Billing And Reimbursement

Billing and reimbursement are an integral part of sustaining telehealth programs and services. There are other types of sustainability models for telehealth, but billing and reimbursement is more common. Other models include contractual agreements between the provider and the patient population, as well as direct payments between patients and providers as with many direct-to-consumer mobile health applications. Regardless of which type of sustainability model is being used, it’s important to be knowledgeable about how insurance payers cover telehealth.

This section provides basic insurance information and definitions used to determine if a service is covered or not. This coverage tool shows which services are covered by South Carolina insurance payers, according to provider type, patient location and CPT service code.

The SCTA continually engages payers for additional telehealth coverage. Each year, partners agree on a list of priorities on which to focus.