PENNSYLVANIA
There are two big pieces of pending legislation in Pennsylvania that could change the way telemedicine happens there. One is the state’s parity law, which would secure greater reimbursement for practitioners and make telemedicine more financially feasible.
The other bill concerns the Interstate Medical Licensure Compact, which would help physicians and patients in Pennsylvania have greater cross-state access. We’ll keep up with these bills, so check this page regularly for updates!
Ready to find out more about Pennsylvania’s telemedicine policy? Keep on reading.
Parity Law
Pennsylvania doesn’t have an active parity law yet, but one has been proposed. A telemedicine parity law requires private payers to reimburse telemedicine services in the same way as in-person services, so if Pennsylvania’s law is passed, providers will have more freedom to practice telemedicine!
Type of Telemedicine Covered
Pennsylvania Medicaid will reimburse for live video only, and specifically for specialty consultations.
Covered Health Services
Medicaid will reimburse for specialty consultations.
Additionally, PA Medicaid will reimburse licensed psychiatrists and licensed psychologists for telepsychiatry outpatient services, including:
Psychiatric diagnostic evaluations
Psychological Evaluations
Pharmacological management
Consultations (with patient/family)
Psychotherapy
Additionally, providers must have documented endorsement to deliver telepsychiatric services from the county mental health program and the HealthChoices Behavioral Health Managed Care Organization. Endorsement must be approved by the regional PA Office of Mental Health and Substance Abuse Services.
Eligible Healthcare Providers
Live video consultation services can be performed by:
Physicians
Certified registered nurse practitioners
Certified nurse midwives
Informed Patient Consent
Informed consent is required for telepsychiatry, but the manner of obtaining is unspecified.
Interstate Telemedicine Licensing
Pennsylvania issues extraterritorial telemedicine licenses to physicians residing or practicing in a neighboring state based on regional availability of services and policies of neighboring states. However, Pennsylvania does not allow licensure exemptions for physician-to-physician out-of-state consultations.
Luckily, these restrictions could change soon. Pennsylvania has introduced legislation to join the Interstate Medical Licensure Compact! Read about the potential impact of such a policy here.
Other Reimbursable Fees
The originating site may bill a facility fee.
Reimbursement Rates
Without a parity law or any other extensive telemedicine legislation, there is nothing mandating equal coverage for in-person and telemedicine care.
Helpful Resources