MAINE
MAINE IS A GREAT EXAMPLE OF A STATE THAT HAS TELEMEDICINE FIGURED OUT! THE AMERICAN TELEMEDICINE ASSOCIATION GAVE MAINE ALMOST A PERFECT GRADE IN A RECENT REPORT OF THE STATE’S TELEMEDICINE POLICY AND MEDICAID COVERAGE.
READY TO FIND OUT MORE ABOUT MAINE’S TELEMEDICINE POLICY? CHECK OUT OUR STATE GUIDE BELOW!
Parity Law
Maine enacted it’s telemedicine parity law for both Medicaid and private insurance back in 2009! This means the state of Maine requires it’s Medicaid program and all private insurance carriers to reimburse telemedicine in the same way as in-person medical services. In other words, it’s a big win for telemedicine!
Type of Telemedicine Covered
Maine law requires coverage for services provided through telemedicine, which includes live video, as well as audio-only under certain circumstances.
Remote Patient Monitoring telemedicine care is covered under Home and Community Benefits for the Elderly and for Adults with Disabilities, although final approval must be obtained from the Department, Office of Aging and Disability Services.
Covered Health Services
Maine’s Medicaid program will cover live video telemedicine as long as there’s a compelling reason to use telehealth (physical, social, geographic barriers).
For more information, check your MaineCare Provider Manual.
Billing Codes
In most cases, we’ve found that payers will accept the appropriate CPT along with the GT modifier to note the medical appointment was delivered via telemedicine. Check with your state Medicaid department or you private payers and ask them the right questions.
Eligible Healthcare Providers
Unlike most other state Medicaid programs, Mainecare does not place any limits on which providers can do telemedicine!
Online Prescriptions
Maine allows for telepharmacy services to dispense medications to a remote site. Pharmacies using tele-pharmacy have to follow all State and Federal regulations the same as a regular pharmacy, which includes having a qualified tele-pharmacy staff.
Providers may prescribe medications based on a telemedicine visit, and may use a telepharmacy service as long as they get pre-authorization.
Informed Patient Consent
Mainecare providers are required to give patients educational resources about telemedicine at their visit. See more details on what to include here.
We always recommend getting a patient’s informed consent for telemedicine visits as a telemedicine best practice! You can read more about how to do telemedicine informed consent here.
Interstate Telemedicine Licensing
Maine has not yet joined the Interstate Medical Licensure Compact to allow for streamlined telemedicine treatment across state lines. To practice telemedicine in Maine, providers will need a Maine medical license.
Check back for updates!
Helpful Resources
· Center for Connected Health Policy – Maine State Page
· Northeast Telehealth Resource Center .
· The American Telemedicine Association State Policy Matrix