers don’t cover. Make sure you understand the costs, so you don’t have any unexpected bills later.
Read online doctor reviews: Telemedicine is still a relatively new field, so it’s helpful to learn about the process from people who’ve already gone through it. Online doctors in Florida should have an established web presence. This means you can use a search engine or use their name as a keyword on social media platforms to find feedback about their services. Patient reviews can help you find out more information about pricing and highlight any issues with a provider that may have occurred while using telehealth services.
Stay up-to-date with Florida laws and provisions regarding telemedicine. You can find additional information about telehealth services at the following websites: