WEST VIRGINIA
Parity Law
A state telemedicine parity law requires private payers to reimburse telemedicine services in the same way as in-person services. Many states have passed a telemedicine parity law.
Unfortunately, West Virginia does not currently have a telemedicine parity law in place and has not yet proposed one. However, private payers may still reimburse for telemedicine services in West Virginia – they are just not required to be law.
Type of Telemedicine Covered
West Virginia Medicaid currently covers live video telemedicine, with no reimbursement for store-and-forward, or telephone consultations.
Covered Health Services
West Virginia Medicaid reimburses for medical consultations (initial follow-up, consultation in hospitals, outpatient facilities, or medical offices), nutrition and exercise services, and behavioral health consultations.
Billing Codes
West Virginia Medicaid will reimburse for telemedicine services that meet the requirements of the following CPT codes:
99241-99245
99251-9925
99261-99263
99271-99275
Medicaid providers must bill the appropriate CPT code along with the GT modifier to denote telemedicine.
Online Prescriptions
Providers in West Virginia must establish an ongoing physician-patient relationship in order to issue a prescription.
However, West Virginia law also saws that telemedicine can be used to establish this relationship, as long as the manner is approved by the appropriate board.
Informed Patient Consent
West Virginia requires providers to get a patient’s informed consent before doing a telemedicine visit. We recommend this anyway as a telemedicine best practice. You can find the recommended patient consent form here.
Interstate Telemedicine Licensing
Great news! West Virginia recently passed a bill to join the Interstate Medical Licensing Compact. As a member of the Compact, West Virginia providers will be able to go through an expedited licensing process for other Compact states. Learn more at http://www.licenseportability.org/.
Restrictions on Locations
West Virginia’s Medicaid program limits where the patient and provider need to be located for the telemedicine service to be reimburseable. Patients and providers need to be located in a non-metropolitan statistical professional shortage area.
Helpful Resources
West Virginia Medicaid Provider Manual