Certain payors will reimburse for tele-health services equal to office visits while others may not or have
Currently, there are 33 states that have parity laws that mandate private payer reimbursement for telemedicine
services. To learn more, visit the American Telemedicine
You may also visit the Center for Connected Health Policy to learn more
about patient and provider requirements that determine reimbursement. Additionally, they provide in-depth
information on legislation for both public and private healthcare programs and is a fantastic resource for those
looking to dive deep into individual state policy.
Parity laws allow for providers to be paid at the same rate irrespective of whether services are provided by
telehealth or in-person. Parity laws are equalizing payments with traditional practice. Each provider must
review their private payor contracts to determine what services are eligible for telehealth.
Footnote: A map of state parity law status around the country.
Medicare currently pays for telehealth services, but with a major asterisk. They are required to be provided
only in rural or in provider shortage areas and must be provided at certain types of facilities. Medicare does
allow telehealth services for CCM (chronic care management) and RPM (remote patient monitoring) to be paid for
regardless of patient or provider location. And now they are also allowing demonstration projects for ESRD (end
stage renal disease) patients to provide telehealth services irrespective of their location
Medicaid allows for all tele-health services in 49 states. Refer to the CCHP website
for state-specific details
Telehealth is a very useful tool to decrease cost of care for capitated providers while still providing
significant improvement for access to care of patients.
Direct pay providers may charge patients their own custom rates for concierge care.