What Telehealth Parity Laws Mean for Physicians

If you’re a physician looking into telehealth, you’ve probably had to learn a new vocabulary — from originating patient site to telepresenter.

At the top of these must-know telemedicine-related terms is the telehealth parity law. Knowing a little about what telehealth parity laws are, and what their status is across the U.S. can go a long way in understanding how to get to reimbursed for telemedicine.

So, let’s jump right in. Here’s a quick review of telehealth parity law FAQs we get at eVisit.

So what’s a telehealth parity law?telehealth_parity_laws

Just remember the term “parity,” meaning “equal.” A telehealth parity law requires
private payers within that state to reimburse for a telemedicine service at the same rate as the comparable in-person service. Basically, if your state has a telemedicine parity law in effect, getting reimbursed for telemedicine is that much easier.

Which states have telehealth parity laws?

The number keeps going up every day. Currently, 29 states and Washington D.C. have passed telemedicine parity laws. You can view the full, state-by-state list here. Several additional states have proposed parity laws and are just waiting for them to pass. But the more states pass these parity laws, combined with the increased momentum in telemedicine adoption, the more likely it is that telehealth parity will soon be a country-wide phenomenon.

What kind of telemedicine do telehealth parity laws cover?

Depending on what kind of telemedicine service you’re interested in (live video, remote patient monitoring, store-and-forward), the parity law may or may not be directly relevant to you. Most telehealth parity laws are specifically directed at live video telemedicine. Think about it – the law is advocating coverage for a virtual visit that is comparable to and potentially replacing an in-person medical visit.

In some states, parity laws may also cover other forms of telemedicine, but the general default is live video. But, if you’re focusing in on another form of telehealth, don’t sweat! Every new piece of legislation related to telemedicine helps push the entire industry forward, and will no doubt promote further support for more wide-ranging forms of telemedicine in the near future.

Are there any variations or limitations across state telehealth parity laws?

Yes. While the basic purpose of a telehealth parity law is the same across states (to cover telemedicine services at the same rates as in-person medical service), the state decides whether the parity law applies to just private payers, or to private payers and Medicaid. Some states also apply the parity law to state employee health plans.

In a select few states, the telehealth parity law in place only applies in specific circumstances or in specific regions. For instance, Arizona has a “partial” parity law that only guarantees parity when telemedicine services are provided in a rural area. The best way to find out if your state has any restrictions or fine print is to check the American Telemedicine Association’s state policy center.

What’s a common misconception about telehealth parity laws?

Many people think that if their state does not have a telehealth parity law, they can’t get reimbursed for telemedicine. That’s actually not true. We’ve seen over the past couple years that the large commercial payers are starting to offer and cover telehealth services due to cost-savings. So regardless of whether there is a parity law in your state, private payers may still reimburse for telemedicine. It’s just that when there is a parity law in place, it’s extra reassurance for providers.