MARYLAND
With about 61% of general acute care hospitals are already using telehealth, teleradiology, remote monitoring, diagnostic and image review, Maryland has made giant strides since passing it’a telehealth laws in 2012.
Although new regulations put into effect in October 2014 limit the location for patient setting and the allowable types of providers, Maryland is moving forward with innovation and expansion of telemedicine.
Ready to find out more about Maryland’s telemedicine policy? Check out our state guide below!
Parity Law
Maryland’s private insurance parity law was enacted in 2012. Private payers in Maryland are required to cover telemedicine services the same way as in-person medical services.
Type of Telemedicine Covered
Maryland telehealth only reimburses live video interactions, although the Medicaid agency has the discretion to authorize coverage of RPM and store-and-forward on a case-by-case basis.
Covered Health Services
The Maryland Medical Assistance Program will reimburse for medically necessary consultation services delivered by an approved provider.
Billing Codes
Nervous about billing for telemedicine? Check out our information below:
Use E&M codes 99241-99245 99251-99255 for consultation services along with the appended –GT modifier.
Use the -GT modifier along with the evaluation and management (E&M) codes 99201-99205; 99211-99215 for ?community outpatient services or 99281-99285 and 99288 for emergency room outpatient services
If the service location is a physician’s office: HCPCS code Q3014 for the telehealth originating site facility fee
?If the service location is a hospital, use revenue code 0780 for the standard facility fee
If the service location is a an out-of-state hospital, use HCPCS code Q3014 for the telemedicine originating site facility fee
For more information on Physicians’ Services billing, check your Maryland Medicaid Provider Manual.
Eligible Healthcare Providers
Physicians, Nurse practitioners, Nurse midwives, and providers at free-standing renal dialysis centers, federally qualified health centers, hospitals (including EDs), and local health departments can bill for telemedicine.
If you’re a Maryland provider interested in telemedicine, you must be a Medicaid provider and submit a Telemedicine Provider Addendum. See the MD telemedicine provider manual for more information.
Informed Patient Consent
Unless there’s an emergency, MD providers have to obtain and document a patient’s consent for telemedicine.
Interstate Telemedicine Licensing
MD has exceptions to its MD-only licensed physicians rule for telemedicine. The Maryland Medicaid program allows physicians in the adjoining states of Delaware, Virginia, West Virginia, and Pennsylvania to provide telemedicine services to a patient in Maryland, as long as they have an agreement set with an eligible originating site in Maryland.
Restrictions on Locations
Maryland Medicaid uses a hub-and-spoke model for telemedicine. This means a live video telemedicine will take place with the patient and the referring provider at the spoke site (also called originating site) and the specialist or consulting provider at the hub site (also called distant site).
The following locations qualify as hub and spoke sites:
Free-standing renal dialysis centers
Federally Qualified Health Centers
Hospitals, including emergency departments
Local health departments
Nursing facilities
Provider-Patient Relationship
Live video telemedicine can be used to establish a physician-patient relationship.
Reimbursement Rates
Telemedicine services are reimbursed at the same rate as in-person medical services. Hooray!
Helpful Resources
Center for Connected Health Policy
The American Telemedicine Association State Policy Matrix
Mid-Atlantic Telehealth Resource Center