Telemedicine

The delivery of healthcare services remotely using telecommunications technology, which may require separate state licensure and specific payer credentialing for providers practicing across state lines.

Telemedicine is the delivery of healthcare services through technology, typically video visits, phone consultations, or remote patient monitoring. It has been around for decades but exploded during the COVID-19 pandemic and is now a permanent fixture in healthcare. The credentialing implications of telemedicine are significant. The fundamental rule is that you need to be licensed in the state where the patient is located at the time of the visit, not where you are located. If you are sitting in Texas doing a video visit with a patient in California, you need a California medical license. This means telehealth providers who see patients in multiple states need to maintain licenses and credentialing in every state they serve. The costs and administrative burden add up fast. The Interstate Medical Licensure Compact helps by streamlining the licensing process, but it does not eliminate the need for separate licenses. Payer credentialing for telehealth has its own quirks. Some payers credential telehealth providers through a streamlined process. Others require the full standard credentialing process regardless of whether you are seeing patients in person or virtually. Some payers require you to have a physical practice location in the state even if you are providing services exclusively via telehealth. Reimbursement for telehealth services varies by payer and by state. Some states have telehealth parity laws that require payers to reimburse telehealth visits at the same rate as in-person visits. Others allow lower reimbursement rates. Medicare has expanded its telehealth coverage significantly since 2020, but some of those expansions are temporary and subject to legislative renewal. If you are building a telehealth practice, start the credentialing process early for every state you plan to serve. It can take several months to get licensed and credentialed across multiple states, and you cannot see patients until both are in place.