SOUTH DAKOTA TELEMEDICINE LAW
South Dakota’s telemedicine policies have volleyed back and forth, but the state’s lawmakers are still making progress. The state added restrictions on patient settings and types of telemedicine that can receive Medicaid coverage.
However, South Dakota also recently joined the Interstate Medical Licensure Compact and received a grant from U.S. Bureau of Justice Assistance to implement telehealth drug treatment program for nonviolent offenders.
Read on to see exactly what’s happening in South Dakota telehealth:
Parity Law
Unfortunately, South Dakota doesn’t have a parity law, and no legislation for one has been introduced within the last two years. Hopefully neighboring state Montana, which does have a parity law, will be a good influence!
Type of Telemedicine Covered
South Dakota’s Medicaid program defines telemedicine as “real time,” so store-and-forward technology isn’t covered, but two-way interactive video is. Additionally, The Department of Health and Human Services, Adult Services and Aging, offers reimbursement for home monitoring.
Covered Health Services
South Dakota Medicaid covers:
Patient office consultation
Inpatient hospital consultation
Pharmacologic management
Office or other outpatient visit
Diabetes outpatient self-management education services
Additionally, Medicaid will cover an individual’s home monitoring services if:
The individual is residing at home;
The individual is age 60 or older or is age 18 or older with a disability; and
The individual is not eligible for other programs which provide the same type of service.
Billing Codes
99241 – 99245 Patient office consultation
99251 – 99255 Inpatient hospital consultation
90863 Pharmacologic management, including prescription and review of medication
99211 – 99215 Established patient office or other outpatient visit
G0108 Diabetes outpatient self-management education services, individual
G0109 Diabetes outpatient self-management education services, group
Originating sites can bill a facility fee with Q3014
Informed Patient Consent
All telemedicine services must comply with South Dakota Medicaid’s Out-Of-State Prior Authorization Requirements, found on the Medicaid Out-Of-State Prior Authorization form.
Interstate Telemedicine Licensing
Great news–South Dakota has adopted the Federation of State Medical Boards’ model language for an interstate telemedicine compact. Read more about that here.
Restrictions on Locations
State law stipulates that telemedicine originating sites cannot be within the same community as the distant site.
Originating sites which can bill a facility fee include:
Office of a physician or practitioner
Outpatient hospital
Critical Access Hospital
Rural Health Clinic
Federally Qualified Health Center
Indian Health Services Clinic
Community Mental Health Center
Reimbursement Rates
South Dakota Medicaid reimburses live video telemedicine at the same rate as in-person services.
Helpful Resources