Nebraska Telemedicine & Telehealth Reimbursement Overview

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

Written patient consent required prior to any service delivery.

See NE Revised Statutes Sec. 71-8505.

Live video telemedicine is reimbursed as a synchronous electronic exchange, at an equal rate to in-person services.

NE Revised Statutes. Sec. 44-312(1)

Store and forward is considered an asynchronous electronic exchange, so it’s possibly eligible for reimbursement.

NE Revised Statutes. Sec. 44-312(1)

Telehealth includes services originating from a patient’s home or any other location where such patient is located.

44-7,107

No reference found

Medicaid

Written or email consent required before initial service delivery.

See Pg. 7 of Nebraska Total Care Telehealth Resource Manual

Live video will be reimbursed as a synchronous electronic exchange.

See Article 3 of NE Rev. Statute, 71-8503(3)

Store and forward is eligible for reimbursable as an asynchronous electronic exchange, but restrictions may apply.  Only specified for teleradiology.

See Pg. 17 of Nebraska Total Care Telehealth Resource Manual

Telehealth includes services originating from a patient’s home or any other location where such patient is located.

See Page 9 Nebraska Total Care TELEHEALTH RESOURCE

One of 19 States that does not specify the type of healthcare provider allowed to practice telemedicine.  Offering the most flexibility.

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

Written patient consent required prior to any service delivery.

See NE Revised Statutes Sec. 71-8505.

Medicaid

Written or email consent required before initial service delivery.

See Pg. 7 of Nebraska Total Care Telehealth Resource Manual

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Live Video Reimbursement
State Law

Live video telemedicine is reimbursed as a synchronous electronic exchange, at an equal rate to in-person services.

NE Revised Statutes. Sec. 44-312(1)

Medicaid

Live video will be reimbursed as a synchronous electronic exchange.

See Article 3 of NE Rev. Statute, 71-8503(3)

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Store & Forward Reimbursement
State Law

Store and forward is considered an asynchronous electronic exchange, so it’s possibly eligible for reimbursement.

NE Revised Statutes. Sec. 44-312(1)

Medicaid

Store and forward is eligible for reimbursable as an asynchronous electronic exchange, but restrictions may apply.  Only specified for teleradiology.

See Pg. 17 of Nebraska Total Care Telehealth Resource Manual

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Originating Site & Transmission Fees
State Law

Telehealth includes services originating from a patient’s home or any other location where such patient is located.

44-7,107

Medicaid

Telehealth includes services originating from a patient’s home or any other location where such patient is located.

See Page 9 Nebraska Total Care TELEHEALTH RESOURCE

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Eligible Practitioners
State Law

No reference found

Medicaid

One of 19 States that does not specify the type of healthcare provider allowed to practice telemedicine.  Offering the most flexibility.

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

Any insurer offering (1) any individual or group sickness and accident insurance policy, certificate, or subscriber contract delivered, issued for delivery, or renewed in this state, (2) any hospital, medical, or surgical expense-incurred policy, or (3) any self-funded employee benefit plan to the extent not preempted by federal law, shall not exclude, in any policy, certificate, contract, or plan offered or renewed on or after August 24, 2017, a service from coverage solely because the service is delivered through telehealth as defined in section 44-312 and is not provided through in-person consultation or contact between a licensed health care provider and a patient. This section does not apply to any policy, certificate, contract, or plan that provides coverage for a specified disease or other limited-benefit coverage.

Nebraska Section 44-7,107

State laws require service parity, but payment parity is not available.  Check with insurers to verify reimbursement.

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: