Medicaid covers remote patient monitoring, but coverage does vary significantly from state to state. Moreover, on October 24, 2023, the Center for Connected Health Policy (CCHP) released its summary of state telehealth policy changes for Fall 2023. This guide will tell you which states Medicaid covers for remote patient monitoring and how Medicaid remote patient monitoring coverage is determined.
Medicaid Remote Patient Monitoring Coverage Across States
With 70 million people with limited income enrolled in Medicaid, the need for RPM is substantial. Furthermore, the Centers for Medicare (CMS) and Medicaid Services understand this population may need remote patient monitoring the most. Medicaid beneficiaries are more likely to develop chronic diseases like heart failure, diabetes, and cancer than those without Medicaid.
Medicare reimbursement for remote patient monitoring services differs from Medicaid and private insurance coverage. To elaborate, each state specifies its policies and conditions for Medicaid remote patient monitoring services reimbursement. Therefore, each state can decide:
- Whether to cover remote patient monitoring
- What conditions are eligible for RPM
- Where in the state RPM can be utilized
- What types of restrictions will be enforced
- How much to reimburse for RPM services
Exploring Medicaid Remote Patient Monitoring by State
Medicaid coverage for remote patient monitoring devices and services is rapidly expanding but not universal. Medicaid does not cover RPM services in all states. In the next section, we’ll review which states cover RPM services. In addition, as of the fall of 2023, the Center for Connected Health Policy lists the following 37 states that offer some form of Medicaid reimbursement for RPM. However, please note that states listed with * are only reimbursed through CTBS.
The review period for this report took place from late May through early September 2023. Therefore, It’s important to note that some states may have enacted significant legislative changes or administrative policies after CCHP review. These changes might not be included in this updated list.
- Alabama
- Alaska
- Arizona
- Arkansas
- California*
- Colorado
- Florida
- Hawaii*
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts*
- Michigan
- Minnesota
- Mississippi
- Missouri
- Nebraska
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- South Carolina
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia*
- Wisconsin
Some states not listed above have laws requiring Medicaid coverage of RPM services; however, they lack official policies that explicitly state coverage. Each state has unique rules and regulations for remote patient monitoring coverage. For more information about your state’s Medicaid reimbursement guidelines for RPM, visit the CCHP website.
The following section describes updates Medicaid programs are responding to the COVID-19 pandemic.
Medicaid COVID-19 Policies
In response to the COVID-19 pandemic, states were temporarily encouraged to loosen Medicaid telehealth guidelines. This was to prevent unnecessary exposure to the virus and minimize clinic overcrowding.
As a result, these changes included:
- Expanding services that can be provided via remote patient monitoring
- Adjusting payment rates and waiving co-pays
- Waiving requirements to establish patient-provider relationships in person
- Allowing verbal consent instead of written consent
- Lifting geographic requirements and allowing the home to serve as the originating site
- Expanding which Medicaid populations can receive RPM services
- Enabling more providers to provide remote services
COVID-19 is listed as a category in CCHP’s 50 State policy tool. However, COVID policies are not part of the fall 2023 summary report. State policies that were made permanent or extended were included in the report. The online policy finder tool will be phased out for the Winter 2023-2024 updates.
Understanding Medicaid Remote Patient Monitoring State by State
Medicare and Medicaid telehealth coverage is not the same. States have the power to determine Medicaid coverage for remote patient monitoring services. Unlike Medicare, each state can decide on its own rules and regulations for RPM reimbursement if they decide to reimburse for RPM at all. Remote patient monitoring allows clinicians to provide care between visits, identify complications early, and provide treatment before symptoms exacerbate.
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