Question
How do you get reimbursement for having a remote site assistant that supports evaluative techniques? Has anyone put together a list of states in the US that have OT telehealth regulation information?
Answer
Private insurance is where we are seeing legislative activity. There are about 30 states that are mandating parity, and that number has grown dramatically just in the past few years. As far as Medicaid, there are about 5 states that I am aware of that reimburse OTs who provide service through telehealth for Medicaid recipients. Occupational therapy practitioners, as well as other rehab professionals, are not currently recognized as providers for telehealth on Medicare's provider list. However, some of the opportunities with bundled payments and alternative delivery, alternative models, accountable care organizations and so forth creates some opportunities for us.
As far as the reimbursement for technicians, I am finding that some institutions are not getting reimbursed directly for the technician or for even using telehealth. But because they are able to prevent secondary complications, they are able to improve the satisfaction of care, and the continuity of care of their clients from one setting to another. They are finding that those added benefits are outweighing the cost of using telehealth. They are absorbing those costs for the added benefits that they are getting. Then again, with some of the incentives that are being split among organizations that create cost savings, that could be a way that telehealth gets fit into that as a mechanism that is ultimately saving costs and improving efficiency, quality, and patient satisfaction.
AOTA is currently working on updating the list. Some states have put a policy statement on their website. North Carolina and South Carolina both come to mind. Some states have specifically spoken of telehealth in their practice act. Kentucky is one of those states. Illinois is a state that comes to mind as being touted as a model.
Link to AOTA’s State-by-State Chart of Telehealth Laws for Occupational Therapy (Member-only resource): https://www.aota.org/Advocacy-Policy/State-Policy/StateNews/2016/state-telehealth-law-chart-occupational-therapy.aspx.
