Kansas Telemedicine & Telehealth Reimbursement Overview

Provider Reimbursement Eligibility
Consent for Telemedicine Live Video Reimbursement Store & Forward Reimbursement Originating Site & Transmission Fees Eligible Practitioners
State Law

No reference found

Live Video is included in Kansas’ definition of telemedicine & telehealth.  Requiring reimbursement for Live Video as of January 1, 2019.

See Definition of Telemedicine Sec 1(a-5)

Store-and-forward is included in the state’s definition of telemedicine; however, it also requires that the patient be present at the originating site, limiting reimbursement for store-and-forward.

See Definition of Telemedicine Sec 1(a-5)

The states telemedicine act defines an originating site as a site at which a patient is located at the time healthcare services are provided by means of telemedicine; however, it makes no reference to reimbursement for originating site fees.

See Definition of Telemedicine Sec 1(a-3)

The Kansas Telemedicine Act states that ‘‘Healthcare provider’’ means a physician, licensed physician assistant, licensed advanced practice registered nurse or person licensed, registered, certified or otherwise authorized to practice by the behavioral sciences regulatory board.

See Definition of Telemedicine Sec 1(a-2)

Medicaid

Written consent for telehealth home services is required.

See KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-25

The Kansas Telemedicine Act requires that the Kansas Medical Assistance Program reimburse for live video.  See parity law information below.

Kansas Medicaid requires the patient to be present at the originating site, indicating that store and forward will not be reimbursed.

See KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-25

No Reference Found

The Kansas Telemedicine Act states that ‘‘Healthcare provider’’ means a physician, licensed physician assistant, licensed advanced practice registered nurse or person licensed, registered, certified or otherwise authorized to practice by the behavioral sciences regulatory board. The act applies to Kansas Medical Assistance Programs.

See Definition of Telemedicine Sec 1(a-2)

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

See Telemedicine Reimbursement Guide – Medicare Section

See Telemedicine Reimbursement Guide – Medicare Section

See Telemedicine Reimbursement Guide – Medicare Section

See Telemedicine Reimbursement Guide – Medicare Section

Private Payors

Private payors are actively exploring telemedicine and telehealth, but each provider is different. If you are in network with a specific provider, call and request documentation of their policy related to telehealth.

Self Pay

There are no limitations for self pay patients/clients, and providing telehealth services is a great way to increase revenue with patients that are selfpay or value premium services.

Provider Reimbursement Eligibility
Consent for Telemedicine
State Law

No reference found

Medicaid

Written consent for telehealth home services is required.

See KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-25

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Live Video Reimbursement
State Law

Live Video is included in Kansas’ definition of telemedicine & telehealth.  Requiring reimbursement for Live Video as of January 1, 2019.

See Definition of Telemedicine Sec 1(a-5)

Medicaid

The Kansas Telemedicine Act requires that the Kansas Medical Assistance Program reimburse for live video.  See parity law information below.

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Store & Forward Reimbursement
State Law

Store-and-forward is included in the state’s definition of telemedicine; however, it also requires that the patient be present at the originating site, limiting reimbursement for store-and-forward.

See Definition of Telemedicine Sec 1(a-5)

Medicaid

Kansas Medicaid requires the patient to be present at the originating site, indicating that store and forward will not be reimbursed.

See KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-25

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Originating Site & Transmission Fees
State Law

The states telemedicine act defines an originating site as a site at which a patient is located at the time healthcare services are provided by means of telemedicine; however, it makes no reference to reimbursement for originating site fees.

See Definition of Telemedicine Sec 1(a-3)

Medicaid

No Reference Found

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Eligible Practitioners
State Law

The Kansas Telemedicine Act states that ‘‘Healthcare provider’’ means a physician, licensed physician assistant, licensed advanced practice registered nurse or person licensed, registered, certified or otherwise authorized to practice by the behavioral sciences regulatory board.

See Definition of Telemedicine Sec 1(a-2)

Medicaid

The Kansas Telemedicine Act states that ‘‘Healthcare provider’’ means a physician, licensed physician assistant, licensed advanced practice registered nurse or person licensed, registered, certified or otherwise authorized to practice by the behavioral sciences regulatory board. The act applies to Kansas Medical Assistance Programs.

See Definition of Telemedicine Sec 1(a-2)

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Private Payors

Private payors are actively exploring telemedicine and telehealth, but each provider is different. If you are in network with a specific provider, call and request documentation of their policy related to telehealth.

Self Pay

There are no limitations for self pay patients/clients, and providing telehealth services is a great way to increase revenue with patients that are selfpay or value premium services.

Telemedicine CPT Codes

Unique CPT codes do not exist specifically for telemedicine or telehealth. Instead a modifier is applied to existing codes.

  • For interactive audio and video sessions, place a GT modifier in front of the CPT codes you typically use for in person services.
  • For services provided via an asynchronous telecommunication system, simply add a GQ modifier in front of the CPT codes you typically use for in person services.

Telehealth Parity

Payment or reimbursement of covered healthcare services delivered through telemedicine may be established by an insurance company, nonprofit health service corporation, nonprofit medical and hospital service corporation or health maintenance organization in the same manner as payment or reimbursement for covered services that are delivered via in-person contact are established.

The parity law also requires compliance by the Kansas Medical Assistance Program or Medicaid.

See Senate Substitute for House Bill 2028
Passed May, 2018
Effective January 1, 2019

Definitions

Telehealth Parity

Telehealth services are equal to in person services and reimbursed at the same rate.

Asynchronous Communication

The exchange of messages, such as among the hosts on a network or devices in a computer, by reading and responding as schedules permit rather than according to some clock that is synchronized for both the sender and receiver or in real time. Email, chat and text messaging are primary examples of asynchronous communication.

Distant or Hub Site

The location or site where the practitioner or provider is located while utilizing telemedicine services to meet with patients.

Originating Site

The location of the patient at the time services are provided. An originating site can be the client's home or a public facility like a rural hospital or physician's office. Many payors will reimburse for an originating site fee if it meets specific requirements. Rural use cases provide an applicable example for an eligible originating site fee where the patient will go to a local medical facility like a primary care physician's office and meet with a specialist located in distant urban health facility.

Additional Telemedicine Resources

Telehealth and telemedicine are fast growing and changing segments. Both state licensure and state legislation are changing rapidly along with federal legislation and for this reason the information provided cannot be considered legal advice. We make every attempt to keep state specific information up to date, but encourage you to validate this information through the following sites: