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)
A community mental health center(CMHC)
Other Reimbursable Fees
Idaho Medicaid will reimburse the transmission fee of the distant and originating site for mental telehealth services.
Reimbursement Rates
Good news! Reimbursement rates in Idaho are the same as for in-person services.
Helpful Resources
Center for Connected Health Policy – Idaho State Page
Northwest Regional Telehealth Resource Center.
The American Telemedicine Association State Policy Matrix
Idaho State Health Education Center