Last updated 12/16/2024
Consent Requirements
With written consent of the patient receiving medication assisted treatment through telehealth services provided under this section, the health care provider shall provide notification of the patient’s medication assisted treatment to the doorway, as defined in RSA 167:4-d, II(c), within the region where the patient resides.
SOURCE: NH Revised Statutes Annotated, 167:4-d, (Accessed Dec. 2024).
The recipient has consented to using telehealth, including teledentistry, as a method of receiving services.
Each participating medical provider shall: … Ensure the patient’s informed consent to the use of telehealth and advise members of any relevant privacy considerations.
The provider shall present the patient with basic information about the services that the patient will be receiving via telehealth.
The patient shall provide his or her consent to participate in services utilizing this technology.
Telehealth sessions shall not be recorded without the patient’s consent.
Culturally competent translation or interpretation services shall be provided when the patient and the distant provider do not speak the same language.
Documentation in the patient’s medical record shall reflect that the patient was informed of the patient’s rights policies which include the following:
- The right to refuse to participate in services delivered via telehealth;
- The role of the provider at the distant site and the professional staff at the originating site who shall be responsible for follow up or ongoing care;
- The city and state of the distant site provider and all questions regarding the equipment and the technologies are addressed;
- The right to be referred to in-person emergency care when clinically appropriate;
- The right to be informed of all the parties who shall be present at each end of the telehealth transmission; and
- The right to know how an emergency would be handled by the provider during a telehealth visit.
Source: NH Admin Rules, HE-C 5004.02, 07, (Accessed Dec. 2024).
Last updated 12/16/2024
Definitions
“Telehealth services” shall comply with 42 C.F.R. section 410.78, except for 42 C.F.R. section 410.78(b)(4). The use of the term “telemedicine” shall comply with the Centers for Medicare and Medicaid Services requirements governing the aforementioned telehealth services.
SOURCE: NH Revised Statutes 167:4-d (Accessed Dec. 2024).
“Teledentistry” means the acquisition and transmission of all necessary subjective and objective diagnostic data through interactive audio, video, or data communications by a dental provider subject to RSA 317-A:21-e to a NH Medicaid enrolled dentist at a distant site for triage, dental treatment planning, and referral.
“Telehealth” means a two-way, real-time interactive communication between a patient and a physician or medical provider at a distant site through telecommunications equipment including video, audio, and audio-only equipment.
Source: NH Admin Rules, HE-C 5004.1, (Accessed Dec. 2024).
Telehealth is the use of telecommunications technologies for remote delivery of medical services. Telehealth is used to facilitate live contact directly between an individual/individual’s family and a provider.
SOURCE: NH Department of Health and Human Services, Medicaid to Schools Program Medicaid to Schools Technical Assistance Guide pg. 91, (May 3, 2022), (Accessed Dec. 2024).
Last updated 12/16/2024
Email, Phone & Fax
Medical providers described in He-C 5004.03(a) above, shall be permitted to perform health care services through the use of all modes of telehealth, including video and audio, audio-only, or other electronic media.
Source: NH Admin Rules, HE-C 5004.03, (Accessed Dec. 2024).
“Telehealth services” shall comply with 42 C.F.R. section 410.78, except for 42 C.F.R. section 410.78(b)(4).
SOURCE: NH Revised Statutes 167:4-d & 42 CFR Sec. 410.78. (Accessed Dec. 2024).
The Medicaid program shall provide reimbursement for all modes of telehealth, including video and audio, audio-only, or other electronic media provided by medical providers to treat all members for all medically necessary services.
Eligible medical providers shall be allowed to perform health care services through the use of all modes of telehealth, including video and audio, audio-only, or other electronic media.
SOURCE: NH Revised Statutes Annotated, 167:4-d, (Accessed Dec. 2024).
Effective as of 4/1/2022, FQ modifier identifying the service was furnished using audio-only communication technology has been added to MMIS.
SOURCE: NH Medicaid Provider Bulletin, New Modifiers and Telehealth POS (Mar. 25, 2022), (Accessed Dec. 2024).
Care Coordination for behavioral health includes Communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge*
SOURCE: NH Medicaid Provider Provider Communication, To NH Medicaid Enrolled Providers, July 12, 2024, (Accessed Dec. 2024).
Last updated 12/16/2024
Live Video
POLICY
The Medicaid program shall provide coverage and reimbursement for health care services provided through telemedicine on the same basis as the Medicaid program provides coverage and reimbursement for health care services provided in person.
The combined amount of reimbursement that the Medicaid program allows for the compensation to the distant site and the originating site shall not be less that the total amount allowed for health care services provided in person.
The Medicaid program shall provide reimbursement for all modes of telehealth, including video and audio, audio-only, or other electronic media provided by medical providers to treat all members for all medically necessary services.
Nothing in this section shall be construed to prohibit the Medicaid program from providing coverage for only those services that are medically necessary and subject to all other terms and conditions of the coverage. Services delivered through telehealth under this section shall comply with all applicable state and federal law or regulation as allowed by the Medicaid program. Any conflict with the provisions of this section and federal law or regulation shall preempt and supersede any provision of this section.
This section shall be conditioned upon review and approval of a state plan amendment submitted by the department to the Centers for Medicare and Medicaid Services, as deemed necessary.
SOURCE: NH Revised Statutes 167:4-d (Accessed Dec. 2024).
All recipients shall be eligible for telehealth services when:
- Telehealth, including teledentistry, is determined medically necessary pursuant to He-W 530.01(e); and
- The recipient has consented to using telehealth, including teledentistry, as a method of receiving services.
Payment for Services
- Payment to medical providers, described in He-C 5004.03 above, shall be made in accordance with rates established by the department in accordance with RSA 161:4, VI(a).
- Services delivered via telehealth shall be reimbursed pursuant to RSA 167:4-d III(b) and (c).
- Medical providers shall use appropriate CPT procedure codes and modifiers when billing.
- Dental providers shall use CDT procedure codes when billing.
- All claims for payment shall be submitted to the department’s fiscal agent.
- All providers shall maintain supporting records in accordance with He-W 520.
- All providers shall be responsible for determining that the recipient is Title XIX eligible on the date of service.
- Payment for store and forward and remote patient monitoring shall only be available as funding and resources within the current state fiscal year are available.
Source: NH Admin Rules, HE-C 5004.02, and .13 (Accessed Dec. 2024).
An individual providing services by means of telemedicine or telehealth directly to a patient shall:
- Use the same standard of care as used in an in-person encounter;
- Maintain a medical record; and
- Subject to the patient’s consent, forward the medical record to the patient’s primary care or treating provider, if appropriate; and
- Provide meaningful language access if the individual is practicing in a facility that is required to ensure meaningful language access to limited-English proficient speakers pursuant to 45 C.F.R. section 92.101 or RSA 354-A, or to deaf or hard of hearing individuals pursuant to 45 C.F.R. section 92.102, RSA 521-A, or RSA 354-A.
Under this section, Medicaid coverage for telehealth services shall comply with the provisions of 42 C.F.R. section 410.78 and RSA 167:4-d.
SOURCE: NH Revised Statute 310-A:1-g, (Accessed Jul. 2024).
Medicaid covers services delivered via telehealth, as well as remote patient monitoring and store and forward services.
SOURCE: NH Medicaid, General Billing Manual, Oct. 2023, (Accessed Dec. 2024).
ELIGIBLE SERVICES/SPECIALTIES
Coverage under this section shall include the use of telehealth or telemedicine for Medicaid-covered services provided within the scope of practice of a physician or other health care provider as a method of delivery of medical care:
- Which is an appropriate application of telehealth services provided by physicians and other health care providers, as determined by the department based on the Centers for Medicare and Medicaid Services regulations, and also including persons providing psychotherapeutic services as provided in He-M 426.08 and 426.09;
- By which telemedicine services for primary care and remote patient monitoring shall only be covered in the event that the patient has already established care at an originating site via face-to-face in-person service. A provider shall not be required to establish care via face-to-face in-person service when:
- The provider is a Department of Veteran Affairs (VA) practitioner or VA-contracted practitioner not required to obtain a special registration pursuant to 21 U.S.C. section 831(h);
- The patient is being treated by, and is physically located in a correctional facility administered by the state of New Hampshire or a New Hampshire county;
- The patient is being treated by, and is physically located in a doorway as defined in RSA 167:4-d, II(c);
- The patient is being treated by and is physically located in a state designated community mental health center pursuant to RSA 135; or
- The patient is being treated by, and physically located in, a hospital or clinic registered in a manner fully consistent with 21 U.S.C. section 823(f); and
By which an individual shall receive medical services from a physician or other health care provider who is an enrolled Medicaid provider without in-person contact with that provider.
