HAR §17-1737-51.1. Telehealth services

(a) Telehealth services is the use of communication equipment to link health care practitioners and patients in different locations. It may be used in place of a face-to-face, “hands on” encounter for consultation, office visits, individual psychotherapy and pharmacologic management. For purposes of this section, the term “patient” refers to individuals eligible for medical assistance. (b) Telehealth services may be provided to patients only if they are presented from an originating site located in either a: (1) Rural Health Professional Shortage Area (HPSA) as defined by section 332(a)(1)(A) of the Public Health Service Act; (2) In a county outside of a Metropolitan Statistical Area, as defined by Section 1886(d)(2)(D) of the Social Security Act; or (3) From an entity that participates in a Federal telemedicine demonstration project that has been approved by the Secretary of Health and Human Services as of December 31, 2000. (c) Interactive audio and video telecommunication systems must be used. Interactive telecommunications systems must be multi-media communications that, at a minimum, include audio and video equipment, permitting real-time consultation among the patient, consulting practitioner, and referring practitioner. Telephones, facsimile machines, and electronic mail systems do not meet the requirements of interactive telecommunications system. As a condition of payment UNOFFICIAL 1737-70 the patient must be present and participating in the telehealth visit. (d) An originating site is the location of a patient at the time the service being furnished via a telecommunications system occurs. Originating sites authorized to furnish telehealth services are listed below: (1) The office of a physician or practitioner; (2) A hospital; (3) A critical access hospital; (4) A rural health clinic; and (5) A federally qualified health center. An exception to this provision is an entity participating in a Federal telehealth demonstration project that is approved by or is receiving funding from the Secretary of Health and Human Services as of December 31, 2000. An entity participating in a Federal telehealth demonstration project qualifies as an originating site regardless of geographic location. (e) A distant site is the site at which the physician or practitioner delivering the service is located at the time the service is provided via a telecommunications system. (f) Coverage of telehealth services is based on Medicare’s criteria. Each provider must bill the appropriate CPT procedure code with the modifier code “TM” indicating the services were provided via telehealth. Only providers eligible to participate in the medical assistance program will be reimbursed for telehealth services. Reimbursements to an originating site and distant site are based on the Hawaii Medicaid fee schedule. [Eff 02/07/05] (Auth: HRS §346-59) (Imp: 42 C.F.R. §410.78; Pub. L. 105-33)