Telemedicine -- Reimbursement -- Rulemaking.

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  • (1)
    • (a) As used in this section, communication by telemedicine is considered face-to-face contact between a health care provider and a patient under the state's medical assistance program if:
      • (i) the communication by telemedicine meets the requirements of administrative rules adopted in accordance with Subsection (3); and
      • (ii) the health care services are eligible for reimbursement under the state's medical assistance program.
    • (b) This Subsection (1) applies to any managed care organization that contracts with the state's medical assistance program.
  • (2) The reimbursement rate for telemedicine services approved under this section:
    • (a) shall be subject to reimbursement policies set by the state plan; and
    • (b) may be based on:
      • (i) a monthly reimbursement rate;
      • (ii) a daily reimbursement rate; or
      • (iii) an encounter rate.
  • (3) The department shall adopt administrative rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, which establish:
    • (a) the particular telemedicine services that are considered face-to-face encounters for reimbursement purposes under the state's medical assistance program; and
    • (b) the reimbursement methodology for the telemedicine services designated under Subsection (3)(a).




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