IDAHO

IDAHO TELEMEDICINE LAW

Idaho may be the Gem State, but it needs more polish to shine in telemedicine access and availability! There is no private payer parity law in place and there has not been any legislative activity on this front in the last two years. Keep an eye on Idaho in the coming years to track health policies’ progress.

Ready to find out more about Idaho’s telemedicine policy? Check out our state guide below!

Parity Law

Idaho does not have a private payer parity law, nor has any legislation for parity been presented in the last several years. However, this doesn’t mean you won’t get paid for telemedicine! While a telemedicine parity law would require all private payers in the state to reimburse for telemedicine, many payers will still cover it anyway.

Type of Telemedicine Covered

Idaho Medicaid will reimburse for some live-video telemedicine, limited to mental health services and developmental disabilities (DD) services.

Covered Health Services

Psychotherapy with evaluation and management

Psychiatric diagnostic interview

Pharmacological management

DD therapeutic consultation

DD crisis intervention

Billing Codes

The following codes and modifier may only be used for telemedicine services provided by a physician:

90791 with UI modifier – Psychiatric Diagnostic Evaluation (by physician)

90833 – Psychotherapy, 30 minutes with patient and/or family member, when performed with an evaluation and management service (by a primary care provider)

H0034 – Medication training and support, per 15 minutes

Claims must include a “GT” modifier appended to the procedure code The originating site may bill for the transmission of telehealth:

Q3014 (originating site fee) The distant site may bill for the transmission of telehealth:

T1014 (distant site fee) DD Telehealth Reimbursement

H2019 HO (therapeutic consultation)

H2011 HO (crisis intervention)

Claims must include a “GT” modifier. The originating site may bill for the transmission of telehealth.

Want more details? Check out the Idaho State Medicaid Page!

Eligible Healthcare Providers

The following healthcare providers can bill for telemedicine through Idaho Medicaid:

Physician

Nurse practitioner

Physician assistant

Nurse midwife

Clinical nurse specialist

Clinical psychologist

Clinical social worker

Registered dietitian or nutrition professional

Online Prescriptions

In Idaho, providers can prescribe medication via telemedicine to established patients. The state does prohibit prescription of any drugs for abortion.

Informed Patient Consent

The patient’s written informed consent is required to do a telemedicine visit.

Cross-State Telemedicine Licensing

Exciting news! Idaho has recently adopted the Federation of State Medical Board (FSMB)’s model language for an interstate medical licensure. That means Idaho is actively working to streamline the process of getting permission to practice in other states. You can read about Idaho’s participation in the Interstate Medical Licensure Compact in this bill.

Patient-Provider Relationship

Providers can only practice telemedicine with established patients.

Restrictions on Locations

Idaho’s Medicaid patients must be located in a rural or underserved area to be eligible.

Authorized originating sites include:

The office of a physician or practitioner

A hospital

A critical access hospital (CAH)

A rural health clinic (RHC)

A federally qualified health center (FQHC)

A hospital-based or critical access hospital-based renal dialysis center (including satellites)

A skilled nursing facility (SNF)