(HARTFORD, CT) – Governor Ned Lamont today announced that he has signed into law legislation that extends for another two years the relaxed telehealth services provisions that he previously enacted through an emergency executive order due to the COVID-19 pandemic.
Telehealth services are those that enable healthcare providers to interact with patients, including those with Medicaid coverage, by using electronic methods, such as videoconferencing and telephones, without needing to meet in person.
“There is a widespread sense that telehealth is here to stay, and these next two years offer an opportunity for stakeholders to collaborate in formulating a policy that everyone can live with,” Albrecht says. “I think most providers see the extension as a ‘vote of confidence’ for telehealth by our legislators, although it comes with an underlying mandate to figure out how to make it work for the long-term, within the next 24 months. We have now have to roll up our sleeves and get that done.”
CT passed a new temporary law, active until June 30, 2023, that requires reimbursement of synchronous interactions, asynchronous store and forward transfers or remote patient monitoring, as well as audio-only if the provider is in-network under certain circumstances. After the law expires the law will revert back to what is CT’s ‘permanent statute’ section, unless new legislation is passed before that time that further amends the law.
Based on a previous law and permanent statute, Connecticut Medicaid is also required to cover telemedicine services for categories of health care that the commissioner determines are appropriate, cost effective and likely to expand access to medically necessary services where there is a clinical need for those services to be provided by telehealth or for Medicaid recipients for whom accessing appropriate health care services poses an undue hardship. The CT Medicaid Program manuals do not mention reimbursement for telemedicine but does indicate that while they do not provide reimbursement for behavioral health services provided electronically or over the phone, there is an exception for case management behavioral health services for clients age eighteen and under. There is no reference to remote patient monitoring.
SOURCE: HB 5596 (2021 Session), & CT Statute 17b-245e, (Accessed Oct. 2021).
An additional new law requires reimbursement of audio-only telehealth under certain circumstances.
Unique CPT codes do not exist specifically for telemedicine or telehealth. Instead a modifier is applied to existing codes.
Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of the general statutes delivered, issued for delivery, renewed, amended or continued in this state shall provide coverage for medical advice, diagnosis, care or treatment provided through telehealth, to the extent coverage is provided for such advice, diagnosis, care or treatment when provided through in-person consultation between the insured and a health care provider. Such coverage shall be subject to the same terms and conditions applicable to all other benefits under such policy.