TABLE OF CONTENTS
|Reimbursement for: Most telehealth services except for store-and-forward encounters, though technical components may be covered separately||Reimbursement for: All telehealth services according to patient’s coverage type||Reimbursed at the same rate as in-person services|
In Georgia, private insurers and Medicaid cover mental and physical telehealth services the same way they cover in-person visits. Georgia Medicaid requires an interactive telecommunication system for reimbursement, which limits coverage for store-and-forward practices. Georgia Medicaid also usually requires both provider and patient to be present at certain specified locations during a telehealth visit. These locations include places like provider offices, hospitals, or rural health clinics. However, in light of the COVID-19 crisis, Georgia Medicaid temporarily waived any restrictions on originating sites (where the patient is located) and distant sites (where the provider is located). Eventually, they added the patient’s home as an eligible originating site and permitted audio-only phone calls. It is not yet clear whether these changes will be permanent.
Eligible Health Care Providers
Many types of health care providers are eligible to provide telehealth services under Georgia law. Some of these provider types were recently made eligible during the COVID-19 crisis, but they may be added permanently once the crisis has resolved. Providers must also be licensed in Georgia and currently enrolled in the Georgia Medicaid program. A current list includes:
In Georgia, providers are permitted to prescribe medications during telehealth consultations as long as they have personally seen and examined the patient or are providing medical care on behalf of a physician, physician assistant, or advanced practice registered nurse licensed in Georgia who has done so. Georgia regulations encourage practitioners to make “diligent efforts” to have the patient seen for an in-person visit at least annually, but this isn’t actually required as long as the other specifications are met.
One important exception for prescribing telehealth providers is that they may not prescribe controlled substances or dangerous drugs based solely on a telehealth consult. However, if the physician is on-call or covering for another provider, they may prescribe up to a 72-hour supply of these medications for patients of another provider. There are also exceptions for prescribing certain medications for the treatment of attention deficit disorder (ADD).
If your regular provider offers telehealth services, it’s easy to continue receiving care even when you can’t make it into the office. If you’re using a telehealth service, it’s important to do your research before selecting a provider.
Telemedicine in Georgia is growing and changing rapidly. To stay up to date with new regulations, providers, insurance coverage, and Georgia Medicaid consult our online sources.