WYOMING

MASTER MEDICAID TELEHEALTH LAWS
WITH THE HELP FROM GD

Summary

Wyoming Medicaid reimburses for live video under some circumstances. There is no reference to store-and-forward or remote patient monitoring reimbursement.

Definitions

“Telehealth is the use of an electronic media to link beneficiaries with health professionals in different locations…This means that the patient must be able to see and interact with the off-site physician at the time services are provided via telehealth technology.”

Source: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 109 (Apr. 1 2019). (Accessed Apr. 2019).

Live Video

Policy

Reimbursement is made for exams performed via a real time interactive audio and video telecommunications system. The patient must be able to see and interact with the off-site practitioner during the exam. A medical professional is not required to be present with the client at the originating site unless medically indicated.

Source: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 109-110 (Apr. 1 2019). (Accessed Apr.2019).
Eligible Services / Specialties

See manual for list of eligible hub site billing codes.
For end-stage renal disease-related services, there must be at least one in-person exam
per month of the vascular access site.
Quality assurance/improvement activities relative to telehealth delivered services need to be identified, documented and monitored. An evaluation process must also be instituted.
Progress notes should indicate the visit took place via teleconference and must clearly
identify the location of the hub and spoke sites.

SSource: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 111-113 (Apr. 1 2019). (Accessed Apr.2019).

 

Eligible Providers

Wyoming Medicaid reimburses the following eligible providers:
• Physicians;
• Advanced practice nurses with a specialty of psychiatry/mental health;
• Physician’s assistant;
• Psychologists and neuropsychologists;
• Mental health professionals (LCSW, LPC, LMFT, LAT);
• Speech therapist.
Provisionally licensed mental health professionals cannot bill Medicaid directly, but must
provide services through a supervising provider.

 

Source: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 110-111 (Apr. 1 2019). (Accessed Apr.2019).
Source: AL Medicaid Management Information System Provider Manual, (105-60) (Accessed Mar. 2019).
Eligible Sites

Eligible originating sites:
• Hospitals;
• Physician or practitioner offices (includes medical clinics);
• Psychologists or neuropsychologists offices;
• Community mental health or substance abuse treatment centers (CMHC/SATC);
• Advanced practice nurses with specialty of psychiatry/mental health offices;
• Office of a Licensed Mental Health Professional;
• Federally Qualified Health Centers;
• Rural Health Clinics;
• Skilled nursing facilities;
• Indian Health Services Clinics;
• Hospital-based or Critical Access Hospital-based renal dialysis centers (including
satellites);
• Development Center;
• Family Planning Clinics;
• Public Health Offices;
• Client’s Home.
A medical professional is not required to be present at the originating site, unless medically
indicated.
Each site is able to bill their own services as long as they are an enrolled Medicaid provider
(includes out-of-state Medicaid providers).

Source: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 109-110 (Apr. 1 2019). (Accessed Apr.
2019).
Facility/Transmission Fee

Yes, for originating site fees.
No reimbursement for transmission fees.

 

Source: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 109 & 112 (Apr. 1, 2019). (Accessed Apr.2019).

Store-and-Forward

Policy

Wyoming Medicaid states that reimbursement is made for exams performed via a real-time interactive audio and video.

Source: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 109 (Apr. 1, 2019). (Accessed Apr. 2019).
Email / Phone / Fax

No reimbursement for email.
No reimbursement for telephone.
No reimbursement for FAX.

 

Source: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 112 (Apr. 1, 2019). (Accessed Apr. 2019).
Consent

If the patient and/or legal guardian indicates at any point that he/she wants to stop using the technology, the service should cease immediately and an alternative appointment set up.
A telehealth consent form must be completed.

 

Source: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 113 (Apr. 1, 2019). (Accessed Apr. 2019).
Out of State Providers

Out-of-state providers are allowed if they are enrolled as a Wyoming Medicaid provider.

Source: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 109 (Apr. 1, 2019). (Accessed Apr. 2019).
Miscellaneous

Providers shall not bill for both the spoke and hub site. Any telehealth provider such as Community Mental Health Centers and Substance Abuse Treatment Centers can bill telehealth services where the provider is at one location and the client is at a different location even though the pay to provider is the same. A single pay to provider can bill both the originating site (spoke site) and the distant
site provider (hub site) when applicable. See below for billing and documentation requirements.

Source: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 109-110 (Apr. 1, 2019). (Accessed Apr. 2019).

 

No reimbursement for patient attendants who instruct the patient on the use of equipment or supervises/monitors a patient during the telehealth encounter.
No reimbursement for consults between health professionals.

Source: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 112 (Apr. 1, 2019). (Accessed Apr. 2019).

Professional Regulation /
Health & Safety

Definitions

Physicians and Surgeons
“Telemedicine means the practice of medicine by electronic communication or other means from a physician in a location to a patient in another location, with or without an intervening health care provider.”

Source: WY Statutes Sec. 33-26-102.(a( xxix)) (Accessed Apr. 2019).

 

Occupational Therapy
“Occupational therapy telehealth means the provision of occupational therapy services across a distance, using telecommunications technology for the evaluation, intervention or consultation without requiring the occupational therapist and recipient to be physically located in the same place.”

Source: WY Statutes Sec. 33-40-102.(a(v)) (Apr. 2019) (Accessed Apr. 2019).

 

Board of Chiropractic Examiners
“Telehealth” means the delivery of healthcare services using electronic communications, information technology, or other means between a licensee in one location and a patient in another location with or without an intervening healthcare provider.

Source: WY Admin Rules. Board of Chiropractic Examiners. Ch. 1, Sec. 3 (t).(Accessed Apr. 2019).
Consent

No reference found.

 

Miscellaneous

Boards have power to adopt telehealth/telemedicine definitions applicable to their regulated profession and standards for the practice of telemedicine/telehealth.

Source: WY Code 33-1-303(a(iv)) (HB 164 – 2017). (Accessed Apr. 2019).

 

Professional Board Telehealth-Specific Regulations
WY Board of Chiropractic Services

Source: WY Admin. Code, Chiropractic Board, Ch. 11 (Accessed Apr. 2019).
Online Prescribing

TPrescribing a controlled substance through the Internet, World Wide Web or any similar proprietary or common carrier electronic system without a documented physician-patient relationship is subject to review, discipline and consequences to license.

Source: WY Statutes Annotated Sec. 33-26-402(a(xxxiii)) (2012). (Accessed Apr. 2019).
Cross-State Licensing

Member of the Interstate Medical Licensure Compact.

Source: Interstate Medical Licensure Compact. The IMLC (Accessed Apr. 2019).

 

Member of the Nurse Licensure Compact

Source: Nurse Licensure Compact (Accessed Apr. 2019).

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