U.S. Telemedicine Policies: State-by-State Licensing, Reimbursement, And Regulations.pdf

State-by-State Overview (Updated September 2024)

## Licensure Requirements

- All States: Physicians engaging in telemedicine must be licensed in the state where the patient is located or registered in a state with an interstate practice registry.
- 10 States + Virgin Islands: Issue a special purpose/telemedicine license for cross-state practice.
- 9 States: Require registration or a waiver for interstate practice.
- 3 States + D.C.: Offer regional/proximal reciprocity.
- 1 State: Allows pro bono interstate practice.
- 39 States + D.C./Virgin Islands: Have licensure exceptions and/or consultation exceptions for services rendered across state lines.

## Medicaid Reimbursement

- All 50 States & D.C.: Provide reimbursement for live video in Medicaid fee-for-service.
- 33 States: Reimburse for store-and-forward.
- 37 States: Reimburse for remote patient monitoring.
- 43 States + D.C.: Reimburse for audio-only.
- 25 States: Reimburse for all four methods with certain limitations.

## Private Payer Laws

- 43 States + D.C., Virgin Islands: Govern private payer telehealth reimbursement policies.
- 40 States + D.C., Virgin Islands: Have private payer parity laws.

## Other Rules/Regulations/Guidelines (Select States)

Alabama:
- Live Video, Store-and-Forward, Remote Patient Monitoring, Audio-only
- Licensure exceptions and consultation exceptions for cross-state services

Arizona:
- Live Video, Store-and-Forward, Remote Patient Monitoring, Audio-only
- Registration required for interstate practice
- Payment parity

California:
- Live Video, Store-and-Forward, Remote Patient Monitoring, Audio-only
- Reimbursement through CTBS limits codes and amounts

Colorado:
- Live Video, Store-and-Forward, Remote Patient Monitoring, Audio-only
- Payment parity

Connecticut:
- Live Video, Store-and-Forward, Remote Patient Monitoring, Audio-only
- No specific exceptions noted

Delaware:
- Live Video, Store-and-Forward, Remote Patient Monitoring, Audio-only
- Licensure and registration requirements for interstate practice

Florida:
- Live Video, Store-and-Forward, Remote Patient Monitoring, Audio-only
- Special purpose/telemedicine license allowed across state lines

Georgia:
- Live Video, Store-and-Forward, Remote Patient Monitoring, Audio-only
- May issue special purpose licenses for cross-state practice
- Payment parity

Hawaii:
- Live Video, Store-and-Forward, Remote Patient Monitoring, Audio-only
- Reimbursement through specific statutes and regulations

Idaho:
- Live Video, Store-and-Forward, Remote Patient Monitoring, Audio-only
- Guidelines for appropriate telemedicine regulation (2020)

Illinois:
- Live Video, Store-and-Forward, Remote Patient Monitoring, Audio-only
- Reimbursement through specific laws and regulations
- Payment parity

(Other states' details are available in the original text.)