ASPE ISSUE BRIEF: State Medicaid Telehealth Policies Before and During the COVID-19 Public Health Emergency

ASPE ISSUE BRIEF: State Medicaid Telehealth Policies Before and During the COVID-19 Public Health Emergency

This ASPE issue brief examines state Medicaid telehealth coverage and policies before and after the COVID-19 PHE was declared in January 2020.

KEY POINTS

Some state Medicaid programs have been innovators and early adopters of telehealth for the delivery of services, often paying for care via telehealth not traditionally covered by Medicare. For instance, even before the PHE, 47 states allowed for behavioral services to be delivered via telehealth and 36 states did so for primary care.
Since the COVID-19 PHE, states have significantly expanded beneficiary access to telehealth for the delivery of Medicaid-covered services and providers, with all states now covering primary care and behavioral health services delivered via telehealth.
Many states have expanded coverage for telehealth modalities to include telephone-only, text-based communication, and remote patient monitoring, as well as authorizing patients’ homes as an originating site.
At least 42 states and the District of Columbia now specify that some covered telehealth services are paid at the same rate as in-person services.
Claims data show that services delivered via telehealth increased more than 20-fold, from roughly 6 telehealth services per 1,000 Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries in February 2020 to over 150 per 1,000 in April 2020. Rates declined after April but still remained far above the pre-pandemic level
Research shows that Medicaid beneficiaries, as well as patients who are older, people of color, those with limited English proficiency, and have lower incomes, have lower rates of visits delivered via telehealth during COVID-19 than other populations, especially visits by video.