In Kentucky, Medicaid reimbursement levels are equivalent for in-person and telehealth services, but there can be differences in costs through private insurance plans. Here’s a quick look at some of the regulations and how they may affect payments.
|Reimbursement for: Live video and store-and-forward services are both covered by Medicaid. Remote monitoring services are typically excluded.||Reimbursement for: Telehealth services receive the same level of reimbursement as in-person consultations.||Reimbursement levels are equal, regardless of distance when providers meet quality standards unless specifically contracted at different rates.|
Kentucky takes a unique approach to parity laws. Medicaid offers equal reimbursement for equivalent services unless the provider and Medicaid have directly negotiated a reduced rate. A doctor’s appointment in the office or via Telehealth costs you the same copay if you have one.
If you have private insurance, you’ll need to contact your insurance company to determine costs. Kentucky’s parity laws provide a baseline that ensures equivalent reimbursement but offers both insurance companies and health care providers the option to negotiate separate rates for in-office and remote services.
Since Kentucky considers the place of service to be where the patient is located, there’s no requirement for your doctor to be located within state limits. However, all Kentucky health care providers must be licensed to practice in Kentucky before offering ongoing care.
Eligible Health Care Providers
In Kentucky, your health care provider must be licensed in the state to offer telehealth services, but there are no special regulations limiting the types of services you can receive. As long as the provider can offer equal care via telehealth, it’s legal for them to do so. Some providers you might see via Telehealth include:
If you need a prescription, you’ll need to go to your current doctor or schedule a longer telehealth visit, since your doctor must have an established relationship with you before giving you a new prescription. Establishing a relationship is possible via Telehealth. Doctors using telehealth platforms typically build your relationship by getting a verbal medical history and updating your medical records after they verify your identity. Then, before calling in a prescription for you, they may ask you to help them perform an exam remotely.
Your current primary care doctor may already offer telehealth options and may also be able to help you with referrals to specialists who also offer telehealth services. If you don’t have a doctor or your current doctor doesn’t offer remote appointments, take some time to perform due diligence.
As telehealth expands into underserved areas, it’s a good idea to keep on top of any changes to the law that may affect your ability to find a doctor. Stay up-to-date on the latest news for Telehealth in Kentucky by visiting these sites.