Medicaid Telehealth Expansion

Telehealth defined

Wisconsin Medicaid defines telehealth as a way for patients to receive care in ways other than face to face. This can include video or other types of remote communication used to deliver care to a patient or transfer medical information during:

  • Health care delivery
  • Diagnosis
  • Consultation
  • Treatment

Join our email list to receive email notices about Medicaid telehealth expansion.

If you have questions, email us at dhstelehealth@dhs.wisconsin.gov.

 

Our vision

The vision of the Wisconsin Department of Health Services (DHS) for telehealth includes expanding permanent telehealth policy to include the following service delivery methods:

 Interactive services

Interactive services icon, speech bubbles with camera

Health care is delivered using communication technology that allows two-way, real-time interaction.

  • Current permanent policy: DHS reimburses for select services.
  • New policy: DHS will reimburse for additional telehealth services that are functionally equivalent to face-to-face services (can be delivered through audio or video communication without a drop in quality, safety, or effectiveness).

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

 

 Asynchronous services

Asynchronous Services Icon, two computers with heartbeat logos

Exchanging information between two or more parties not at the same time. An example includes “store-and-forward” software that allows information to be sent and received at different times.

  • Current permanent policy: DHS reimburses limited services delivered via asynchronous or store-and-forward telehealth.
  • New policy: DHS reimburses for specific asynchronous services.

Example: Having 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 medical and other forms of health data and electronically send that information securely for assessment and recommendations. This transfer takes place between individuals and health care providers in different locations.

  • Current permanent policy: DHS covers the majority of remote patient monitoring services.
  • New policy: DHS reimburses for additional remote patient monitoring services, such as remote physiologic monitoring.

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

 

 Provider-to-provider consults

Provider to Provider icon with people symbols and speech bubbles

A provider requests the opinion and/or treatment advice from an expert consultant to help treat a patient. This does not require face-to-face contact between the patient and consultant.

  • Current permanent policy: DHS does not reimburse separately for consultations between providers regarding a member.
  • New policy: DHS may reimburse separately for consultations between providers regarding a member if they meet specified criteria.

Example: Your primary care doctor finds a strange spot on your skin and takes a picture to send to a dermatologist to diagnose and come up with a plan.

 

 Medicare parity

Medicare Parity Icon Medicaid and Medicare venn diagram

Services covered under Medicare will be covered under Medicaid when possible.

  • Current permanent policy: DHS reimburses for select Medicare services delivered via telehealth.
  • New policy: DHS reimburses for additional services covered under Medicare when possible.

 

 

Service areas

DHS is dedicated to increasing member access to care and making sure providers have what they need to deliver telehealth services. A phased approach will roll out service areas along with updates and systems changes to support them. Current work includes the following service areas:

  • School-based services
  • Provider-to-provider consults
  • Medication therapy management
  • Medicare parity
  • Targeted case management
  • Therapies (occupational therapy, physical therapy, speech therapy) 
  • Behavioral health (mental health, substance abuse, behavioral treatment)
  • Remote patient monitoring
  • Dentistry
  • Select asynchronous services

 Temporary vs. Permanent Telehealth

Temporary telehealth policy established to ensure access to health services during the COVID-19 pandemic will continue until DHS establishes permanent, expanded policy. For information on in-person and remote services during the COVID-19 pandemic, visit the COVID-19: ForwardHealth Updates for You and Your Family page.

The telehealth expansion project is in its early stages, and DHS is currently collecting stakeholder input on expanded policy.

 

Stakeholder engagement

DHS is gathering input about the launch of telehealth expansion efforts to significantly expand Wisconsin Medicaid’s permanent telehealth policy. DHS is hosting two all-inclusive input sessions and has hosted several topic-specific sessions that explain telehealth expansion policies and gather input from attendees:

Member, participant, and advocates all-inclusive webinar

DHS hosted an all-inclusive webinar for members, participants, families, and advocates. Watch the recording and view the presentation in English (PDF), Spanish (PDF), and Hmong (PDF).

Provider and provider associations all-inclusive webinar

DHS hosted an all-inclusive webinar for Medicaid providers and provider associations. Watch the recording and view the presentation (PDF).

Behavioral health input sessions

DHS hosted several input sessions specific to behavioral health topics: Crisis intervention (PDF)behavioral treatment (PDF)comprehensive community services (PDF), Community Support Program (PDF), and mental health and substance abuse (PDF).

 

Are you a provider?

Visit the ForwardHealth Portal for more information about telehealth policy.

Last Revised: August 6, 2020