General Requirements

(1) Telehealth for workers’ compensation is an available option for medically appropriate healthcare services to be provided with the voluntary consent and agreement of the injured worker and the willingness of the healthcare services provider as provided in these rules. (2) Medically appropriate healthcare services do not include treatment where an in-person physical examination is necessary, such as the following conditions or services: (a) Anaphylactic or severe allergic reactions; (b) Respiratory distress or shortness of breath; (c) Difficulty speaking, altered mental status, confusion, or weakness in arms or legs of recent or acute onset; TELEHEALTH FOR WORKERS’ COMPENSATION CHAPTER 0800-02-31 (d) Chest pain or pressure; (e) Post seizure or epilepsy episode; (f) Any bleeding that has not already stopped by direct pressure; (g) Significant burns (with or without blistering); (h) Human or animal bites; (i) Serious penetrating wounds or embedded foreign bodies; (j) Complicated eye injuries; (k) Deformity of extremity or suspicion for a fracture, unless an X-ray is available; (l) Significant physical trauma; (m) Severe headaches; (n) Dizziness; (o) Loss of consciousness for any reason; or (p) Manual therapy. (3) The list of health conditions in paragraph (2) above is not exhaustive or proscriptive. There may be extraordinary or extenuating circumstances where some of the above conditions might be appropriate for telehealth, such as situations or settings where in-person immediate care cannot be given in a timely manner. (4) Health benefits provided through a telehealth encounter under the workers’ compensation law shall comply with all state requirements. (5) Telehealth providers shall be held to the same standard of care as healthcare services providers providing the same healthcare services through in-person encounters. (6) Telehealth providers rendering healthcare treatment and/or healthcare services to an injured worker claiming benefits under the Tennessee workers’ compensation law at the time of the telehealth consult shall be licensed according to the Tennessee statutes, rules, or executive orders in effect at the time of service by the provider’s appropriate licensing board and shall comply with the workers’ compensation law and the rules and regulations of both the bureau and the Tennessee department of health. (7) An employer shall provide coverage for workers’ compensation medical services provided during a telehealth encounter in a manner that is consistent with what the workers’ compensation law requires for in-person encounters for the same healthcare service(s). Payment shall be in accordance with the Tennessee workers’ compensation medical fee schedule in Rule 0800-02-18 and corresponding rules for medical payments in Rule 0800-02- 17 in effect on the date of service. (8) Records/recordings requirements for telehealth services shall be the same as if the visit with the provider were in person and face-to-face. A telehealth provider shall be compliant with all federal and state of Tennessee laws for records/recordings. A recording shall not substitute for a written record. TELEHEALTH FOR WORKERS’ COMPENSATION CHAPTER 0800-02-31 (9) Telehealth services are subject to any and all appropriate utilization review protocols or other protocols for healthcare treatment adopted by the bureau, shall be based on evidence-based guidelines, and shall be in accordance with the Tennessee standards of medical practice. (10) All services shall be delivered to the eligible employee at no cost to the employee in accordance with the provisions of T.C.A. § 50-6-204. (11) The provision of medical services via telehealth does not change or in any way affect the requirements for causation, date of maximum medical improvement, or permanent impairment ratings required of an authorized treating physician pursuant to the workers’ compensation law. In all workers’ compensation claims, statements of causation, date of maximum medical improvement, permanent restrictions, and permanent impairment rating(s) must be provided by a medical doctor, doctor of osteopathy, or doctor of chiropractic in accordance with the workers’ compensation law.