MICHIGAN TELEMEDICINE LAW
MICHIGAN TELEMEDICINE IS MAKING STEADY PROGRESS IN EXPANDING ACCESS AND AVAILABILITY OF TELEHEALTH SERVICES IN THE WOLVERINE STATE WITH THE REMOVAL OF DISTANCE RESTRICTIONS. DESPITE THESE ADVANCES, MICHIGAN STILL ONLY OFFERS REIMBURSEMENT FOR LIVE-VIDEO TELEMEDICINE SERVICES.
READY TO FIND OUT MORE ABOUT MICHIGAN’S TELEMEDICINE POLICY? CHECK OUT OUR STATE GUIDE BELOW!
Parity Law
Michigan’s private insurance parity law was enacted in 2012. Thanks to the parity law, Michigan now requires private payers to cover telemedicine the same way they would in-person services.
Type of Telemedicine Covered
For now, Michigan Medicaid only reimburses for live video telemedicine. The state defines telemedicine as “real-time” medical service that substitutes for an in-person doctor visit.
Covered Health Services
Michigan Medicaid will reimburse live video telemedicine visits for the following purposes:
Inpatient Consults
Office or other outpatient consults
Office or other outpatient services
Psychiatric diagnostic procedures
Subsequent hospital care
Training services, diabetes
End stage renal disease (ESRD) related services
Behavior change intervention, individual
Behavior health and/or substance abuse treatment services
Education service, telehealth
Nursing facility subsequent care – initial visit for nursing facility services must be face-to-face
Want more details? Check out the Michigan State Medicaid Manual.
Billing Codes
Here are a few of the eligible CPT codes to use when billing for telemedicine through Michigan’s Medicaid program:
|
99241 – 99275 |
Consultations |
|
99201 – 99215 |
Office or other outpatient visits |
|
90804 – 90809 |
Individual Psychotherapy |
|
90862 |
Pharmacologic Management |
|
90801 |
Psychiatric diagnostic interview exam |
|
90805, 90807, and 90809 |
Psychotherapy services that include medical evaluation and management services |
Don’t forget your GT modifier! Providers should also use the GT modifier with the relevant code to note telemedicine.
Eligible Healthcare Providers
Michigan’s Medicaid program allows the following healthcare providers to bill for telemedicine:
Physician (MD, DO, DPM)
Nurse Practitioner
Physician’s Assistant (billed under the supervising physician)
Nurse-Midwife
Psychologist
Social Worker
Online Prescriptions
Providers must have an existing physician-patient relationship to write prescriptions via telemedicine. Fortunately, Michigan also allows providers to establish a relationship via a telemedicine visit!
Informed Patient Consent
Some states require providers to get a patient’s informed consent specifically for a telemedicine visit. Currently, Michigan has no requirements for getting patient consent for telemedicine.
However, we recommend doing this anyway as a telemedicine best practice! You can read more about how to do telemedicine informed consent here.
Interstate Telemedicine Licensing
Michigan recently introduced a bill to become part of the Interstate Medical Licensure Compact. If the bill passes, it will be much easier for Michigan providers to get licensed in other participating states, and treat patients via telemedicine across state lines!
Restrictions on Locations
Michigan’s Medicaid program does have some restrictions on where a patient needs to be during the telemedicine visit.
Here are the eligible originating sites:
County mental health clinics or publicly funded mental health facilities;
Federally Qualified Health Centers;
Hospitals (inpatient, outpatient, or Critical Access Hospitals);
Physician or other providers’ offices, including medical clinics;
Renal dialysis facilities;
Rural Health Clinics;
Skilled nursing facilities;
Tribal Health Centers.
Reimbursement Rates
Telemedicine is billed the same as in-person healthcare services.
Helpful Resources
Center for Connected Health Policy – Michigan State Page
Upper Midwest Telehealth Resource Center
The American Telemedicine Association State Policy Matrix
Upper Peninsula Telemedicine Network
Univ of Michigan Medical School – Telemedicine