South Carolina Reimbursement for Telehealth

South Carolina Medicaid will reimburse for live video and covers telemedicine when the service is medically necessary and under the following circumstances:

  • The medical care is individualized, specific, and consistent with symptoms or confirmed diagnosis of the illness or injury under treatment, and not in excess of the beneficiary’s need;
  • The medical care can be safely furnished, and no equally effective and more conservative or less costly treatment is available statewide.
Telepsychiatry

To qualify for reimbursement, interactive audio and video equipment that permits two-way real-time or near real-time communication with the client, consultant, interpreter, and referring clinician.

Additional requirements include:

  • Reimbursement requires the “real-time” presence of a client.
  • Reimbursement is available for psychiatric diagnosis assessment with Medicaid and medical evaluation and management codes.
  • GT modifier must be used when billing the for telepsychiatric services.
  • All equipment must operate at a minimum communication transfer rate of 384 kbps.

Center for Connected Health Policy
https://www.cchpca.org

There are currently no parity laws mandating insurance companies reimburse for Telehealth sessions although many are seeing the advantages and choosing to do so.  Please contact the payers directly to see what they would cover.

At Secure Telehealth we offer a HIPAA- compliant Live video solution for delivering health services.  Our solutions meet all f the criteria outilines above for security and quality.  We have over 10 years of experience helping organizations implement successful telehealth programs.  We fully manage your telehealth program so you don't have to.  Your patients work directly with us to get set up for their first appointment and when they have questions or technical problems, they call us so that none of your time is wasted and appointments are not missed.  Contact us below for more information about telehealth solutions in South Carolina.

 

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