Medical providers below shall be allowed to perform health care services through the use of all modes of telehealth, including video and audio, audio-only, or other electronic media. See eligible provider section for list of eligible providers.
Nothing in this section shall be construed to prohibit the Medicaid program from providing coverage for only those services that are medically necessary and subject to all other terms and conditions of the coverage. Services delivered through telehealth under this section shall comply with all applicable state and federal law or regulation as allowed by the Medicaid program. Any conflict with the provisions of this section and federal law or regulation shall preempt and supersede any provision of this section.
SOURCE: NH Revised Statutes 167:4-d (Accessed Dec. 2024).
Telehealth services shall be subject to the same service limits set forth in He-W 530.03.
Teledentistry services shall be subject to the same service limits set forth in He-W 566.04.
Telehealth services, provided through a medicaid managed care organization (MCO), as defined in He-W 506.03(h) shall be furnished in an amount, duration, and scope that is no less than the amount, duration, and scope for the same services furnished to recipients under fee-for-service as defined in He-W 506.03(f).
Installation to provide telehealth services or maintenance of telehealth hardware, software, or other equipment shall not be covered by Medicaid.
Source: NH Admin Rules, HE-C 5004.04 and 05, 09 (Accessed Dec. 2024).
Medicaid to Schools Program
Medical services delivered via telehealth including those services in a school setting are reimbursable pursuant to RSA 167:4-D. Claims should be submitted with the appropriate procedure code and TM modifier along with modifier GT and place of service (02 for telehealth).
SOURCE: NH Medicaid to Schools Billing Guidelines and Billable Procedure Codes Companion to the Technical Assistance Guide, pg. 2 ( Mar. 1, 2022), ( Accessed Dec. 2024).
Any direct service that would have previously been rendered and Medicaid covered as face-to-face may now be rendered via telehealth. This includes both medical services as well as behavioral health services. Follow up with students on home activities that normally would have been done face-to-face would be considered direct services. Work that Rehabilitation Assistants are doing remotely in support of students such as sensory exercises, teaching communication skills or other such medically related activities in support of the student’s plan of care would be billable. Notification to NH Medicaid to transition an individual from face- to- face direct treatment to telehealth visits is not required.
NH Medicaid pays the same rate as if the service was provided face-to-face. Billing for the service delivered should identify the CPT codes typically used for in-person visits with the addition of the GT modifier and place of service 02 (telehealth) to the claim form. The use of the GT modifier and the 02 place of service are for all Medicaid to Schools covered procedure codes both medical and behavioral health. Medicaid is not adopting a different set of procedure codes specific to telehealth.
SOURCE: NH Department of Health and Human Services, Medicaid to Schools Program Medicaid to Schools Technical Assistance Guide pgs. 91 & 92, (May 2, 2022), (Accessed Dec. 2024).
The following new modifiers listed below have been added to MMIS:
- FQ – the service was furnished using audio-only communication technology
- FR – the supervising practitioner was present through two-way, audio/video communication technology
- FS – split (or shared) Evaluation and Management service
- FT- unrelated Evaluation and Management (E/M) visit during a postoperative period, or on the same day as a procedure or another E/M visit
These modifiers are effective 4/1/2022 and are informational only.
SOURCE: NH Medicaid Provider Bulletin, New Modifiers and Telehealth POS (Mar. 25, 2022), (Accessed Dec. 2024).
A Comprehensive Medication Review (CMR) is an interactive person-to-person or telehealth medication review and consultation conducted in real-time between the patient and/or other authorized individual, such as prescriber or caregiver, and the pharmacist or other qualified provider and is designed to
SOURCE: NH Medicaid Provider Provider Communication, To NH Medicaid Enrolled Providers, July 12, 2024, (Accessed Dec. 2024).
ELIGIBLE PROVIDERS
“Distant site” means the location of the health care provider delivering services through telemedicine at the time the services are provided.
