Medicaid Telehealth Expansion

What is telehealth?

Telehealth is audio and video contact with your doctor or health care provider using your phone, computer, or tablet. It may include:

  • Health care services
  • Getting a diagnosis
  • Consultations to discuss your treatment
  • Treatment for your medical condition

Medicaid will pay your doctor for telehealth services when they are provided to you in a way that is “functionally equivalent” to the services you would get during an in-person visit. This means you can see and hear your doctor as well as you can in person. Also, the visit should be just as safe and effective.

    What services will be included?

    The Wisconsin Department of Health Services (DHS) aims to provide more flexibility for Wisconsin Medicaid members to make it easier to receive health care. To do this, DHS will expand current permanent telehealth policy on the first day of the month after the COVID-19 federal public health emergency ends. For example, if the public health emergency ends on April 12, 2022, permanent telehealth policy will become effective on May 1, 2022.

    Services that will be available through telehealth for Wisconsin Medicaid members include:

     General health care

    Many services that are equal to the in-person service, for example:

    • Doctor’s visits: A visit with a healthcare provider to discuss a medical or behavioral health problem you have
    • Medication therapy management: Consultations with a pharmacist to review medications you are taking
     School-based services

    Health care services documented in a child’s Individual Education Program.

     Dentistry

    Consultation and care for teeth and mouth conditions.

     Targeted case management

    Services delivered by a county agency or health department to help you gain access to and coordinate medical, social, educational, vocation, and other services.

     Therapies
    • Occupational therapy
    • Physical therapy
    • Speech therapy
     Behavioral health

    Services for mental health, substance abuse, and behavioral treatment.

     Keep in touch

    • Join our email list to receive information about Medicaid telehealth expansion.
    • If you have questions, email us.

     Resources

    Members
    • FAQs about telehealth are available.
    • "Telehealth Expansion—What's New is 2020" webinar held February 2, 2022: Watch the recording and view the presentation in English (PDF)Spanish (PDF), and Hmong (PDF). Note: Information contained in the webinar materials may have changed since the publication date. Revisit this page or join our email list for the most up-to-date information. 
    Providers

    Visit the ForwardHealth Portal for more information about telehealth policy.

    Stakeholders

    Visit the Medicaid Telehealth Expansion: Stakeholder Engagement webpage for information on input sessions and workgroups.

     

    How does it work?

    There are a few ways you will be able to receive services through telehealth:

     Interactive services

    Interactive services icon, speech bubbles with camera

    Health care is delivered using communication technology, like a phone, computer, or tablet that allows two-way, real-time interaction.

    Example: You talk to your doctor on the computer where you can see and hear each other.

     

     Asynchronous services

    Asynchronous Services Icon, two computers with heartbeat logos

    Two or more people exchange information but not at the same time. One type of asynchronous service is “store-and-forward” software that allows information to be sent and received at different times.

    Wisconsin Medicaid will now cover specific asynchronous services.

    Example: You have an X-ray performed, which is then sent to your doctor to read later.

     

     Remote patient monitoring

    Remote patient monitoring icon, people with heart monitor, doctor with computer

    Technology is used to collect your medical and health data and electronically send that information securely to your health care provider for assessment and recommendations.

    Wisconsin Medicaid will now cover additional remote patient monitoring services, such as remote physiologic monitoring.

    Example: A scale you have at home automatically sends your weight to your doctor.

    What about things like immunizations that cannot be done through telehealth?

     While you can get many services through telehealth, there are some, like recommended immunizations, that need to happen in person. The easiest way to get immunizations for yourself and your children is by making an appointment with your doctor or calling your health maintenance organization. You may also be able to get shots at your local pharmacy, local health department, or at a community-based health care center. DHS can help you find an appointment near you.

     Telehealth During COVID-19

    DHS established extra flexibilities for telehealth during the COVID-19 pandemic to ensure access to health services during this critical time. These flexibilities are in addition to permanent telehealth policy, and will continue until the end of the federal public health emergency.

    Learn more about extra telehealth flexibilities during COVID-19 on the COVID-19: ForwardHealth Updates for You and Your Family webpage.

    Last Revised: April 27, 2022