Telehealth means the delivery of medically necessary

“Telehealth means the delivery of medically necessary somatic or behavioral health services to a
patient at an originating site by distant site provider, through the use of technology-assisted commu-
nication.”
Source: Code of Maryland Admin. Regs. Sec. 10.09.49.02. (Accessed Sept. 2019).
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Policy
Reimbursement for telehealth is required for services appropriately delivered through tele-
health and may not exclude from coverage a health care service solely because it is through
telehealth.
The Department may require providers to submit a registration form to include information
required for the processing of telehealth claims.
Source: MD General Health Code Sec. 15-105.2 & Insurance Code 15-139. (Accessed Sept. 2019).
Managed Care
MCOs shall provide coverage for medically necessary telemedicine services.
Source: Code of Maryland Admin. Regs. Sec. 10.09.67.31. (Accessed Sept. 2019).
Maryland Medicaid provides a telehealth program that employs a “hub-and-spoke” model.
Communication must be in real time, and the participant must be at an originating site with a
telepresenter.
Source:
MD Medicaid Telehealth Program. Telehealth Provider Manual, p. 1. Updated May 2, 2018. (Accessed Sept. 2019).

© 2019 Public Health Institute / Center for Connected Health Policy
MARYLAND / 2
Medicaid Telehealth Reimbursement
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Policy
Mental Health
The Department shall grant approval to a telemental health provider to be eligible to receive
State or federal funds for providing interactive telemental health services if the provider
meets requirements of this chapter and for outpatient mental health centers; or if the tele-
mental heath provider is an individual psychiatrist.
Source:
Code of Maryland Admin. Regs. Sec. 10.21.30.03. (Accessed Sept. 2019).
Eligible Services / Specialties
Covered Services - Somatic and behavioral health services: Providers must contact the par -
ticipant’s Healthchoice MCO or Beacon Health Option with questions regarding prior authori -
zation requirements for telehealth services.
Source: MD Medicaid Telehealth Program. Telehealth Provider Manual, p. 2. Updated May 2, 2018. (Accessed Sept. 2019).
Medically necessary services are covered by the Maryland Medical Assistance Program as
long as they are:
• Distinct from services provided by the originating site provider;
• Able to be delivered using technology-assisted communication; and
• Clinically appropriate to be delivered via telehealth;
Source:
Code of Maryland Admin. Regs. Sec. 10.09.49.05. (Accessed Sept. 2019).
Services should be billed with the GT modifier.
Source: Code of Maryland Admin. Regs. Sec. 10.09.49.11. (Accessed Sept. 2019).
Mental Health Eligible Services:
• Diagnostic interview;
• Individual therapy
• Family therapy
• Group therapy, up to 8 individuals
• Outpatient evaluation and management
• Outpatient office consultation
• Initial inpatient consultation
• Emergency department services
Source: Code of Maryland Admin. Regs. Sec. 10.21.30.09. (Accessed Sept. 2019).