Mississippi Telemedicine & Telehealth Reimbursement Overview

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

Patient’s informed consent should be obtained before providing care through telemedicine.

See Pg. 61 of MS State Board of Medical Licensure

Private payers are required to provide coverage for live video consultations.

See MS Code Sec. 83-9-351

Private payers are required to provide coverage and reimbursement for store and forward services.

See MS Code Sec. 83-9-353

The originating site is eligible to receive a facility fee.

See MS Code Sec. 83-9-351

Healthcare provider as it’s defined in Sec. 376.1450.  Service must be within the scope of practice.

Medicaid

Signed patient consent is required.

MS Admin. Code Title 23, Part 225, Rule. 1.6(A)

Medicaid is required to cover telemedicine for live video services.

See MS Code Sec. 83-9-351

Store and forward is reimbursable, but patients need to be notified of their right to interactive electronic options.

MS Code Sec. 83-9-353

Reimbursement for teleradiology services.

See MS Div. of Medicaid, Radiology Services Provider Reference Guide, pg. 4-5

Originating sites are eligible to receive a facility fee.

MS Admin. Code Title 23, Part 225, Rule. 1.5(A)

Providers must be enrolled as a Medicaid provider.  Specific provider restrictions apply.

MS Admin. Code Title 23, Part 225, Rule. 1.2(C)

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

Patient’s informed consent should be obtained before providing care through telemedicine.

See Pg. 61 of MS State Board of Medical Licensure

Medicaid

Signed patient consent is required.

MS Admin. Code Title 23, Part 225, Rule. 1.6(A)

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Live Video Reimbursement
State Law

Private payers are required to provide coverage for live video consultations.

See MS Code Sec. 83-9-351

Medicaid

Medicaid is required to cover telemedicine for live video services.

See MS Code Sec. 83-9-351

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Store & Forward Reimbursement
State Law

Private payers are required to provide coverage and reimbursement for store and forward services.

See MS Code Sec. 83-9-353

Medicaid

Store and forward is reimbursable, but patients need to be notified of their right to interactive electronic options.

MS Code Sec. 83-9-353

Reimbursement for teleradiology services.

See MS Div. of Medicaid, Radiology Services Provider Reference Guide, pg. 4-5

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Originating Site & Transmission Fees
State Law

The originating site is eligible to receive a facility fee.

See MS Code Sec. 83-9-351

Medicaid

Originating sites are eligible to receive a facility fee.

MS Admin. Code Title 23, Part 225, Rule. 1.5(A)

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Eligible Practitioners
State Law

Healthcare provider as it’s defined in Sec. 376.1450.  Service must be within the scope of practice.

Medicaid

Providers must be enrolled as a Medicaid provider.  Specific provider restrictions apply.

MS Admin. Code Title 23, Part 225, Rule. 1.2(C)

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

MS’s parity law was enacted in 2013.  The law requires parity for telemedicine under private insurance, state employee health plans, and public assistance.  In 2014, lawmakers passed a law requiring insurance plans to cover and reimburse for services via store-and-forward, as well as remote patient monitoring for chronic disease management.

Miss. Code Ann. § 83-9-351

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: