New Jersey Medicaid reimburses for TelePsychiatry and Telemedicine PDF Print E-mail

New Jersey Telemedicine law  - July 2017 Allows for greater reimbursement for telehealth and telemedice. Click Here for more information and what providers need to know courtesy of Foley Health Care law 

New Jersey Medicaid reimburses for telespychiatry as of December, 2013


1) Telepsychiatry must meet all confidentiality requirements required in
HIPAA and HITECH regulations. Sessions may not be recorded.
2) Consumers must provide informed consent to participate in any service
utilizing telepsychiatry. Should a client choose not to participate, they
must be made aware of other face to face options and services. If they
choose to participate, the clients must be informed and aware of the
location of the psychiatrist/APN providing the telepsychiatry service.
3) All telepsychiatry transmissions must be on a secure line which utilizes an
encryption process that ensures confidentiality and the integrity of the
information being transmitted.
4) The interactive audiovisual equipment must provide for two-way
communication at a minimum bandwidth of 384 kbps (kilobits per second).
5) Telepsychiatry services must be provided from, and in, a location that is
properly lit allowing for clear visual contact.
6) The Medicaid client must receive services at the mental health clinic or
outpatient hospital program and the mental health clinic/hospital must bill
for all services under their Medicaid provider number. The clinician
cannot bill for services directly.
7) The psychiatrist or psychiatric APN may be off-site but must be a
practitioner currently licensed to practice within the State of New Jersey.
When consumers receiving telepsychiatry services are under the care of a
multidisciplinary treatment team, the psychiatrist or psychiatric APN
providing telepsychiatry services must have regular communication with
them and be available for consultation.
8) All services shall be provided by practitioners operating under an affiliation
agreement between providers and the independent clinic or outpatient
hospital program that describes the program and practitioners’ roles and
responsibilities, as well as how telepsychiatry services will be coordinated
between the facilities. When the provider is acting as the Medical Director,
they must be contracted to provide these services.
9) In the event that the psychiatrist or psychiatric APN require a physical
evaluation as part of their clinical assessment, the hosting provider shall
have an RN available to complete and share the results of the physical
10) The provider shall establish criteria to ensure authentication and
identification of the Medicaid client participating in a telepsychiatry
session. The provider shall ensure that the client has sufficient
knowledge on how to operate any equipment before the session begins.
They shall also ensure that staff is readily available to answer any
technical questions or concerns the participant may have before, during or
after the session.
11) All services shall be documented to show the provision of service was by
telepsychiatry if applicable. The clinic or hospital program is responsible
for maintaining all documentation of services for which they are the
primary, billing provider. Off-site clinicians must have access to the
client’s chart with the ability to document the therapeutic services
12) All services currently billed by an independent mental health clinic or
outpatient hospital program as mental health services, provided by a
psychiatrist or psychiatric APN, shall be eligible for provision by
telepsychiatry except for group therapy. Hospitals shall utilize existing
outpatient revenue codes and independent clinics shall bill using the
appropriate HIPAA compliant HCPCS code with a GT modifier.
13) The mental health clinic and hospital providers are limited to billing for
services permitted by the Division of Medical Assistance and Health
14) Before any telepsychiatry services may be provided, each participating
program shall establish policy and procedures which address all the areas
noted in this newsletter. These policies and procedures must be reviewed
and approved by the Division of Medical Assistance and Health Services
(DMAHS), in consultation with the Division of Mental Health and Addiction
Services (DMHAS) or the Children’s System of Care (CSOC), depending
on the program focus. Interested providers should contact their local
Medical Assistance Customer Center (MACC) before providing
telepsychiatry services.


Last Updated on Wednesday, 09 August 2017 10:29