Telehealth Remains an Essential Part of Patient Care
Massachusetts law continues to require coverage for medically necessary telehealth services. However, reimbursement policies vary by payer, service type, and patient location.
Physicians should regularly review payer policies and billing requirements to ensure accurate reimbursement and compliance.
Is Telehealth Covered?
Commercial and public health plans must cover medically necessary services that can be appropriately delivered through telehealth.
Coverage generally includes:
- Audio-video telehealth services
- Behavioral health services
- Many primary care and specialty services
- Certain audio-only and asynchronous services, depending on the payer
Coverage and reimbursement requirements vary by payer.
Understanding Telehealth Reimbursement
Behavioral Health Services
Massachusetts law provides permanent payment parity for behavioral health services delivered through both audio-video and audio-only telehealth.
Other Medical Services
Reimbursement for many non-behavioral health telehealth services varies by payer.
Physicians should confirm:
- Coverage policies
- Reimbursement rates
- Billing requirements
- Documentation standards
Practicing Across State Lines
When treating patients located outside Massachusetts, physicians must comply with the laws and licensure requirements of the patient's state.
Many pandemic-era flexibilities have expired, and requirements vary significantly across states.
Why Telehealth Policy Still Matters
Telehealth has become an essential part of care delivery, but inconsistent reimbursement policies continue to create challenges for physicians and patients.
Variations in payment rates, coverage requirements, and administrative processes can affect:
- Patient access to care
- Practice sustainability
- Administrative burden
- Physician autonomy in care delivery
MMS Advocacy
The Massachusetts Medical Society continues to advocate for policies that:
- Protect telehealth payment parity
- Reduce administrative burden
- Promote consistent reimbursement policies across payers
- Preserve physician autonomy in clinical decision-making
- Expand access to virtual care
Questions? MMS Members can contact the Physician Practice Resource Center:
Phone: (800) 322-2303 ext. 7702
Email: pprc@mms.org
