Last Modified: 01/06/2012
VIII Reimbursement Issues for Ti
Given the rapid adoption of telehealth and tele-intervention, reimbursement for this mode of delivery also is rapidly changing. The typical sources of reimbursement for early intervention services are Medicaid, private insurance, and Part C. This section provides links to further information to pursue reimbursement from these sources.
Telehealth Resource Centers
Telehealth Resource Centers (TRCs) assist organizations, providers and communities in implementing cost effective and sustainable telehealth programs. TRCs are HRSA- designated focal points for information and resources to advance the use of telehealth, including issues regarding reimbursement. The Telehealth Resource Centers are supported by grants from the Office for the Advancement of Telehealth.
You can also contact any of the regional centers listed below:
- California Telemedicine & eHealth Center
- 877.590.8144
- Center for Telehealth and eHealth Law
- 202.230.5090
- Great Plains Telehealth Resource & Assistance Center
- 888.239.7092
- Northwest Regional Telehealth Resource Center
- 866.488.0475
- Southwest Telehealth Resource Center
- 520.626.4498
As an example of information offered by these telehealth centers, The California Telemedicine and eHealth Center has published a report entitled: Telemedicine Reimbursement: A National Scan of Current Polices and Emerging Initiatives [PDF]. This report provides an overview of telemedicine reimbursement across the country from both private and public insurance programs.
Medicaid Reimbursement
The Northwest Telehealth Resource Center has several documents that provide guidelines for requesting reimbursement from Medicare and Medicaid, such as the “ATA Strategies for Medicaid Reimbursement.”
Private Insurance Reimbursement
State legislation can also help ensure that private insurance covers tele-intervention. For example, advocates in Maine recently worked to ensure the passage of legislation to ensure private coverage for telepractice.
Part C Reimbursement
Each state’s Part C Early Intervention program determines their policies regarding the reimbursement of direct services, and this holds true for the reimbursement of tele-intervention services as well. As of September, 2011 the learning community members in Utah, Washington, Oklahoma, Colorado, and Wisconsin all received reimbursement for Part C services delivered in this manner. It is important that new programs about to embark on tele-intervention communicate with their state’s Part C program to ensure their approval of providing TI and their provision of reimbursement for direct services.