Pursuant to RSA 167:4-d(f), medical providers shall include, but are not limited to the following:
- Physicians and physician assistants, governed by RSA 329 and RSA 328-D;
- Advanced practice nurses, governed by RSA 326-B and registered nurses under RSA 326-B employed by home health care providers under RSA 151:2-b;
- Midwives, governed by RSA 326-D;
- Psychologists, governed by RSA 329-B;
- Allied health professionals, governed by RSA 328-F;
- Dentists, governed by RSA 317-A;
- Mental health practitioners governed by RSA 330-A;
- Community mental health providers employed by community mental health programs pursuant to RSA 135-C:7;
- Alcohol and other drug use professionals, governed by RSA 330-C;
- Dietitians, governed by RSA 326-H; and
- Professionals certified by the national behavior analyst certification board or persons performing services under the supervision of a person certified by the national behavior analyst certification board.
Each participating medical provider shall:
- Be licensed to practice by the state of New Hampshire;
- Be a NH enrolled Title XIX provider;
- Request and obtain prior authorization in accordance with He-W 531.07 and dental request per He-W 566.07;
- Assure the same rights to confidentiality and security as provided in face-to-face services; and
- Ensure the patient’s informed consent to the use of telehealth and advise members of any relevant privacy considerations.
Medical providers shall adhere to the same standards of clinical practice and record keeping that apply to other covered services.
Source: NH Admin Rules, HE-C 5004.03, (Accessed Dec. 2024).
“Distant site ” means the location of the health care provider delivering services through telemedicine at the time the services are provided.
“Telehealth services” shall comply with 42 C.F.R. section 410.78, except for 42 C.F.R. section 410.78(b)(4). These sections limits providers that can be reimbursed for telehealth to the following:
- Physician
- Physician assistant
- Nurse practitioner
- Clinical nurse specialist
- Nurse-midwife
- Clinical psychologist and clinical social worker (may not seek payment for medical evaluation and management services)
- Registered dietician or nutrition professional
- Certified registered nurse anesthetist
Medical providers below shall be allowed to perform health care services through the use of all modes of telehealth, including video and audio, audio-only, or other electronic media. Medical providers include, but are not limited to, the following:
- Physicians and physician assistants, governed by RSA 329 and RSA 328-D;
- Advanced practice nurses, governed by RSA 326-B and registered nurses under RSA 326-B employed by home health care providers under RSA 151:2-b;
- Midwives, governed by RSA 326-D;
- Psychologists, governed by RSA 329-B;
- Allied health professionals, governed by RSA 328-F;
- Dentists, governed by RSA 317-A;
- Mental health practitioners governed by RSA 330-A;
- Community mental health providers employed by community mental health programs pursuant to RSA 135-C:7;
- Alcohol and other drug use professionals, governed by RSA 330-C;
- Dietitians, governed by RSA 326-H; and
- Professionals certified by the national behavior analyst certification board or persons performing services under the supervision of a person certified by the national behavior analyst certification board
SOURCE: NH Revised Statutes 167:4-d, (Accessed Dec. 2024).
Medicaid to Schools Program
All services provided via telehealth must be within the provider’s professional scope of practice and He-W 589.04. The following provider types are eligible to provide telehealth services:
- Occupational Therapists (OTs)
- Physical Therapists (PTs)
- Speech and Language Pathologists (SLPs)
- Rehabilitation Assistants
- Psychologists
- Board Certified Behavior Analysts (BCBAs)
- School Physicians
- Psychiatrists
- Advanced Registered Nurse Practitioners (APRNs) and Registered Nurses (RNs)
- Licensed alcohol and drug counselors (LADC) and master licensed alcohol and drug counselors (MLADC) per He-W 513
- Psychotherapists and Mental Health Practitioners
SOURCE: NH Department of Health and Human Services, Medicaid to Schools Program Medicaid to Schools Technical Assistance Guide pg. 91, (May 3, 2022), (Accessed Dec. 2024).
ELIGIBLE SITES
“Originating site” means the location of the patient, whether or not accompanied by a health care provider, at the time services are provided by a health care provider through telehealth, including, but not limited to, a health care provider’s office, a hospital, or a health care facility, or the patient’s home or another nonmedical environment such as a school-based health center, a university-based health center, or the patient’s workplace.
