Vermount has had a telehealth parity law since 2012, which even includes coverage under state employee health plans. In 2017, the state expanded this coverage further, by removing previous restrictions on the patient’s location at the time of care. Now Vermont patients can receive virtual care from their own homes!
Yes – this type of service is reimbursable through VT Medicaid as long as it is clinically appropriate and within the provider’s licensed scope of practice. This includes the provision of mental health and substance use disorder treatment. Vermont Medicaid has an established telemedicine Place of Service (POS) code 02 (Telehealth) for use by practitioners providing telehealth services from off site.
Note: Audio-only or written interactions, such as communication by telephone, email, instant messaging, fax or online questionnaires are generally not considered telemedicine and are not covered services under Vermont Medicaid.
Effective July 1, 2020, Vermont Medicaid announced continued coverage and reimbursement for HCPCS G2010 and new coverage and reimbursement for interprofessional consultations when performed through store and forward technology (i.e., provider to provider store and forward, CPT codes 99451 & 99452). Thus, providers are reminded that the allowed modifier for CPT codes 99451 & 99452 is modifier GQ (i.e., “through an asynchronous telecommunications system”).”
Vermont Medicaid reimburses for live video under certain circumstances. Home health monitoring is considered a Medicaid benefit and is available under certain conditions. An administrative rule indicates store-and-forward is reimbursed for teledermatology and teleophthalmology. Additionally, audio-only telephone is also required to be reimbursed under certain circumstances.