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State Telehealth
Laws and Medicaid

Program Policies
AT-A- GLANCE I FALL 2024
Since the COVID-19 pandemic in 2020, Medicaid programs across the United States have gradually stabilized and
refined their telehealth policies. The policy trends show a continued expansion of telehealth reimbursement in
targeted areas, as well as expanded cross-state licensing allowances, while states simultaneously implement various
guardrails, often through professional telehealth requirements.
The Report’s Methodology Audio-only

Audio-only has seen huge growth in Medicaid
• States were last reviewed between late May and early September 2024. reimbursement since the COVID pandemic. Audio-only
• CCHP only counts states as providing Medicaid reimbursement if official reimbursement in Medicaid is sometimes limited to
Medicaid documentation is found confirming they are reimbursing for a use in certain instances, such as only with established
specific modality. A statutory requirement alone is not considered enough. patients, and for specific conditions, such as mental
• Sources included state statutes, administrative codes, Medicaid health. Some states also mirror Medicare by having a list
manuals, and other Medicaid communications (such as newsletters, of eligible codes that are reimbursable via audio-only.
announcements, alerts, and updates). Medicaid fee schedules were not a
source for this report.
• A state is counted as reimbursing for a modality/eligible site even if they
do so in a very limited way. Therefore, it’s always important to check the Certain Medicaid programs specify that telehealth
state’s specific requirements. services provided at a patient’s residence are eligible for
• For the licensing section specifically, note that while CCHP’s search of reimbursement when billed with Place of Service Code 10,
statute and regulations was confined to telehealth, if we happened to denoting availability of home-based telehealth services.
come across a more general licensing exception, we did include it in our
reporting. However, to be counted as having a telehealth-specific license The home is recognized as an eligible originating site in 47
or registration, the licenses/registrations did need to specifically reference states and the District of Columbia.
telehealth (or remote care) in some way.
Medicaid Reimbursement 31
STATES
While live video is widely reimbursed in state All modalities
Medicaid programs, most states still have limitations
on allowable telehealth modalities, eligible sites,
services, and providers. However, a trend of gradual
50 42
change is emerging to improve telehealth accessibility. STATES
Medicaid programs are now often allowing STATES, DC AND PUERTO RICO Remote patient
Live Video monitoring*
reimbursement for services and professions that may
not have considered using telehealth previously, such
as ambulance services utilizing telehealth for triage
during transport, and doula services where telehealth
is being integrated in certain circumstances, for
example in the early stages of labor. Lists of service
codes eligible for telehealth-delivered services (similar 45 37
to Medicare) have also become more common. These STATES AND DC
Audio-only telephone STATES
changes reflect a measured but promising shift toward Store-and-
broader adoption of telehealth within Medicaid forward*
programs across the states. *Some states that are included in the counts above reimburse this
modality solely as part of Communication Technology-Based Services
(CTBS), which have their own separate codes and reimbursement rates.
FALL
2024 State Telehealth Laws and Medicaid Program Policies I AT-A-GLANCE
Private Payer Laws State Example:

Forty-four states, the District of Columbia, Puerto NEW YORK recently extended their
Rico and the Virgin Islands have a private payment parity requirement, initially tied
23
payer law that addresses telehealth to the COVID public health emergency,
reimbursement. Both Puerto Rico and through April 2026, and Connecticut made
STATES Pennsylvania are the two new states that their COVID payment parity requirement
Have explicit have added private payer policies since permanent. Another common clarification is
payment
parity. Fall 2023. States also continue to amend that insurers cannot mandate the use of any
their laws in order to clarify payment specific technology or telemedicine platform
parity requirements. as a condition for reimbursement.
Licensure
Thirty-eight states, as well as DC offer some type of limited exception to in-state licensing requirements. California is an
example of a state with new limited out-of-state provider allowances for marriage and family therapists, clinical social
workers, and clinical counselors, as well as physicians treating patients with life-threatening conditions, provided certain
conditions are met. CCHP also found that twenty-two states as well as the Virgin Islands have telehealth-specific special
registration or licensure processes that are available as an alternative to full in-state licensure. Colorado is an example
of a state that recently passed a telehealth specific licensure registration process, requiring providers to register with the
appropriate regulatory board and complete other requirements.
Adoption of Interstate Compacts continues to be common for states. Here are the numbers:
FALL
2024 State Telehealth Laws and Medicaid Program Policies I AT-A-GLANCE
Prescribing State Example:

States are increasingly focusing on elucidating MONTANA amended its rules for
telehealth prescription requirements, and a noticeable physicians and physician assistants,
trend involves defining parameters related to provider- removing the requirement for an in-person
patient relationships. It’s important to highlight that examination before prescribing Schedule II
regulations concerning the prescription of controlled controlled substances. Now, providers must
substances are generally more rigorous than those for comply with Drug Enforcement Agency (DEA)
non-controlled substances. regulations, reflecting a more standardized
approach aligned with federal guidelines.
Note: Providers must also comply with federal limits on
prescribing controlled substances.
Consent
FORTY-SEVEN STATES, DC, AND PUERTO RICO include some sort of consent requirement in
their statutes, administrative code, and/or Medicaid policies. SOUTH DAKOTA AND MONTANA
added consent requirements since Fall 2023. Consent requirements sometimes require written consent, while
other times verbal consent may be acceptable. Most consent laws are vague about the frequency with which
provider must obtain a telehealth specific consent from their patients. Some states may have different consent
requirements across payers and providers as well.
Professional Board Standards

Many state professional boards continue to implement telehealth practice requirements for various
professions. While the majority of states have telehealth practice standards in place for providers, such as
physicians and mental health professionals, more state boards are starting to adopt professional standards
for other types of practices, for example acupuncture providers and dietitians. Standards typically contain a
requirement that telehealth services meet the same standard of care as in-person services. Sometimes they
also include a requirement that a provider be able to refer a patient to a local provider for follow-up care in
case an in-person interaction is needed.
Center for Connected Health Policy

The Federally Designated National Telehealth Policy Resource Center • [email protected] • 877-707-7172
© 2024 Center for Connected Health Policy / Public Health Institute • www.cchpca.org
This fact sheet was made possible by Grant #U6743496 from the Office for the Advancement of Telehealth, Health Resources and Services Administration, DHHS.

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State Telehealth

Laws and Medicaid

The Report’s Methodology Audio-only

Private Payer Laws State Example:

Prescribing State Example:

Professional Board Standards

Center for Connected Health Policy

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