OHIO TELEMEDICINE LAW
Ohio has a comprehensive telemedicine outlook that includes behavioral health services, school-based speech therapy and pharmacological management. Though their parity law has yet to be enacted, the state is making strides in other areas.
For example, though Ohio isn’t yet part of the Interstate Medical Licensure Compact, the state has some of the least-restrictive policies for out-of-state physicians. Ohio offers a special telemedicine permit rather than requiring full state licensure for practicing physicians.
Ready to find out more about Ohio’s telemedicine policy? Keep on reading.
Parity Law
Ohio has a proposed parity law for private insurance and Medicaid, but it has yet to be enacted, as of January 2016. Check this page regularly for updates!
Type of Telemedicine Covered
Ohio’s Medicaid program defines telemedicine only as interactive, real-time and synchronous care. Reimbursement is only covered for live video telemedicine, not store-and-forward, home health monitoring, or email/phone/fax.
Covered Health Services
Telemedicine health services that are covered by Ohio Medicaid include:
Consultations by physicians
School-based speech therapy
Behavioral health counseling and therapy
Mental health assessment
Pharmacological management
Community psychiatric supportive treatment service
Billing Codes
The following provider types will be eligible as an originating site, either using a Q3014 HCPCS code (Q3014) or a GQ modifier:
Primary Care Clinic
Outpatient Hospital
Rural Health Clinic (Medical)
Federally Qualified Health Clinic (Medical)
Physician
Professional Medical Group
Podiatrist
Optometrist.
When the following codes are billed in lieu of a Q3014, a GQ modifier must be used to signify a telemedicine originating service was also present during the visit:
99201-99215
99241-99245
99251-99255
92002
92004
92012
92014
For more on billing, including stipulations for mental health services, Federally Qualified Health Centers and Rural Health Clinics, read the Ohio Medicaid Manual.
Online Prescriptions
Physicians may not prescribe drugs based on a telemedicine visit if there is not a pre-established physician-patient relationship. Luckily, the relationship may be established via telemedicine.
Informed Patient Consent
The originating site is responsible for securing the informed consent of the patient. Written informed consent is required for mental and behavioral health services.
Interstate Telemedicine Licensing
Great news! Qualifying out-of-state physicians don’t need to have a full license to practice telemedicine in Ohio. They also have the option to apply for a telemedicine permit to practice in the state.
Restrictions on Locations
Home health monitoring is not seen as fit for Medicaid coverage. The originating site must be more than five miles from the distant site. Medicaid allows beneficiaries to choose the patient location when telemedicine is used for some mental/behavioral health services.
Helpful Resources