Out of State Providers
Providers must maintain a practice at a physical location in the Commonwealth or be able to make appropriate referral of patients to a Provider located in the Commonwealth in order to ensure an in-person examination of the patient when required by the standard of care.
Providers must meet state licensure, registration or certification requirements per their regulatory board with the Virginia Department of Health Professions to provide services to Virginia residents via telemedicine. Providers shall contact DMAS Provider Enrollment (888-829-5373) or the Medicaid MCOs for more information.
The purpose of this bulletin is to notify all providers that, pursuant to Virginia Acts of Assembly 2023, Chapter 112 (HB 1602, SB 1418), 1) licensed health care providers who provide health care services exclusively through telemedicine are not required to maintain a physical presence in the Commonwealth to be considered an eligible provider for enrollment as a Medicaid provider and 2) telemedicine services provider groups with licensed health care providers are not required to have an in-state service address to be eligible to enroll as a Medicaid vendor or Medicaid provider group. Providers wishing to enroll can access DMAS’s online provider enrollment process through the Provider Enrollment link located on the DMAS Medicaid Enterprise System (MES) Provider Resources site at https://vamedicaid.dmas.virginia.gov/provider.
In-state telemedicine providers will continue to need to meet the Virginia Department of Health Profession’s (DHP’s) licensing requirement and out-of-state telemedicine providers need to continue to meet DHP’s licensing requirements in addition to their state licensing requirements to provide telemedicine services to Virginia Medicaid members.
For the purposes of this subdivision, a health care provider duly licensed by the Commonwealth who provides health care services exclusively through telemedicine services shall not be required to maintain a physical presence in the Commonwealth to be considered an eligible provider for enrollment as a Medicaid provider.
For the purposes of this subdivision, a telemedicine services provider group with health care providers duly licensed by the Commonwealth shall not be required to have an in-state service address to be eligible to enroll as a Medicaid vendor or Medicaid provider group.
SOURCE: Code of Virginia Sec. 32.1-325 (Accessed Apr. 2025).
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