Wiki E-visits when a patient resides in a different state

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Jessim929

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Hi all.
One of my docs posed this question and I am at a loss for an answer, so I hope someone can help me....
Our practice is in Las Vegas, NV. We frequently have patients that reside in Arizona or California. Is there any rule prohibiting billing an e-visit when the patient is in a different state from the doctor? Is there anything different in the documentation or billing of the visit?
Thanks!
 
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In my opinion, there is no easy answer to this one. You should look for guidance from your state medical board and check your payer guidelines. CMS has lifted some of the geographic restrictions during the COVID-19 pandemic but their changes do not override state regulations or other payer rules. We're in Ohio and the State Board of Medicine specifically states the patient must reside in the State of Ohio to be treated by an Ohio physician using telehealth.
 
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trarut said:
In my opinion, there is no easy answer to this one. You should look for guidance from your state medical board and check your payer guidelines. CMS has lifted some of the geographic restrictions during the COVID-19 pandemic but their changes do not override state regulations or other payer rules. We're in Ohio and the State Board of Medicine specifically states the patient must reside in the State of Ohio to be treated by an Ohio physician using telehealth .
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I had a feeling this was going to be the answer. That's why I deferred it to my bosses. Let them set the company policy! :) Thank you!!
 
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Our clinics provide care across state lines, but the providers are licensed in the states that their patients reside in. I agree with checking with your state medical board and payers as they may not have adopted the COVID-19 leniencies that CMS has published.
 
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