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    v1.0.31
    OpenPayerPolicy UpdatesAdministrative/Operational PolicyNew Hampshire DHHS Telehealth Coverage | OpenPayer
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    CurrentNew Hampshire Department of Health and Human ServicesPolicy Emergency Order #8

    Temporary expansion of access to Telehealth Services to protect the public and health care providers

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    This emergency order requires regulated health insurance carriers, authorized health benefit plans, and New Hampshire Medicaid programs to allow in-network providers to deliver clinically appropriate, medically necessary covered services through telehealth. It also establishes payment parity, COVID-19 cost-sharing protections, and no restrictions on eligible originating sites.

    Policy Summary
    PayerNew Hampshire Department of Health and Human Services
    PolicyTemporary expansion of access to Telehealth Services to protect the public and health care providers
    Policy CodePolicy N/A
    Change TypeEmergency telehealth expansion
    Effective DateMar 17, 2020
    Next Review DateN/A
    Key ActionAllow and provide clinically appropriate, medically necessary covered services through telehealth using video, audio-only, or other electronic media.
    SourceLink
    POLICY UPDATE CHANGES

    Requires applicable health plans to allow in-network providers to deliver medically necessary covered services through all telehealth modalities, including video, audio-only, and other electronic media.

    Requires carriers to pay in-network telehealth services at rates no lower than the rates for corresponding traditional in-person services.

    Requires coverage without copayments, deductibles, or coinsurance for medically necessary COVID-19 treatment delivered via telehealth by in-network providers.

    Removes restrictions on eligible originating sites for telehealth services.

    OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.

    All modesPermitted telehealth modalities
    100% parityPayment rate protection
    $0COVID-19 treatment cost-sharing
    NoneOriginating-site restrictions
    MultipleEligible provider types

    Telehealth Coverage and Cost-Sharing Requirements

    COVID-19 telehealth cost-sharing waiver

    COVID-19-related telehealth treatment receives enhanced cost-sharing protection when all of the following conditions apply:

    ALL of the following

    • The medically necessary treatment is related to COVID-19.
    • The treatment is delivered via telehealth by an in-network provider.
    • No copayment, deductible, or coinsurance is charged.

    Required Provider and Carrier Actions

    Note

    Deliver covered services through telehealth

    Allow and provide clinically appropriate, medically necessary covered services to members through telehealth. Covered modalities include video and audio, audio-only, and other electronic media.

    Billing Rule

    Maintain telehealth payment parity

    Bill telehealth services according to carrier instructions. Payment rates for in-network telehealth services must be no lower than the rates established for corresponding traditional in-person services.

    Billing Rule

    Waive cost-sharing for COVID-19 telehealth treatment

    Do not impose copayments, deductibles, or coinsurance on medically necessary treatment related to COVID-19 when delivered via telehealth by an in-network provider.

    Billing Rule

    Permit all eligible originating sites

    Accept telehealth services without restricting the eligible originating site. The originating site may include the patient's home and other listed locations.

    • Practitioner's offices
    • Schools
    • Hospitals, including critical access hospitals and hospitals with renal dialysis centers
    • Skilled nursing facilities
    • FQHCs and RHCs
    • Community mental health centers

    Telehealth Terms

    Originating site
    DefinitionThe location of the member at the time the telehealth service is furnished via a telecommunications system.
    Eligible locationsExamples include a practitioner's office, a patient's home, schools, hospitals, skilled nursing facilities, FQHCs/RHCs, and community mental health centers.
    Site restrictionThere shall be no restriction on eligible originating sites for telehealth services.
    Telehealth
    DefinitionVideo and audio, audio-only, or other electronic media used by medical providers to deliver health care services remotely.
    Permitted modalitiesTelehealth includes video and audio, audio-only, and other electronic media.
    Policy Summary
    PayerNew Hampshire Department of Health and Human Services
    PolicyTemporary expansion of access to Telehealth Services to protect the public and health care providers
    Policy CodePolicy N/A
    Change TypeEmergency telehealth expansion
    Effective DateMar 17, 2020
    Next Review DateN/A
    Key ActionAllow and provide clinically appropriate, medically necessary covered services through telehealth using video, audio-only, or other electronic media.
    SourceLink
    On This Page
    Telehealth Coverage and Cost-Sharing RequirementsRequired Provider and Carrier ActionsTelehealth Terms
    UseMedical providers may use telehealth to treat members for medically necessary covered services.