State Modalities Services Non-Physician Providers Reimbursement Geographic Restrictions Alabama Hub and Home monitor Store and forward (dermatology only) Psychiatric services Dermatology Home health (only for physicians participating in primary care case management program) No. Hub: Normal FFS Spoke: None Alaska Hub and spoke Home monitor Store and forward Covers all Medicaid services except: Home and waiver, pharmacy, DME, transportation, accommodation, ESRD, Midwife, PCA, private duty nursing, and vision (including optician services). Yes, nurse practitioners. Hub: Normal FFS Spoke: Normal FFS, but limited to live interactions Arizona Hub and spoke Home monitor Store and forward Covers all medically necessary Medicaid services. Yes, referring provider can be physician, PA, RN practitioner, RN midwife, or clinical psychologist. Consultants also can include behavioral health professional, or an occupation, physical, speech, or respiratory therapist. Provider can designate a trained telepresenter if the PCP is not present. Hub: Normal FFS Spoke: Normal FFS Arkansas Hub and spoke Home monitor Physician consultations. Home health Psychiatric services No. Hub: Normal FFS Spoke: Normal FFS . California Hub and spoke Home monitor Store and forward Email and telephone Covers all medically necessary Medicaid services. Yes, any provider of qualifying services. Hub: Normal FFS Spoke: Normal FFS and $17 facility fee based
Colorado Hub and Home monitor Covers all medically necessary Medicaid services. Yes, any provider of qualifying services. Hub: Normal FFS Spoke: Normal FFS if services provided; only $17 facility fee otherwise. Must be a resident of a county with than 150,000 residents Connecticut None Delaware Hub and spoke Store and forward Will begin reimbursement July 1, 2012. Unclear what services will be covered. District of Columbia None Florida demonstration project only. Georgia Hub and spoke Physician consultations only Yes, physician assistants, and ARNPs may bill for their services. Hub: Normal FFS Spoke: Normal FFS Hawaii Hub and spoke Home monitor Covers all medically necessary Medicaid services. Yes, any provider of qualifying services. Hub: Normal FFS Spoke: Normal FFS Transportation costs covered. Must be in HPSA and/or county outside a MSA Idaho Hub and spoke Psychiatric care only. No. Hub: Normal FFS Spoke: $20 Illinois Hub and spoke and forward Physician consultations Psychiatric services Yes, any provider of qualifying services. Hub: Normal FFS Spoke: Normal FFS and $17 facility fee. Indiana Hub and spoke All medically necessary Medicaid services except ambulatory and outpatient surgery, home health, radiological, laboratory, LTC, anesthesia, audiological, Yes, any provider of qualifying services. Hub: Normal FFS Normal FFS, only if hub site deems provider’s presence medically Hub and spoke sites must be more than 20 miles apart.
chiropractic, DME, optometric, speech therapy, physical therapy, transportation, and Medicaid waiver services necessary. Facility fee. Iowa None Kansas Hub and Home monitor Physician consultations Mental health services Home health care Pharmacological management services Yes, any provider of qualifying services. Hub: Normal FFS Spoke: Normal FFS, $20 facility fee. Home health: Reduced rates Kentucky Hub and Store and forward Physician consultations Psychiatric services (12 per yr) Yes, ARNPs and PAs working under physician supervision. Hub: Normal FFS Spoke: Normal FFS Louisiana Hub and Physician consultations Mental health services Yes, RNs, PAs and allied health professionals Hub: FFS, no less than 75% normal payment Spoke: FFS, no less than 75% normal payment Maine Hub and spoke Home monitor Physician consultations Other medically appropriate services Yes, RNs, PAs and other allied health professionals. Hub: Normal FFS Spoke: Normal FFS Maryland Hub and spoke Psychotherapy Mental health pharmacologic management Psychiatric interview No, distant provider must be a psychiatrist. Hub: Normal FFS Spoke: Normal FFS, $23 facility fee. Limited to “designated rural geographic areas.” Massachusetts None Michigan Hub and Physician consultations Office or other outpatient visits Psychotherapy Pharmacologic management Yes, RNs, PAs, psychologists, social workers Hub: Normal FFS Spoke: Normal FFS, facility fee. Hub and must be at least 50 miles apart
Nebraska Hub and spoke All Medicaid services except DME and supplies, orthotics, prosthetics, personal care pharmacy services, medical transportation services, MHSA, Home & Community waiver services. Yes, any provider of qualifying services. Hub: Normal FFS Spoke: Normal FFS Payment for transmission Also can receive transmission fee of $.05 per minute. Coverage only when no comparable service within 30 mile radius of patient’s home. Nevada None New Hampshire None New Jersey None New Mexico Hub and spoke Physician consultations Evaluation and mgmt services Psychotherapy Pharmacologic management Psychiatric dx interviews ESRD services Medical nutrition services Yes, any provider of qualifying services. Hub: Normal FFS Spoke: Normal FFS, $17 facility fee. Spoke must be located in a and/or a HPSA. New York Hub and spoke Home monitor and forward Physician consultations Home health Yes, any provider of qualifying services. Hub: Normal FFS Spoke: Normal FFS North Carolina Hub and spoke Physician consultations Psychiatric services Yes, any provider of qualifying services. Hub: 75% of FFS Spoke: 25% of FFS Will soon change to 100% at hub and $20 facility fee to spoke. North Dakota Hub and spoke Physician consultations Psychotherapy No. Hub: Normal FFS Spoke: $20, facility fee., plus regular FFS
for any service rendered. Ohio None Oklahoma Hub and Home monitor Physician consultations Mental health services Home health Endocrinology Yes, any provider of qualifying services. Hub: Normal FFS Spoke: Normal FFS, $17 facility fee. Oregon Hub and spoke Telephone and Store and forward Physician consultations Yes, any provider of qualifying services. Hub: Normal FFS Normal FFS, $17 facility fee. Pennsylvania Hub and spoke Home monitor and forward Physician consultations Home health, including health status monitoring, activity and sensor monitoring, and medication dispensing and monitoring Yes, any provider of qualifying services. Hub: Normal FFS Spoke: Normal FFS RPM-$10 per day $90 one-time install/un-install $200 Meds Rhode Island None South Carolina Hub and spoke Store and forward Physician consultations Psychiatric services Stroke treatment Yes, RNs, PAs, clinical, clinical psychologists and clinical social workers may refer patients for tele-consultation. Hub: Normal FFS Spoke: Normal FFS, $17 facility fee. South Dakota Hub and spoke Store and forward Physician consultations Yes, ARNPs, DOs, and nurse midwives are allowed to bill as Hub: Normal FFS Spoke: Normal FFS time