Source: NH Admin Rules, HE-C 5004.1, (Accessed Dec. 2024).
There shall be no restriction on eligible originating or distant sites for telehealth services. An originating site means the location of the member at the time the service is being furnished via a telecommunication system. A distant site means the location of the provider at the time the service is being furnished via a telecommunication system.
SOURCE: NH Revised Statutes Annotated, 167:4-d, (Accessed Dec. 2024).
“Originating site” means the location of the patient, whether or not accompanied by a health care provider, at the time services are provided by a health care provider through telemedicine, including, but not limited to, a health care provider’s office, a hospital, or a health care facility, or the patient’s home or another nonmedical environment such as a school-based health center, a university-based health center, or the patient’s workplace.
SOURCE: NH Revised Statutes 167:4-d (Accessed Dec. 2024).
Effective as of 4/1/2022 place of service 10, telehealth provided in a patient’s home has been added to MMIS.
SOURCE: NH Medicaid Provider Bulletin, New Modifiers and Telehealth POS (Mar. 25, 2022), (Accessed Dec. 2024).
Medicaid to Schools Program
GEOGRAPHIC LIMITS
New Hampshire Medicaid does not follow 42 CFR 410.78(b)(4), listing geographic and site restrictions on originating sites.
SOURCE: NH Revised Statutes 167:4-d (Accessed Dec. 2024).
FACILITY/TRANSMISSION FEE
No reference found.
Last updated 12/16/2024
Miscellaneous
An individual providing services by means of telemedicine or telehealth directly to a patient shall:
- Use the same standard of care as used in an in-person encounter;
- Maintain a medical record; and
- Subject to the patient’s consent, forward the medical record to the patient’s primary care or treating provider, if appropriate.
- Provide meaningful language access if the individual is practicing in a facility that is required to ensure meaningful language access to limited-English proficient speakers pursuant to 45 C.F.R. section 92.101 or RSA 354-A, or to deaf or hard of hearing individuals pursuant to 45 C.F.R. section 92.102, RSA 521-A, or RSA 354-A.
Under this section, Medicaid coverage for telehealth services shall comply with the provisions of 42 C.F.R. section 410.78 and RSA 167:4-d.
SOURCE: NH Revised Statute 310:7, (Accessed Dec. 2024).
A physical therapy assistant may work under a physical therapist’s general supervision. General supervision means that the physical therapist is not required to be on site for direction and supervision, but must be available at least by telecommunication.
SOURCE: NH Medicaid Provider Billing Manual, Therapies PT/OT/ST, (March 2023), pg. 7, (Accessed Dec. 2024).
See regulations for confidentiality and patient rights requirements.
Source: NH Admin Rules, HE-C 5004.06 and 07, (Accessed Dec. 2024).
Last updated 12/16/2024
Out of State Providers
If you are a NH Medicaid enrolled provider located outside of New Hampshire that provide services to patients in NH via telehealth you may need a New Hampshire license. Refer to New Hampshire RSA 310:7 for more information.
During the COVID-19 State of Emergency, the New Hampshire Office of Professional Licensure and Certification issued emergency licenses to certain New Hampshire Medicaid Enrolled Providers located out of state to allow for continuity of care through the emergency. Emergency licenses issued during the New Hampshire COVID-19 State of Emergency were converted to a permanent license pursuant to Senate Bill 277 (2022). These licenses expired on June 3, 2024. If you are practicing in New Hampshire or providing services to individuals in New Hampshire via telehealth, there was a process to renew your license before it expired. To determine if you were issued an emergency license during the COVID-19 State of Emergency, or for instructions on how to renew, please visit the OPLC webpage here.
SOURCE: NH Division of Medicaid Services. Provider Message. May 2024. (Accessed Dec. 2024).
Last updated 12/16/2024
Overview
New Hampshire Medicaid follows the Centers for Medicare and Medicaid Services requirements and Federal regulations for the use of telehealth and telemedicine. Reimbursement is available for live video under some circumstances. New Hampshire statute has a definition for store-and-forward and remote patient monitoring, and regulations that indicate it’s reimbursed as long as funding and resources are available in the fiscal year. A Medicaid provider message dictates specific codes for store-and-forward and remote patient monitoring coverage consistent with Medicare Communication Technology Based Services (CTBS) codes. New Medicaid regulations stipulate that providers are permitted to perform health care services through the use of all modes of telehealth, including video and audio, audio-only, or other electronic media.
