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Telehealth

Methods for healthcare service delivery using telecommunications technologies.

Telehealth

What is telehealth?

Telehealth means methods for healthcare service delivery using telecommunications technologies. Telehealth includes telemedicine, store and forward, and telemonitoring.

The term telehealth is also often used more generally to describe electronic information and telecommunications technologies to support long-distance clinical healthcare, as well as patient and professional health-related education, public health and health administration.

What is telemedicine?

Telemedicine means health care delivered by a provider who is located at a distant site to a beneficiary at an originating site for purposes of evaluation, diagnosis, consultation, or treatment using telecommunications technology via two-way, real-time, audio and video interactive communication, through a secure connection that complies with HIPAA.

The term "telemedicine" is sometimes used interchangeably with "telehealth." Telehealth encompasses the following:

  • Real-time, audio-video communication tools that connect providers and patients in different locations. Tools can include interactive videoconferencing or videoconferencing using mobile health (mHealth) applications (apps) that are used on a computer or hand-held mobile device.
  • Store-and-forward technologies that collect images and data to be transmitted and interpreted later, which may also involve the use of mHealth apps.
  • Remote patient-monitoring tools such as home blood pressure monitors, Bluetooth-enabled digital scales and other devices that can communicate biometric data for review, which may also involve the use of mHealth apps.

Is telemedicine a covered service under Vermont Medicaid?

Yes - this type of service is reimbursable through Vermont 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. Telehealth services should include the appropriate Place of Service codes: Place of Service Code 10 for Telehealth Provided in Patient’s Home or Place of Service Code 02 Telehealth Provided Other Than in Patient’s Home.

Is audio-only (telephone) a covered service under Vermont Medicaid?

Yes - Vermont Medicaid will provide reimbursement at the same rate for medically necessary, clinically appropriate services delivered by telephone. Reimbursement will be at the same rate as currently established for Medicaid-covered services provided through telemedicine/face-to-face as long as the claim is submitted to Vermont Medicaid with a 93 modifier (to indicate “service delivered via telephone, i.e., audio-only”). The V3 modifier used during the Public Health Emergency is no longer accepted as of January 1, 2024.  

List of Audio-Only covered codes by Vermont MedicaidEffective July 1, 2023 (update posted 3/15/2024). 

 

Updates:

See our brochure: 

Telehealth Services:  Information for Vermont Medicaid Providers
 

Click below for additional resources. Want more information or have questions? Contact your Gainwell provider representative at (800) 925-1706.