DELAWARE
Parity Law
Delaware recently passed a telemedicine parity law that requires private payers to reimburse live video telemedicine the same way as in-person visits.
Type of Telemedicine Covered
Private payers and Delaware’s Medicaid program cover live video telemedicine. Also, telephone consultations are covered services included in payments to Federally Qualified Health Centers (FQHC).
Covered Health Services
Delaware Medicaid reimburses all telemedicine services covered under the Medicaid State Plan for regular in-person services. Delaware is one of the few states to reimburse for telerehabilitative services under the home health benefit.
Billing Codes
When billing for telemedicine, use the appropriate CPT/HCPCS procedural code and add a GT modifier (to indicate the service occurred via interactive audio and video telecommunication system).
Want more details? Check out the Delaware State Medicaid Page
Eligible Healthcare Providers
The following providers can be reimbursed for telemedicine:
Physician
Nurse practitioner
Physician assistant
Nurse midwife
Clinical nurse specialist
Clinical psychologist
Psychiatrist
Clinical social worker
Registered dietitian or nutrition professional
Online Prescriptions
Delaware law prohibits providers from prescribing medication without a prior patient-provider relationship. If there is an established relation, providers can prescribe medication, including controlled substances.
Informed Patient Consent
Delaware providers need to get a patient’s informed consent in order to establish a doctor-patient relationship over telemedicine. The manner of obtaining consent is unspecified.
Interstate Telemedicine Licensing
Providers delivering telemedicine in Delaware must be enrolled in the Delaware Medical Assistance Program or in one of the program’s managed care organizations.
Other Reimbursable Fees
Delaware recently passed legislation that says private payer payment for telemedicine must include reasonable compensation to the originating or distant site for the transmission cost.
Reimbursement Rates
Reimbursement rates in Delaware are the same for telemedicine as for in-person services.
Helpful Resources
Center for Connected Health Policy – Delaware State Page
Mid Atlantic Telemedicine Resource Center.
The American Telemedicine Association State Policy Matrix
Delaware Telemedicine Medicaid Manual
Delaware Press Release