Last updated 12/16/2024
Remote Patient Monitoring
POLICY
“Remote patient monitoring (RPM)” means “remote patient monitoring” as defined in RSA 167:4-d, II(e) namely “the use of electronic technology to remotely monitor a patient’s health status through the collection and interpretation of clinical data while the patient remains at an originating site. Remote patient monitoring may or may not take place in real time. Remote patient monitoring shall include assessment, observation, education and virtual visits provided by all covered providers including licensed home health care providers”.
Payment for store and forward and remote patient monitoring shall only be available as funding and resources within the current state fiscal year are available.
Source: NH Admin Rules, HE-C 5004.01, .13 (Accessed Dec. 2024).
“Remote patient monitoring” means the use of electronic technology to remotely monitor a patient’s health status through the collection and interpretation of clinical data while the patient remains at an originating site. Remote patient monitoring may or may not take place in real time. Remote patient monitoring shall include assessment, observation, education and virtual visits provided by all covered providers including licensed home health care providers.
Coverage under this section shall include the use of telehealth or telemedicine for Medicaid-covered services provided within the scope of practice of a physician or other health care provider as a method of delivery of medical care:
(1) Which is an appropriate application of telehealth services provided by physicians and other health care providers, as determined by the department based on the Centers for Medicare and Medicaid Services regulations, and also including persons providing psychotherapeutic services as provided in He-M 426.08 and 426.09;
(2) By which telemedicine services for primary care and remote patient monitoring shall only be covered in the event that the patient has already established care at an originating site via face-to-face in-person service. A provider shall not be required to establish care via face-to-face in-person service when:
- The provider is a Department of Veteran Affairs (VA) practitioner or VA-contracted practitioner not required to obtain a special registration pursuant to 21 U.S.C. section 831(h);
- The patient is being treated by, and is physically located in a correctional facility administered by the state of New Hampshire or a New Hampshire county;
- The patient is being treated by, and is physically located in a doorway as defined in RSA 167:4-d, II(c);
- The patient is being treated by and is physically located in a state designated community mental health center pursuant to RSA 135; or
- The patient is being treated by, and physically located in, a hospital or clinic registered in a manner fully consistent with 21 U.S.C. section 823(f); and
(3) By which an individual shall receive medical services from a physician or other health care provider who is an enrolled Medicaid provider without in-person contact with that provider.
SOURCE: NH Revised Statutes 167:4-d (Accessed Dec. 2024).
Medicaid covers services delivered via telehealth, as well as remote patient monitoring and store and forward services.
SOURCE: NH Medicaid, General Billing Manual, Oct. 2023, (Accessed Dec. 2024).
New Hampshire Medicaid now covers remote patient monitoring and store & forward telehealth services as required with the passage of NH SB258 to amend RSA 167:4-d.
The following new procedure codes have been added to MMIS with an effective date of 10/1/2023:
- CPT code 99453: “Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment.” This service may be billed once per year.
- CPT code 99454: “Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days.” This service may be billed once per month.
- CPT code 99457: “Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month.” Max unit of one per month
- CPT code 99458: CPT code 99458 (Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; additional 20 minutes) This service may be billed once per month.
- CPT code 99091: Collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional. This service may be billed once per month.
These procedure codes do not require a service authorization.
SOURCE: NH Division of Medicaid Services. Provider Message. Oct. 2023. (Accessed Dec. 2024).
CONDITIONS
The following considerations shall apply to RPM, as defined in He-C 5004.01(i) above, medical conditions that may be treated or monitored by means of RPM include but are not limited to:
- Congestive heart failure;
- Diabetes;
- Chronic obstructive pulmonary disease;
- Wound care;
- Polypharmacy, mental or behavioral conditions, and technology dependent care such as the use of continuous oxygen, ventilator care, total parenteral nutrition, or enteral feeding;
- Hypertension;
- Pneumonia; or
- Patients at high risk of hospitalization.
Source: NH Admin Rules, HE-C 5004.05, (Accessed Dec. 2024).
