MISSOURI TELEMEDICINE LAW
Parity Law
Missouri has parity law for private payers, and it’s proposed for Missouri HealthNet (the state’s Medicaid organization). This means the state of Missouri currently requires private payers to cover telemedicine the same way they would needed in-person medical services.
Type of Telemedicine Covered
Missouri’s HealthNet will reimburse for two-way live video, but not store-and-forward technology. The only home monitoring tech that can be reimbursed is safety alert necklaces.
Missouri prohibits the use of “cell phone video” for telemedicine services.
Covered Health Services
Missouri Medicaid covers medically necessary telehealth services. Coverage of services rendered through telehealth at the distant site is limited to:
Consultations made to confirm a diagnosis; or
Evaluation and management services; or
A diagnosis, therapeutic, or interpretative service; or
Individual psychiatric or substance abuse assessment diagnostic interview examinations; or
Individual psychotherapy
Billing Codes
The Missouri Medicaid program advises providers to use the appropriate CPT code for the service along with the “GT” modifier (to denote telemedicine).
Here are a few examples of behavioral health services codes that could be billed, along wit the GT modifier:
90791 GT – Psychiatric Diagnostic Evaluation
90792 GT – Psychiatric diagnostic evaluation with medical services
90832 GT – Psychotherapy, approximately 16 to 37 minutes face- to-face with the patient and/or family member
90834 GT – Psychotherapy, approximately 38 to 52 minutes face- to-face with the patient and or family member
Eligible Healthcare Providers
Health care providers doing telemedicine must be enrolled as a MO HealthNet provider prior to rendering services.
Providers eligible to receive payment for telehealth services include physicians, nurse practitioners, and psychologists
Online Prescriptions
Missouri requires there to be an established physician-patient relationship for the provider to prescribe medication based on a telemedicine visit. See the physician-patient relationship section below for more information.
Informed Patient Consent
The Missouri HealthNet guidebook states health care providers must obtain written informed consent from telehealth patients. We recommend this anyway as a telemedicine best practice. You can find the recommended patient consent form here.
Interstate Telemedicine Licensing
Physicians must hold a full Missouri medical license to practice in the state, even via telehealth technology.
Restrictions on Locations
Missouri policy lists thirteen possible locations as eligible patient settings for telemedicine, but unfortunately patient schools and homes are not included. Missouri recently removed a policy that limited telehealth reimbursement to rural areas.
Physician-Patient Relationship
An established physician-patient relationship is necessary prior to prescribing any drug, controlled substance, or other treatment through the Internet. To establish the relationship, physicians must:
(1) Obtain a reliable medical history and perform a physical examination of the patient
(2) Have sufficient dialogue with the patient regarding treatment options and the risks and benefits of treatment
(3) If appropriate, follow up with the patient to assess the therapeutic outcome
(4) Maintain a contemporaneous medical record that is readily available to the patient, and
(5) Include the electronic prescription information as part of the patient’s medical record.
Reimbursement Rates
Private payer and Missouri HealthNet reimbursement rates are the same for telemedicine and in-person care.
Helpful Resources
Center for Connected Health Policy – Missouri Page
Heartland Telehealth Resource Center