Medicaid payment for telerehabilitation.

OBJECTIVE: To assess current payment practice for telerehabilitation in state Medicaid programs.
DESIGN: Telephone survey.
SETTING: State Medicaid programs. PARTICIPANTS: State Medicaid directors.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Descriptive.
RESULTS: Half of the 35 state Medicaid programs contacted reimbursed at least some telemedicine services other than radiology in 2002. The primary reason for reimbursing for telemedicine is to make services available when there is no local practitioner. Consultation and evaluation and management services were most likely to be reimbursed (12 states). Seven state programs reimbursed telepsychology, and 4 states reported reimbursing for telespeech and language pathology, physical therapy, or occupational therapy.
CONCLUSIONS: Telemedicine helps Medicaid programs deliver specialized care to locations with provider shortages. Telerehabilitation is not yet widespread, despite its potential benefit to people with disabilities who cannot travel to a clinic for rehabilitation therapy. Most Medicaid programs calculate the financial costs and patient benefits when considering payment policies, and about half of states require a state law to allow payment for telerehabilitation. Minnesota, Hawaii, and Nebraska, among the responding states, currently reimburse for telerehabilitation. Research is needed to evaluate the appropriateness of telerehabilitation for Medicaid beneficiaries.