PROVIDER LIMITATIONS
No Reference Found
OTHER RESTRICTIONS
Medical devices supplied to patients as part of RPM services shall comply with section 201 of the Federal Food, Drug and Cosmetic Act (FDA) which requires the wirelessly synced device to be reliable and to transmit data electronically for interpretation and recommendations automatically rather than the patient having to self-report to providers.
Telehealth for developmental disabilities and acquired brain disorder home and community based care waiver services shall be provided in accordance with the Centers for Medicare and Medicaid’s “Appendix K: Emergency Preparedness and Response for Home and Community Based (HCBS) 1915(c) Waivers” (effective March 2020 through 6 months after the end of the federal public health emergency), as available in Appendix A.
Telehealth for choices for independence home and community based waiver services shall be provided in accordance with the Centers for Medicare and Medicaid’s “Appendix K: Emergency Preparedness and Response for Home and Community Based (HCBS) 1915(c) Waivers” (effective March 2020 through 6 months after the end of the federal public health emergency), as available in Appendix A.
Telehealth for in home supports home and community based waiver services shall be provided in accordance with the Centers for Medicare and Medicaid’s “Appendix K: Emergency Preparedness and Response for Home and Community Based (HCBS) 1915(c) Waivers” (effective March 2020 through 6 months after the end of the federal public health emergency), as available in Appendix A.
Source: NH Admin Rules, HE-C 5004.05, (Accessed Dec. 2024).
Last updated 12/16/2024
Store and Forward
POLICY
“Store and forward,” means “store and forward” as defined in RSA 167:4-d, II(f) namely, “as it pertains to telemedicine and as an exception to 42 C.F.R. section 410.78, means the use of asynchronous electronic communications between a patient at an originating site and a health care service provider at a distant site for the purpose of diagnostic and therapeutic assistance in the care of patients. This includes the forwarding and/or transfer of stored medical data from the originating site to the distant site through the use of any electronic device that records data in its own storage and forwards its data to the distant site via telecommunication for the purpose of diagnostic and therapeutic assistance”.
Medical providers described in He-C 5004.03(a) above, shall be permitted to perform health care services through the use of all modes of telehealth, including video and audio, audio-only, or other electronic media.
Payment for store and forward and remote patient monitoring shall only be available as funding and resources within the current state fiscal year are available.
Source: NH Admin Rules, HE-C 5004.01, 03, & .13 (Accessed Dec. 2024).
New Hampshire statute addressing Medicaid has a definition for store-and-forward as it pertains to telemedicine and as an exception to 42 CFR 410.78.
“Store and forward,” as it pertains to telemedicine and as an exception to 42 C.F.R. section 410.78, means the use of asynchronous electronic communications between a patient at an originating site and a health care service provider at a distant site for the purpose of diagnostic and therapeutic assistance in the care of patients. This includes the forwarding and/or transfer of stored medical data from the originating site to the distant site through the use of any electronic device that records data in its own storage and forwards its data to the distant site via telecommunication for the purpose of diagnostic and therapeutic assistance.
The Medicaid program shall provide reimbursement for all modes of telehealth, including video and audio, audio-only, or other electronic media provided by medical providers to treat all members for all medically necessary services.
SOURCE: NH Revised Statutes 167:4-d (Accessed Dec. 2024).
Medicaid covers services delivered via telehealth, as well as remote patient monitoring and store and forward services.
SOURCE: NH Medicaid, General Billing Manual, Oct. 2023, (Accessed Dec. 2024).
New Hampshire Medicaid now covers remote patient monitoring and store & forward telehealth services as required with the passage of NH SB258 to amend RSA 167:4-d.
SOURCE: NH Division of Medicaid Services. Provider Message. Oct. 2023. (Accessed Dec. 2024).
ELIGIBLE SERVICES/SPECIALTIES
The following new procedure codes have been added to MMIS with an effective date of 10/1/2023:
- CPT code G2010 covers “remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment).” This service may be billed twice per month.
These procedure codes do not require a service authorization.
SOURCE: NH Division of Medicaid Services. Provider Message. Oct. 2023. (Accessed Dec. 2024).
GEOGRAPHIC LIMITS
No Reference Found
TRANSMISSION FEE
No Reference Found
