Telemedicine in Colorado: Policies

Colorado has made great strides in improving availability and access to telemedicine in the centennial state. Prior to 2017, Colorado had a partial telemedicine parity law, which mandated coverage for telemedicine in rural areas. Legislation passed in 2017 removed that location restriction and now mandates telemedicine coverage across the entire state, not just rural locations.

In 2019 the Colorado legislature passed a law requiring Medicaid to reimburse at the same rate for telemedicine as if it were an in-person visit. They also added a patient’s home as an originating site.

Colorado Telehealth for providers

Under the COVID-19 emergency, providers can use audio-only communication as well as non-public facing remote communication products to communicate with patients, such as:

• Apple FaceTime
• Facebook Messenger video chat
• Google Hangouts video
• Skype
• Telephone
• AdvanaCare Platform

Colorado Telehealth Billing

Audio only communication is now considered a telehealth visit and is reimbursable under Medicare, CO Medicaid and commercial health plans regulated by the Colorado Division of Insurance. Providers can bill for telehealth visits at the same rate as in-person visits.

CO Medicaid now also includes chat as a telehealth visit, and is reimbursing at the in-person rate.

Reimbursement For Telehealth Services

On July 6, 2020, Governor Polis signed bill SB20-212 to prohibit certain acts by health insurance carriers related to telehealth. The act prohibits a health insurance carrier from:

• Imposing specific requirements or limitations on the HIPAA-compliant technologies used to deliver telehealth services;
• Requiring a covered person to have a previously established patient-provider relationship with a specific provider in order to receive medically necessary telehealth services from the provider; or
• Imposing additional certification, location, or training requirements as a condition of reimbursement for telehealth services.

The act specifies that, to the extent the state board of health adopts rules addressing supervision requirements for home care agencies, the rules must allow for supervision in person or by telemedicine or telehealth.

For the purposes of the Medicaid program, the act:

• Requires the department of health care policy and financing (state department) to allow home care agencies to supervise services through telemedicine or telehealth;
• Clarifies the methods of communication that may be used for telemedicine;
• Requires the state department to reimburse rural health clinics, the federal Indian health service, and federally qualified health centers for telemedicine services provided to Medicaid recipients and to do so at the same rate as the department reimburses those services when provided in person;
• Requires the state department to post telemedicine utilization data to the state department’s website no later than 30 days after the effective date of the act and update the data every other month through state fiscal year 2020-21; and
• Specifies that health care and mental health care services include speech therapy, physical therapy, occupational therapy, hospice care, home health care, and pediatric behavioral health care.

The act appropriates $5,068,381 to the state department from the care subfund for telemedicine expansion services and prohibits the state department from using the appropriation for the state-share of Medicaid services.

See how the expired Executive Order D 2020 020 differs from SB20-212 by reading the Department of Regulatory Agencies’ FAQ.

SB20-212: Reimbursement For Telehealth Services

State Policy Overview

• Medicaid
• Private Payers
• Parity