Wyoming 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 falls under the definition of telemedicine.  Reimbursement not referenced.

See WY Stat § 33-26-102 (2017)

 

No Reference Found

No Reference Found

No Reference Found

Medicaid

A telemedicine consent form is required to be completed, and at any time the patient/guardian has the right to cease using the technology and set up an alternative appointment.

See Pg. 111-112 of the Wyoming Dept of Public Health Manual

Wyoming Medicaid will reimburse eligible providers for exams that are performed via real-time interactive audio/video.

See Pg. 108-113 of the Wyoming Dept of Public Health Manual

Wyoming Medicaid states that reimbursement is only made for exams performed real-time interactive audio and video.  Store and forward does not meet this qualification.

See Page 110-111 of the Wyoming Dept of Public Health Manual

Originating site is where the patient is located at the time of service.  “A medical professional is not required to be present with the client at the originating site unless medically indicated.  However, in order to be reimbursed, services provided must be appropriate and medically necessary.”

See Page 108-110 of the Wyoming Dept of Public Health Manual

Under certain circumstances, providers are eligible to bill for telemedicine services

See Pg. 109 Wyoming Medicaid Manual

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

A telemedicine consent form is required to be completed, and at any time the patient/guardian has the right to cease using the technology and set up an alternative appointment.

See Pg. 111-112 of the Wyoming Dept of Public Health Manual

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Live Video Reimbursement
State Law

Live video falls under the definition of telemedicine.  Reimbursement not referenced.

See WY Stat § 33-26-102 (2017)

 

Medicaid

Wyoming Medicaid will reimburse eligible providers for exams that are performed via real-time interactive audio/video.

See Pg. 108-113 of the Wyoming Dept of Public Health Manual

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Store & Forward Reimbursement
State Law

No Reference Found

Medicaid

Wyoming Medicaid states that reimbursement is only made for exams performed real-time interactive audio and video.  Store and forward does not meet this qualification.

See Page 110-111 of the Wyoming Dept of Public Health Manual

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Originating Site & Transmission Fees
State Law

No Reference Found

Medicaid

Originating site is where the patient is located at the time of service.  “A medical professional is not required to be present with the client at the originating site unless medically indicated.  However, in order to be reimbursed, services provided must be appropriate and medically necessary.”

See Page 108-110 of the Wyoming Dept of Public Health Manual

Medicare

See Telemedicine Reimbursement Guide – Medicare Section

Eligible Practitioners
State Law

No Reference Found

Medicaid

Under certain circumstances, providers are eligible to bill for telemedicine services

See Pg. 109 Wyoming Medicaid Manual

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

There are no laws that currently mandate telemedicine parity.

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: