PLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction. This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.
At A GlancePLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction. This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.
Last updated 08/14/2024
Telehealth means a mode of delivery of healthcare services through HIPAA compliant telecommunications systems, including information, electronic, and communication technologies, remote monitoring technologies, and store-and-forward transfers, to facilitate the assessment, diagnosis, consultation, treatment, education, care management, or self-management of a covered person’s health care while the covered person is located at an originating site and the provider is located at a distant site.
Workers’ Compensation
Telemedicine means two-way, real time interactive communication between the injured worker and the provider at a distant site. This electronic communication involves, at a minimum, audio and video telecommunications equipment. Telemedicine enables the remote evaluation and diagnosis of injured workers in addition to the ability to detect fluctuations in their medical condition(s) at a remote site in such a way as to confirm or alter the treatment plan, including medications and/or specialized therapy.
Last updated 08/14/2024
CO insurers cannot deny coverage solely because the service is provided through telehealth rather than in-person consultation or contact between the participating provider or, subject to section 10-16-704, the nonparticipating provider and the covered person where the health care service is appropriately provided through telehealth; or based on the communication technology or application used to deliver the telehealth services pursuant to this section. However, use of the word solely, may mean they can find other reasons, such as the service doesn’t meet the appropriate standard of care in the insurer’s view.
Subject to all terms and conditions of the health benefit plan or dental plan, a carrier shall reimburse the treating participating provider or the consulting participating provider for the diagnosis, consultation, or treatment of the covered person delivered through telehealth on the same basis that the carrier is responsible for reimbursing that provider for the provision of the same service through in-person consultation or contact by that provider.
According to Revised Bulletin No. B-4.89, the CO Division of Insurance interprets the above law to require reimbursement for telehealth services at no less than for in-person services, and states that carriers must continue to reimburse providers in parity with in-person rates post-COVID-19 public health emergency. In addition, the Bulletin states that payment parity applies to all medically necessary covered health care services that are appropriately provided through telehealth, including but not limited to behavioral health, mental health, substance use disorder, occupational therapy, speech therapy, physical therapy services, dental services, and remote monitoring of patients.
Last updated 08/14/2024
A health benefit plan or dental plan that is issued, amended or renewed shall not require in-person contact between a provider and a covered person for services appropriately provided through telehealth, subject to all terms and conditions of the health plan or dental plan.
Subject to all terms and conditions of the health benefit plan or dental plan, a carrier shall reimburse the treating participating provider or the consulting participating provider for the diagnosis, consultation, or treatment of the covered person delivered through telehealth on the same basis that the carrier is responsible for reimbursing that provider for the provision of the same service through in-person consultation or contact by the provider.
A carrier shall not restrict or deny coverage solely because the service is provided through telehealth or based on the communication technology or application used to deliver the telehealth services.
A health plan or dental plan is not required to pay for consultation provided by a provider by telephone or facsimile unless the consultation is provided through HIPAA compliant interactive audio-visual communication or the use of a HIPAA compliant application via a cellular telephone.
A carrier shall include in the payment for telehealth interactions reasonable compensation to the originating site for the transmission cost incurred during the delivery of health care services through telehealth except for when the originating site is a private residence.
A carrier shall not:
Workers’ Compensation
In addition to the healthcare services listed in Appendix P of CPT, and Division Z- codes (when appropriate), services aligning with the following CPT codes may be provided via telemedicine: G0396, G0397, G0406-G0408, G0425-G0427, G0447, G0459, G0508, G0509, 97129, 97130, 97150, 97542, and 97763. Additional services may be provided via telemedicine with prior authorization. The provider shall append modifier 95 to the appropriate code(s) to indicate synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system.
All treatment provided through telemedicine shall comply with the applicable requirements found in the Colorado Medical Practice Act and Colorado Mental Health Practice Act, as well as the rules and policies adopted by the Colorado Medical Board and the Colorado Board of Psychologist Examiners and shall follow applicable laws, rules and regulations for informed consent.
HIPAA privacy and electronic security standards are required for the originating site and the rendering provider.
The rendering provider may be the only provider involved in the provision of telemedicine services. The rendering provider shall bill place of service (POS) code 02. Maximum allowance is the appropriate code’s non-facility relative weight from RBRVS multiplied by the appropriate CF, unless only a facility weight is established.
An originating site fee may only be billed when the injured worker is receiving services at an authorized originating site. The originating site is responsible for verifying the injured worker and rendering provider’s identities. Originating site must bill with the appropriate facility POS code. Authorized originating sites include:
Maximum allowance for Q3014 is $35.00 per 15 minutes. (Equipment, supplies, and professional fees of supporting providers at the originating site are not separately payable.)
Documentation requirements are the same as for a face-to-face encounter and shall also include the location of both the rendering provider and the injured worker at the time of service, and a statement on how the treatment was rendered through telemedicine (such as secured video).
Treating Physician Telephone or On-line Services – Minimum required documentation elements include: (a) Total time spent on medical discussion and date; (b) The injured worker, family member, or healthcare provider spoken with; and (c) Specific discussion and/or decision(s) made during the discussion. Telephone or on-line services may be billed even if performed within the one day and seven day timelines listed in CPT®. Reimbursement for coordination of care between medical professionals is limited to professionals outside of the Provider’s practice. Telephone services, including those listed in Appendix T and Telephone Services section of CPT®, shall be billed with a modifier 93. Modified RVUs are also listed.
Teledentistry – Synchronous and asynchronous teledentistry codes are also included on the Dental Fee Schedule within the workers’ compensation system.
Last updated 08/14/2024
A health-care or mental health-care provider who delivers health-care or mental health-care services through telemedicine shall provide to each patient, before treating that patient through telemedicine for the first time, the following written statements:
This subsection shall not apply in an emergency.
For initial visits, providers must comply with the requirements posted under Waiving the Face-to-Face Requirement & Required Disclosure Statements. For each subsequent visit, providers must document the member’s consent, either verbal or written, to receive telemedicine services.
Waiving the Face-to-Face Requirement & Required Disclosure Statements
The Health First Colorado requirement for an initial face-to-face contact between provider and member may be waived when treating the member through telemedicine. In-person contact between a health care provider and a member is not required for services delivered through telemedicine that are otherwise eligible for reimbursement.
Prior to treating the member through telemedicine for the first time, the provider must furnish each member with all of the following written statements, which must be signed (electronic signatures will be accepted) by the member or the member’s legal representative:
These requirements do not apply in an emergency. [C. R. S. 2018, 25.5-5-320 (5)].
Covered telemedicine services must be provided only after the member’s consent, either verbal or written, to receive telemedicine services is documented.
All consent for telemedicine services could be verbal during the PHE. Providers must obtain written consent prior to the first visit post-PHE, as described in the Waiving the Face-to-Face Requirement & Required Disclosure Statements section of the Telemedicine Billing Manual.
Home and Community Based Services (HCBS)
HCBS waiver providers shall ensure the use of HCBS Telehealth is the choice of the Member. The HCBS waiver provider shall maintain a consent form for the use of HCBS Telehealth in the Member’s record.
When Remote Supports includes the use of live audio and/or video equipment that permits a Remote Supports Provider to view activities and/or listen to conversations in the residence, the Client who receives the service and each person who lives with the Client shall consent in writing after being fully informed of what Remote Support entails.
Early Childhood Intervention Program
Service coordinators shall ensure individualized family service plans include parental consent for telehealth methods of service.
Last updated 08/12/2024
Telemedicine means the delivery of medical and health-care services and any diagnosis, consultation, or treatment using interactive audio (including but not limited to telephone and relay calls), interactive video (including but not limited to interactive audiovisual modalities), or interactive data communication (including but not limited to live chat and excluding text messaging, electronic mail, and facsimile transmission).
Telemedicine is not a unique service, but a means of providing services approved by Health First Colorado through live interactive audio and video telecommunications equipment.
“ Telemedicine ” means the delivery of medical and health-care services and any diagnosis, consultation, or treatment using interactive audio, interactive video, or interactive data communication.
Telehealth remote monitoring services include the installation and on-going remote monitoring of clinical data through technologic equipment in order to detect minute changes in the client’s clinical status that will allow Home Health agencies to intercede before a chronic illness exacerbates requiring emergency intervention or inpatient hospitalization.
Telehealth allows for the monitoring of a member’s health status remotely via equipment, which transmits data from the member’s home to the member’s home health agency. The purpose of providing telehealth services is to assist in the effective management and monitoring of members whose medical needs can be appropriately and cost-effectively met at home through the frequent monitoring of data and early intervention.
Telemedicine is the term used when a medical provider sees a member through the use of internet connections. This technology is typically used when a member needs to see a medical specialist, but there are no acceptable specialists in the member’s service area. Telehealth is the monitoring of member’s vital signs by their Home Health nurse through electronic submission of the vital sign information from the member’s residence to the member’s Home Health Agency.
Home and Community-Based Services (HCBS)
Telehealth means the broad use of technologies to provide services and supports through HCBS waivers, when the Member is in a different location from the provider.
Telehealth means the provision of health care remotely using telecommunications technologies to provide approved services and supports through HCBS waivers when the Member is in a different location from the provider.
Early Childhood Intervention Program
Telehealth means a method of service provision that utilizes secure interactive videoconferencing to deliver early intervention services.
Behavioral Health
“Telehealth” means delivery of services through telecommunications systems that are compliant with all federal and state protections of individual privacy, to facilitate individual assessment, diagnosis, consultation, treatment, and/or service planning/case management when the individual and the person providing services are not in the same physical location. Telecommunications systems used to provide telehealth include information, electronic, and communication technologies. Telehealth may include audio-only methods in accordance with state and federal regulation unless noted otherwise.
Program of All-Inclusive Care for the Elderly (PACE)
Telehealth means a mode of delivery of health care services through HIPAA-compliant telecommunications systems, including information, electronic, and communication technologies, remote monitoring technologies and store-and-forward transfers, to facilitate the assessment, diagnosis, consultation, treatment, education, care management, or self-management of a covered person’s health care while the covered person is located at an originating site and the provider is located at a distant site.
Last updated 08/13/2024
Telemedicine may be provided through interactive audio, interactive video, or interactive data communication, including but not limited to telephone, relay calls, interactive audiovisual modalities, and live chat as long as the technologies are compliant with HIPAA. The health care or mental health care services are subject to reimbursement policies developed pursuant to the medical assistance program. Reimbursement rate must be, at minimum, the same as a comparable in-person services.
No reimbursement for provider-to-provider consultations provided by telephone (interactive audio), email or facsimile machines.
All rendering providers must bill the appropriate procedure code using Place of Service code 02 or 10 and the appropriate modifiers FQ or FR on the CMS 1500 paper claim form or as an 837P transaction.
Modifiers FQ, FR, 93, and 95 can be added to POS 02 and 10:
FQHCs/RHCs/IHS
Health First Colorado allows telemedicine visits to qualify as billable encounters for Federally Qualified Health Centers (FQHCs), Rural Health Clinic (RHCs), and Indian Health Services (IHS). Services allowed under telemedicine may be provided via telephone, live chat, or interactive audiovisual modality for these provider types.
Physical Therapy, Occupational Therapy, Home Health, Hospice and Pediatric Behavioral Health Providers
Physical therapists, occupational therapists, hospice, home health providers and pediatric behavioral health providers are eligible to deliver telemedicine services.
Behavioral Health
“Telehealth” means delivery of services through telecommunications systems that are compliant with all federal and state protections of individual privacy, to facilitate individual assessment, diagnosis, consultation, treatment, and/or service planning/case management when the individual and the person providing services are not in the same physical location. Telecommunications systems used to provide telehealth include information, electronic, and communication technologies. Telehealth may include audio-only methods in accordance with state and federal regulation unless noted otherwise.
“Session” means a face-to-face, telehealth, or audio-only interaction of the individual and personnel. Session may include but is not limited to individual therapy, group therapy, medication-assisted treatment education and/or monitoring, family therapy, peer professional services, educational/occupational groups, recreational therapy, intake, discharge, service planning, and other therapies.
Services may be provided through synchronous audio-visual methods but must not include text-only methods such as text message or email. Some services may be provided through audio-only methods according to state and federal regulations. If audio-only methods are used, the following must be noted in the individual record:
Screenings should be conducted in-person unless contraindicated. If contraindicated, screenings may be conducted via audio-visual or audio only telehealth. Clinical rationale must be documented in the case of a telehealth screening.
A peer support professional may provide services in a variety of settings, if permitted access, that may include but are not limited to audio-visual or audio-only telehealth.
Outpatient services may be delivered via in-person, audio-visual telehealth, or audio-only telehealth format in accordance with part 2.9 of these rules.
For purposes of Criminal Justice-Involved Individuals, services do not include consistent and regular in-session use of audio-only telehealth.
“Face-to-Face clinical assessment” means a formal and continuous process of collecting and evaluating information about an individual for service planning, treatment, referral, and funding eligibility as outlined in 21.190, and takes place at a minimum upon a request from the responsible person for funded services through the Children and Youth Mental Health Treatment Act. This information establishes justification for services and Children and Youth Mental Health Treatment Act funding. The child or youth must be physically in the same room as the professional person during the Face-to-Face clinical assessment. If the child is out of state or otherwise unable to participate in a Face- to-Face assessment, video technology may be used. If the Governor or local government declares an emergency or disaster, telephone may be used. Telephone shall only be used as necessary because of circumstances related to the disaster or emergency.
Screening Brief Intervention Treatment
Screening Brief Intervention Treatment may be provided via telemedicine (simultaneous audio and video transmission or by telephone audio-only) with the member.
Long Term Services and Supports (LTSS), Home and Community-based Services (HCBS), Services for Individuals with Intellectual and Developmental Disabilities, Early Childhood Intervention Services, State Funded Supported Living Services (State-SLS) Program
Upon department approval, certain eligibility determinations, assessments, referrals, and monitoring contacts may be completed by case managers at an alternate location, via telephone or using virtual technology methods. Such approval may be granted for situations in which face-to-face meetings would pose a documented safety risk to the case manager or Client (e.g. natural disaster, pandemic, etc.).
Adult Day Services (ADS)
Telehealth Adult Day Services are provided through virtual means in a group or on an individual basis. Telehealth ADS are ways for participants to engage in activities, with their community, and connect to staff and other ADS participants virtually or over the phone, only if a participant does not have access or the ability to use video chat technology. Services provided through Telehealth are not required to provide nutrition services. See rule for staffing, documentation, and written policy requirements specific to use of telehealth ADS.
Home Health Services & Family Planning Services
Eligible places of service include telemedicine, provided in accordance with Section 8.095.
Medical-Surgical
Services for which Health First Colorado assistance is not available include, but are not limited to:
Psychiatric services refer to services described in CPT under the heading “Psychiatry”. Health First Colorado benefits are available for face-to-face member contact services only. Benefits are not available for report preparation, telephone consultation, case presentations, or staff consultation.
Psychiatric providers may not bill for:
TCM Monitoring Visits
Rural travel add-ons may be billed for members residing in counties designated as rural or frontier. Rural add-on may not be billed in conjunction with telephone/virtual monitoring. This work includes monitoring the effective and efficient provision of services across multiple funding sources.
Targeted case management via telephone and video is listed as allowed. See manual.
Last updated 08/13/2024
CO Medicaid will cover medically necessary medical and surgical services furnished to eligible members.
Telemedicine services may be provided under two arrangements.
The member must be present during any Telemedicine visit.
It is acceptable to use Telemedicine to facilitate live contact directly between a member and a provider.
In-person contact between a health care or mental health care provider and a patient is not required under the state’s medical assistance program for health care or mental health care services delivered through telemedicine that are otherwise eligible for reimbursement under the program. Any health care or mental health care service delivered through telemedicine must meet the same standard of care as an in-person visit. Telemedicine may be provided through interactive audio, interactive video, or interactive data communication, including but not limited to telephone, relay calls, interactive audiovisual modalities, and live chat as long as the technologies are compliant with HIPAA. The health care or mental health care services are subject to reimbursement policies developed pursuant to the medical assistance program. This section also applies to managed care organizations that contract with the state department pursuant to the statewide managed care system only to the extent that:
The reimbursement rate for a telemedicine service shall, as a minimum, be set at the same rate as the medical assistance program rate for a comparable in-person service. The state department may consider setting the reimbursement rate on a monthly basis as well as on a daily or per-visit basis.
Interim Therapeutic Restorations
In-person contact between a health care provider and a member is not required under the state’s medical assistance program for the diagnosis, development of a treatment plan, instruction to perform an interim therapeutic restoration procedure, or supervision of a dental hygienist performing an interim therapeutic restoration procedure. A health care provider may provide these services through telehealth, including store-and-forward transfer, and is entitled to reimbursement for the delivery of those services via telehealth to the extent the services are otherwise eligible for reimbursement under the program when provided in person. The services are subject to the reimbursement policies developed pursuant to the state medical assistance program.
SOURCE: CO Revised Statutes 25.5-5-321.5 as proposed to be amended by SB 24-176 (2024 Session). (Accessed Aug. 2024).
Colorado Medicaid will reimburse for medical and mental health services delivered through telemedicine that are otherwise eligible for reimbursement under the program.
Health care or mental health care services includes speech therapy, physical therapy, occupational therapy, hospice care, home health care, substance use disorder treatment, and pediatric behavioral health care.
SOURCE: CO Revised Statutes 25.5-5-320 as proposed to be amended by HB 24-1045 (2024 Session). (Accessed Aug. 2024).
Services may be rendered via telemedicine when the service is:
All services provided through telemedicine shall meet the same standard of care as in-person care.
Refer to the Telemedicine Website for a list of billing codes which may be used with Place of Service (POS) 02 or 10.
The reimbursement rate for a telemedicine service shall, as a minimum, be set at the same rate as the medical assistance program rate for a comparable in-person service.
Providers may only bill procedure codes which they are already eligible to bill.
Place of Services codes 02 and 10 can be used during telehealth encounters:
Additionally, modifiers FQ, FR, 93, and 95 can be added to POS 2 and 10:
Physician services may be provided as telemedicine in accordance with Section 8.095.
Any Health First Colorado-covered physician services that are within the scope of a provider’s practice and training and appropriate for telemedicine may be rendered via telemedicine.
Procedure codes listed below under “Telemedicine Modifier GT” will receive an additional $5.00 to the fee listed on the most recent Health First Colorado Fee Schedule when billed using modifier GT.
All Colorado Medicaid clients are eligible for medical and behavioral services delivered by telemedicine.
Covered Telemedicine services must:
The reimbursement rate for a Telemedicine service shall, as a minimum, be set at the same rate as the Colorado Medicaid rate for a comparable in-person service.
Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Services
Other health care services may include other EPSDT benefits if the need for such services is identified. The services are a benefit when they meet the following requirements:
Durable Medical Equipment Encounters
Face-to-face encounters for durable medical equipment, prosthetics, orthotics, and supplies may be performed via telehealth if available.
Telehealth visits are allowed for reauthorization of continuous glucose monitoring in some cases.
Certain providers are authorized to order durable medical equipment and may conduct a related face-to-face encounter via telehealth or telemedicine if those services are covered by the Medical Assistance Program.
Pediatric Behavioral Therapy
Pediatric Behavioral Therapists are covered under the telemedicine policy.
Pediatric Behavioral Therapy (PBT) providers will not be required to collect Electronic Visit Verification (EVV) data when the services are delivered via telehealth, effective May 1, 2023. EVV remains a requirement for all other PBT services when delivered in the home or community.
Screening Brief Intervention Treatment
Screening Brief Intervention Treatment may be provided via telemedicine (simultaneous audio and video transmission or by telephone audio-only) with the member.
Education-Only Services
Colorado Medicaid provides reimbursement for education-only services provided through telemedicine. This includes services such as Diabetes Self-Management Education and Support (DSMES) and tobacco cessation counseling.
Education-only services was removed from the list of “Not Covered Services” section in the provider manual in June 2019.
Abortion Services
Certain medicinal abortion services may be provided by telemedicine. Physicians (MDs/DOs), Certified Nurse Midwives (CNMs), Advanced Practice Nurses (APNs) or Physician Assistants (PAs) who wish to prescribe Mifepristone must complete a Prescriber Agreement Form prior to ordering and dispensing Mifepristone. The medicinal abortion method (not available for use in maternal life-endangering situations) can be provided by these identified provider types and identified places of service effective May 21, 2021, when prescribed or dispensed and provided by eligible Mifepristone-prescribing practitioners.
HCPCS S0199 covers:
Please see Provider Bulletin for further billing information and related requirements.
FQHC/RHC
Health First Colorado allows telemedicine visits to qualify as billable encounters for Federally Qualified Health Centers (FQHCs), Rural Health Clinic (RHCs), and Indian Health Services (IHS). Services allowed under telemedicine may be provided via telephone, live chat, or interactive audiovisual modality for these provider types.
When a Federally Qualified Health Center or a Rural Health Clinic provides care through telemedicine, the claim must include the modifier GT on line(s) identifying the service(s).
When used by an FQHC or RHC, the modifier GT identifies the services as being delivered through telemedicine modality. There is no enhanced payment to FQHCs and RHCs when using the modifier GT.
For Health First Colorado a billable encounter at an FQHC and RHC is an in person or telemedicine face to face visit with a Health First Colorado member. Telemedicine services are limited to the procedure codes identified in the Telemedicine Billing Manual. Services provided via telemedicine must use modifier GT on the claim. All other claim submission information is the same.
Additionally, modifiers FQ and FR can be added to the claim:
The visit definition for a FQHC includes interactive audio (including but not limited to telephone and relay calls), interactive video (including but not limited to interactive audiovisual modalities), or interactive data communication (including but not limited to live chat and excluding text messaging, electronic mail, and facsimile transmission) encounters in accordance with Section 8.095. Any health benefits provided through interactive audio (including but not limited to telephone and relay calls), interactive video (including but not limited to interactive audiovisual modalities), or interactive data communication (including but not limited to live chat and excluding text messaging, electronic mail, and facsimile transmission) must meet the same standard of care as in-person care in accordance with Section 8.095.
Visit for a RHC means a face-to-face encounter, or an interactive audio (including but not limited to telephone and relay calls), interactive video (including but not limited to interactive audiovisual modalities), or interactive data communication (including but not limited to live chat and excluding text messaging, electronic mail, and facsimile transmission) encounter in accordance with Section 8.095 between a clinic client and any health professional providing the services set forth in 8.740.4. Any health benefits provided through interactive audio, interactive video, or interactive data communication must meet the same standard of care as in-person care.
Long Term Services and Supports (LTSS), Home and Community-based Services (HCBS), Services for Individuals with Intellectual and Developmental Disabilities, Early Childhood Intervention Services
Upon department approval, certain eligibility determinations, assessments, referrals, and monitoring contacts may be completed by case managers at an alternate location, via telephone or using virtual technology methods. Such approval may be granted for situations in which face-to-face meetings would pose a documented safety risk to the case manager or Client (e.g. natural disaster, pandemic, etc.).
Home and Community-Based Services for Persons with Intellectual and/or Developmental Disabilities Waiver Programs & Targeted Case Management for Home and Community-Based Services Waiver Programs
Targeted case management via telephone and video is listed as allowed. See manual.
Home and Community-Based Services
Home and Community-Based Services Telehealth (HCBS Telehealth) is a method of service delivery of certain HCBS services listed at Section 8.615.2.
Members eligible to use HCBS Telehealth are those enrolled in the waivers and services as defined in this rule at Section 8.7100. Additional requirements include:
HCBS Telehealth may be used to deliver support through authorized HCBS Waiver Services listed at Section 8.7559A. See Sec. 8.7559 for additional information on services authorized for consultation through telehealth, HCBS telehealth exclusions and limitations, as well as HCBS telehealth provider agency requirements, which include t hat providers that choose to use HCBS Telehealth shall develop and make available a written HCBS Telehealth Policy which includes that p roviders shall ensure the use of HCBS Telehealth is the choice of the Member. HCBS Waiver providers must be able to use a technology solution that allows real-time interaction with the Member which may include audio, visual and/or tactile technologies. Providers shall not use HCBS Telehealth to address a Member’s emergency needs.
HCBS Telehealth does not include reimbursement for the purchase or installation of Telehealth equipment or technologies. HCBS Waiver service providers utilizing Telehealth shall follow all billing policies and procedures as outlined in the Department’s current waiver billing manuals and rates/fees schedules. This includes the prohibition on collecting copayments or charging Members for missing set times for services.
Adult Day Services (ADS)
Adult Day Services (ADS) may be provided out of an Adult Day Services Center or through Non-Center-Based means including Telehealth.
Telehealth Adult Day Services are provided through virtual means in a group or on an individual basis. Telehealth ADS are ways for participants to engage in activities, with their community, and connect to staff and other ADS participants virtually or over the phone, only if a participant does not have access or the ability to use video chat technology. Services provided through Telehealth are not required to provide nutrition services. See rules for staffing, documentation, billing and written policy requirements specific to use of telehealth ADS.
Telehealth Day Habilitation services
Telehealth Specialized Habilitation services includes provider-hosted virtual meetings, groups, and activities where Members virtually engage and interact with provider staff, volunteers, and other Members.
Telehealth Supported Community Connections services includes virtual meetings, groups and activities, that are hosted by non-provider entities where Members virtually engage and interact with persons without disabilities other than those individuals who are providing services to the Member.
Program of All-Inclusive Care for the Elderly (PACE)
Telehealth is allowed for the provision of services delivered under PACE. The PACE organization must visit each participant in-person or via telehealth across all care settings as often as the participant’s condition requires, but no less than once each calendar month. If the PACE organization provides these visits via telehealth, the PACE organization must ensure the telehealth delivery option meets the following requirements:
The telehealth permissions in this section do not apply to the in-person assessment and reassessment requirements as described in 8.497.8.G. In addition to the medical record content requirements set forth in 42 CFR § 460.210(b), the PACE organization must document whether a service or visit was provided in person or via telehealth.
Mobile Crisis Response (MCR) Services
MCR services may be provided via Telemedicine in accordance with Section 8.095 by any one (1) member of the MCR provider’s team, where appropriate. The initial Telemedicine face-to-face crisis response must include at least (1) in-person responder from the MCR team.
Behavioral Health
“Session” means a face-to-face, telehealth, or audio-only interaction of the individual and personnel. Session may include but is not limited to individual therapy, group therapy, medication-assisted treatment education and/or monitoring, family therapy, peer professional services, educational/occupational groups, recreational therapy, intake, discharge, service planning, and other therapies.
The BHE may use telehealth methods for the provision of services under these regulations except for services that specifically require in-person contact. If a service is allowable via telehealth according to state and federal regulations, appropriate methods will be noted within the applicable endorsement Chapter. If an individual prefers to receive services in-person and the BHE does not offer the appropriate service in-person, the BHE shall refer the individual to another entity that offers the service in-person.
If the BHE uses telehealth methods, it must develop and implement policies and procedures regarding telehealth services, including:
Services provided via telehealth methods must be documented in the individual’s record, consistent with documentation requirements for in-person services.
Screenings should be conducted in-person unless contraindicated. If contraindicated, screenings may be conducted via audio-visual or audio only telehealth. Clinical rationale must be documented in the case of a telehealth screening.
A peer support professional may provide services in a variety of settings, if permitted access, that may include but are not limited to audio-visual or audio-only telehealth.
Early intervention services may be delivered via telehealth in accordance with the standards set in part 2.9 of these rules.
Various outpatient services may be delivered via in-person, audio-visual telehealth, or audio-only telehealth format in accordance with part 2.9 of these rules.
Walk-In crisis services follow-up communication may be conducted face-to-face, via telehealth, or via telephone only, based on an individual’s clinical need and preferences. Telehealth may be used to secure expertise for individuals served by the mobile crisis response team with a physical or I/DD.
If telehealth services do not best meet the needs of the individual and the BHE endorsed to provide DUI/DWAI programming cannot accommodate in-person services, the BHE must refer the individual to a provider that can meet the individual’s needs. Level II Four Plus must be completed as in-person services. 1. Telehealth may only be utilized if clinically indicated for the individual, or if the individual is unable to attend in-person. Documentation must be present in the individual record stating why telehealth was utilized.
BHE policies and procedures should include how telehealth services are deployed, how individual preference for in-person services are addressed, and when based on diagnosis or other need, telehealth services are not appropriate.
Essential behavioral health safety net providers offering outpatient behavioral health services must have in-person service offerings in addition to any telehealth services the agency may elect to provide.
School-Linked Health Care Services
School-linked health care services, meaning primary health-care services, behavioral health-care services, oral health-care services, or preventative health-care services, may be delivered through telehealth, mobile services, or referrals for health-care services at a clinic located near school grounds.
SOURCE: CO Statute Sec. 25-20.5-502 as proposed to be amended by SB 24-034 (2024 Session). (Accessed Aug. 2024).
School Health Services
Telehealth codes listed as eligible with GT modifier throughout manual.
Doula Services
Doula services are billed using two Healthcare Common Procedure Coding System (HCPCS) procedure codes, two International Classification of Diseases (ICD)-10 diagnosis codes, and a combination of modifier codes if services are delivered via telemedicine. The modifier codes shown below should only be used in circumstances involving telemedicine.
See billing manual for codes that are allowed via telehealth.
Doulas can provide prenatal and postpartum care in variety of settings, including the member’s home, clinics and provider offices, community-based settings or via telehealth. A full list of allowable places of service for doula services are indicated below.
Labor and delivery services (T1033) cannot be provided via telemedicine with Place of Service codes 02 or 10. While doulas must provide in-person labor and delivery support, location can vary.
Pharmacy Services
Some codes are allowed for telemedicine delivery. Refer to the Telemedicine Services web page for more detail.
Any licensed provider enrolled with Colorado Medicaid is eligible to provide telemedicine services within the scope of the provider’s practice.
All distant providers should bill the appropriate procedure code and Place of Service 02 or 10 and FQ or FR modifiers if appropriate on the CMS 1500 paper claim form or as an 837P transaction.
The following distant provider types may bill using modifier GT:
A primary care provider (PCP) is eligible to be reimbursed as the ‘originating provider’ when present with the patient. In order for a PCP to be reimbursed as a distant provider, the PCP must be able to facilitate an in-person visit in the state of CO if necessary for treatment of the member’s condition.
A specialist is eligible to be an originating provider (if present with the patient) or distant provider.
The distant provider may participate in the telemedicine interaction from any appropriate location.
When the patient is located in a hospital, please use the appropriate place of service code for where the patient is located.
Health First Colorado has expanded the list of providers eligible to deliver telemedicine services to include FQHCs, RHCs, IHS, physical therapists, occupational therapists, home health providers, hospice and pediatric behavioral health providers. Outpatient physical, occupational and speech therapy services must have an interactive audio/visual connection with the member to be provided via telemedicine.
Physical Therapists, Occupational Therapists, Hospice, Home Health Providers and Pediatric Behavioral Health Providers
Physical therapists, occupational therapists, hospice, home health providers and pediatric behavioral health providers are eligible to deliver telemedicine services.
Telemedicine is covered for behavioral health providers under the capitated behavioral health benefit administered by the Regional Accountable Entities (RAEs). Behavioral health providers should contact their RAE for guidance. Visit the Accountable Care Collaborative Phase II web page for more information.
RHC/IHS/FQHC
A telemedicine service meets the definition of a face-to-face encounter for a rural health clinic, Indian health service, or federally qualified health center. The reimbursement rate for a telemedicine service provided by a rural health clinic or federal Indian health service or federally qualified health center must be set at a rate that is no less than the medical assistance program rate for a comparable face-to-face encounter or visit.
For Health First Colorado a billable encounter at an FQHC and RHC is an in person or telemedicine face to face visit with a Health First Colorado member. Telemedicine services are limited to the procedure codes identified in the Telemedicine Billing Manual. Services provided via telemedicine must use modifier GT on the claim. All other claim submission information is the same. Additionally, modifiers FQ and FR can be added to the claim:
eHealth Entities
Providers that meet the definition of an eHealth Entity shall enroll as the eHealth specialty. Electronic Health Entity (eHealth Entity) means a group practice that delivers services exclusively through telemedicine and is enrolled in a provider type that has an eHealth specialty. eHealth entities:
eHealth Entities shall only provide Covered Telemedicine services, including Facilitated Visits. A Facilitated Visit means a Telemedicine visit where the rendering provider is at a distant site and the member is physically present with a support staff team member who can assist the provider with in-person activities. eHealth Entities must maintain a Release of Information in compliance with current HIPAA standards to facilitate communication with the member’s PCMP.
As of October 30th, 2022, there is a provider specialty type for Clinic and Non-Physician Practitioner groups that meet the following definition:
The telemedicine rule 10 CCR 2505-10 8.095 regarding eHealth entities is effective as of October 30, 2022. An eHealth entity is defined as a group practice that delivers services exclusively through telemedicine and is enrolled in a provider type that has an eHealth specialty.
Ambulatory Surgery Centers & Immunizations Manual
For distant provider use procedure code + modifier GT.
If no originating provider is present during a Telemedicine Services appointment, then the location of the originating site is at the member’s discretion and can include the member’s home. However, members can be required to choose a location suitable to delivery of telemedicine services that may include adequate lighting and environmental noise levels suitable for easy conversation with a provider.
Services can be provided via telemedicine between a member and a distant provider when a member is located in their home or other location of their choice.
A primary care provider (PCP) is eligible to be reimbursed as the ‘originating provider’ when present with the patient. In order for a PCP to be reimbursed as a distant provider, the PCP must be able to facilitate an in-person visit in the state of CO if necessary for treatment of the member’s condition.
A specialist is eligible to be an originating provider (if present with the patient) or distant provider.
If practitioners at both the originating site and the distant site provide the same service to the member, both providers submit claims using the same procedure code with modifier 77 (Repeat procedure by another physician).
Telemedicine can work:
Eligible place of service includes Telemedicine, including interactive audio (including but not limited to telephone and relay calls), interactive video (including but not limited to interactive audiovisual modalities), or interactive data communication (including but not limited to live chat and excluding text messaging, electronic mail, and facsimile transmission). Any health benefits provided through interactive audio (including but not limited to telephone and relay calls), interactive video (including but not limited to interactive audiovisual modalities), or interactive data communication (including but not limited to live chat and excluding text messaging, electronic mail, and facsimile transmission) must meet the same standard of care as in-person care.
Speech Therapy
Telemedicine POS 02 and Telehealth POS 10 are allowed place of service codes.
Therapy Providers
POS Code 02 or 10 should be used to report services delivered via telecommunication depending on the location of the member when receiving telehealth services. POS 02 is used when the member is receiving telehealth service in a place that is not their home. POS 10 is used when a member is receiving telehealth services when the member is located in their home.
Outpatient physical, occupational, and speech therapy services must have an interactive audio/visual connection with the member to be provided via telemedicine.
Physical Therapy and Occupational Therapy
Place of Service Codes
Telemedicine place of service (POS) code 02 is available for specific procedure codes. Visit the Telemedicine – Provider Information web page for a list of allowed procedure codes.
Home Health Services
Services shall be provided in the client’s place of residence or one of the following places of service: Services may be provided using interactive audio (including but not limited to telephone and relay calls), interactive video (including but not limited to interactive audiovisual modalities), or interactive data communication (including but not limited to live chat and excluding text messaging, electronic mail, and facsimile transmission) instead of in-person contact. Any health benefits provided through interactive audio, interactive video, or interactive data communication must meet the same standard of care as in-person care.
Telehealth monitoring is available for members who are eligible through the Home Health benefit and should not be billed as telemedicine. Providers rendering telehealth monitoring should consult the Home Health Billing Manual on the Billing Manuals web page under the CMS 1500 drop-down.
Family Planning Services
Eligible places of service include telemedicine provided in accordance with Section 8.095.
FQHC/RHC
FQHCs, RHCs, and IHS providers can serve as an originating site allowing a member to connect with a distant provider that is not affiliated with the originating site. The service must be submitted on a professional service claim form (the 1500). Refer to the Telemedicine Billing Manual for the coverage of the originating site procedure code.
Doula Services
Doulas can provide prenatal and postpartum care in variety of settings, including the member’s home, clinics and provider offices, community-based settings or via telehealth. A full list of allowable places of service for doula services are indicated below.
Labor and delivery services (T1033) cannot be provided via telemedicine with Place of Service codes 02 or 10. While doulas must provide in-person labor and delivery support, location can vary.
Allowed Place of Service Codes
Pediatric Behavioral Therapies
Place of Service:
Telemedicine place of service (POS) code 02 is available for specific procedure codes. Visit the Telemedicine – Provider Information web page for a list of allowed procedure codes.
Pharmacy Services
Allowed Place of Service Codes
Telemedicine place of service (POS) codes 02 and 10 are available for specific procedure codes. Refer to the Telemedicine Billing Manual for further details.
No Reference Found.
In some cases, the originating provider site will not be providing clinical services, but only providing a site and telecommunications equipment. In this situation, the telemedicine originating site facility fee is billed using procedure code Q3014.
Originating providers bill as follows:
Providers eligible for the originating site facility fee include:
Provider types not listed above may facilitate Telemedicine Services with a distant provider but may not bill procedure code Q3014. Examples include Nursing Facilities, Intermediate Care Facilities, Assisted Living Facilities, etc.
When an originating site bills Q3014 (telemedicine originating site facility fee), there is generally no rendering provider actually involved in the service at the originating site. However, a rendering provider number is still required and must be affiliated with the billing provider. The facility may enter either the member’s usual provider’s number, or another provider number affiliated with that site as the rendering provider. When the member sees a rendering provider at the originating site and also uses the site as the telemedicine originating site, the facility bills the rendered service procedure code and Q3014 for the use of the telemedicine facility. The same rendering provider number is entered in field 19D.
Using modifier GT with specific codes adds $5.00 to the fee listed for the service. A specific list of eligible codes is provided in the manual. Other codes can be billed, but don’t pay the telemedicine transmission fee.
The state department shall establish rates for transmission cost reimbursement for telemedicine services, considering, to the extent applicable, reductions in travel costs by health care or mental health care providers and patients to deliver or to access such services and such other factors as the state department deems relevant.
Ambulatory Surgery Centers & Immunizations
Telemedicine: For originating provider use procedure code Q3014.
Last updated 08/14/2024
Services appropriately billed to managed care should continue to be billed to managed care. All managed care requirements must be met for services billed to managed care. Managed care may or may not reimburse telemedicine costs.
Specialty Code 878 is a new code that will be added to the Colorado interChange for Provider Types 16 (Clinic) and 25 (Non-Practitioner). Telemedicine only providers are to use Specialty Code 878. Telemedicine and in-person providers will continue to use the appropriate specialty code for their chosen provider type. Providers choosing telemedicine can only have one specialty. The telemedicine specialty does not allow Primary Care Medical Provider (PCMP) enrollment with a Regional Accountable Entity (RAE).
Telemedicine Confidentiality Requirements
All Health First Colorado providers using telemedicine to deliver Health First Colorado services must employ existing quality-of-care protocols and member confidentiality guidelines when providing telemedicine services. Health benefits provided through telemedicine must meet the same standard of care as in-person care. Record-keeping should comply with Health First Colorado requirements in 10 CCR 2505-10, Section 8.130.2.
Transmissions must be performed on dedicated secure lines or must utilize an acceptable method of encryption adequate to protect the confidentiality and integrity of the transmission. Transmissions must employ acceptable authentication and identification procedures by both the sender and the receiver. Providers of telemedicine services must implement confidentiality procedures that include, but are not limited to:
Rural Provider Access and Affordability Stimulus Grant Program
Pursuant to C.R.S. § 25.5-1-207, the Rural Provider Access and Affordability Stimulus Grant Program provides grants to qualified providers to improve health care affordability and access to health care services in rural communities and to drive financial sustainability for rural hospitals and clinics. Rural Stimulus Grant funds must be used for Health Care Affordability Projects or Health Care Access Projects to improve health care affordability and access in Rural Communities.
Veterans Mental Health Services Program
There is established in the Division of Veterans Affairs a veterans mental health services program to promote access to mental health services for eligible veterans by reimbursing providers for sessions with an eligible veteran. The division shall reimburse providers who participate in the program for mental health-care sessions, either in person or by telehealth, with eligible veterans. Each eligible veteran may receive twenty-six reimbursed sessions per year. Subject to available appropriations, an eligible veteran may receive, and the division shall reimburse a provider for, additional reimbursed sessions if a provider determines additional sessions are necessary. The division shall determine a reasonable rate of reimbursement for each mental health-care session with an eligible veteran pursuant to the program, which rate must be the same regardless of whether the appointment is for a telehealth or an in-person appointment.
Recently Passed Legislation – Telehealth Remote Monitoring Grant Program
Legislation creates within the state department the Telehealth Remote Monitoring Grant Program to provide grants to outpatient health-care facilities located in a designated rural county or a designated health-care professional shortage area to assist the hospitals and clinics with the financial costs associated with providing telehealth remote monitoring for outpatient clinical services. See legislation for additional details on the grant program and recipient eligibility.
SOURCE: CO Revised Statutes 25.5-5-337 as proposed to be added by SB 24-168 (2024 Session). (Accessed Aug. 2024).
Recently Passed Legislation – School-Based Health Center Grant Program
Legislation expands the school-based health center grant program to provide support for innovations in school-based health care, including school-linked health-care services, with includes services provided via telehealth. Subject to available appropriations, money awarded through the grant program may also be directed to evidence-informed school-linked health-care services models, including telehealth services by a provider located in this state and mobile health units, to expand access to primary health-care services, behavioral health-care services, oral health-care services, and preventative health-care services, unless the Division determines that adequate school-linked health-care services proposals have not been submitted for the grant cycle.
SOURCE: CO Statute Sec. 25-20.5-503 as proposed to be amended by SB 24-034 (2024 Session). (Accessed Aug. 2024).
Telehealth Pilot Program – Connect to Health Pilot Project
The State of Colorado has launched a telehealth pilot program to increase local access to health services, from Julesburg to Dolores. In a collaborative effort between the Office of eHealth Innovation (OeHI) and the Colorado State Library, 17 rural libraries (representing 24 different branches) were funded to implement initiatives to increase telehealth access for their communities.
Libraries could choose to implement tele-hubs – a private space within the library that patrons can reserve to connect virtually with a healthcare provider or participate in virtual wellness services. These spaces will have the equipment and internet connectivity needed to support virtual services, and patrons can get assistance with the technology from library staff. Alternatively, some libraries chose to implement “telehealth kits,” so that patrons who have adequate connectivity at home can borrow the equipment and connect with a provider in the comfort of their home. For more information, visit the Connect to Health website.
Last updated 08/14/2024
Any licensed provider enrolled with Colorado Medicaid is eligible to provide telemedicine services within the scope of the provider’s practice. Providers that meet the definition of an eHealth Entity shall enroll as the eHealth specialty.
Electronic Health Entity (eHealth Entity) means a group practice that delivers services exclusively through telemedicine and is enrolled in a provider type that has an eHealth specialty. eHealth entities:
Last updated 08/13/2024
Colorado Medicaid reimburses for live video for medical and mental health services. They also provide reimbursement for remote patient monitoring and audio-only in certain instances. Colorado Medicaid requires a member to be present and participating in a telemedicine service, excluding the possibility of utilizing store-and-forward, except in the case of teledentistry for an interim therapeutic restoration. Colorado Medicaid also recently adopted rules to authorize e-consults through the Department’s e-consult platform, which allows asynchronous exchanges between primary care and specialty providers.
Last updated 08/13/2024
Telehealth monitoring is available for members who are eligible through the Home Health benefit and should not be billed as telemedicine. Providers rendering telehealth monitoring should refer to the Home Health Billing Manual located on the Billing Manuals web page under the CMS 1500 drop-down menu.
The CO Medical Assistance Program will reimburse for home health care or home and community-based services through telemedicine at a flat fee set by the state board.
Home care agencies and home care placement agencies rules must allow for supervision in person or by telemedicine or telehealth. Any rules adopted by the board shall be in conformity with applicable federal law and must take into consideration the appropriateness, suitability and necessity of the method of supervision permitted.
Home Health Telehealth means the remote monitoring of clinical data transmitted through electronic information processing technologies, from the client to the home health provider which meet HIPAA compliance standards.
The Home Health Agency shall create policies and procedures for the use and maintenance of the monitoring equipment and the process of telehealth monitoring. The Home Health Agency shall provide monitoring equipment that possesses the capability to measure any changes in the monitored diagnoses and meets all the safety requirements in the regulation. Home Health Telehealth services are covered for clients receiving Home Health Services for telehealth monitoring.
CO Medicaid reimburses telehealth remote monitoring services including installation and on-going remote monitoring of clinical data through technologic equipment in order to detect minute changes in the member’s clinical status that will allow Home Health agencies to intercede before a chronic illness exacerbates requiring emergency intervention or inpatient hospitalization.
CO Medicaid covers home health telehealth, which includes frequent and ongoing self-monitoring of members through equipment left in the member’s home which is designed to measure the common signs and symptoms of disease exacerbation before a crisis occurs allowing for timely intervention and symptom management.
Recently Passed Legislation – Telehealth Remote Monitoring Services for Outpatient Clinical Services
Telehealth remote monitoring means the ongoing remote assessment and monitoring of clinical data through technological equipment in order to detect changes in a member’s clinical status, which allows health-care providers to intervene before a health condition exacerbates and requires emergency intervention or inpatient hospitalization.
On or before September 1, 2024, the state department shall initiate a stakeholder process to determine the billing structure for telehealth remote monitoring for outpatient clinical services. See legislation and Telemedicine Provider Information website for more information on the stakeholder process and requirements.
On or before June 30, 2025, the state board shall promulgate rules regarding the billing structure based on feedback from the stakeholder process.
SOURCE: CO Revised Statutes 25.5-5-337 as proposed to be added by SB 24-168 (2024 Session). (Accessed Aug. 2024).
Recently Passed Legislation – Continuous Glucose Monitors Coverage
Continuous glucose monitor means an instrument or a device designed for the purpose of aiding in the treatment of diabetes by measuring glucose levels on demand or at set intervals through a small, electronic sensor that slightly penetrates an individual’s skin when applied and that is designed to remain in place and active for a least seven days. Beginning November 1, 2025, the state department shall provide coverage for a continuous glucose monitor and related supplies to members under the Medicaid Medical and Pharmacy benefit.
SOURCE: CO Revised Statutes 25.5-5-338 as proposed to be added by SB 24-168 (2024 Session). (Accessed Aug. 2024).
Continuous Glucose Monitor (CGM) Coverage – Refer to the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Billing Manual for CGM criteria with adherence to the member’s regimen and treatment plan.
TCM Monitoring Visits
Rural travel add-ons may be billed for members residing in counties designated as rural or frontier. Rural add-on may not be billed in conjunction with telephone/virtual monitoring. This work includes monitoring the effective and efficient provision of services across multiple funding sources.
A member is eligible only if they meet the following criteria:
The following requirements must be met:
Recently Passed Legislation – Telehealth Remote Monitoring Services for Outpatient Clinical Services
Beginning July 1, 2025, the state department shall provide reimbursement for the use of telehealth remote monitoring for outpatient clinical services if:
The state board shall promulgate rules regarding additional eligibility requirements. The eligibility requirements must prioritize members who are pregnant and carrying a high-risk pregnancy.
SOURCE: CO Revised Statutes 25.5-5-337 as proposed to be added by SB 24-168 (2024 Session). (Accessed Aug. 2024).
Recently Passed Legislation – Continuous Glucose Monitors Coverage
Beginning November 1, 2025, the state department shall provide coverage for a continuous glucose monitor and related supplies to members under the Medicaid Medical and Pharmacy benefit. Coverage criteria must align with the current glucose monitor local coverage determination standards issued by the Centers for Medicare and Medicaid that are used to determine coverage for Medicare-eligible individuals, including individuals with gestational diabetes not being treated with insulin. Coverage pursuant to this section includes the cost of any necessary repairs or replacement parts for the continuous glucose monitor.
SOURCE: CO Revised Statutes 25.5-5-338 as proposed to be added by SB 24-168 (2024 Session). (Accessed Aug. 2024).
Any home health agency is eligible to provide services. A specific list of agencies providing these services via telehealth is listed.
Acute home health agencies and long-term home health agencies are reimbursed for the initial installation and education of telehealth monitoring equipment and can be billed once per client per agency. The agency can also bill for every day they receive and review the client’s clinical information.
No prior authorization needed, but agencies should notify the Department or its designee when a client is enrolled in the service.
A home health-care or home- and community-based services provider who delivers services through telemedicine shall provide to each patient, before treating that patient through telemedicine for the first time, the following written statements:
The provisions of paragraph (a) of this subsection (4) shall not apply in an emergency.
Recently Passed Legislation – Telehealth Remote Monitoring Services for Outpatient Clinical Services
The assessment and monitoring of the health data transmitted by telehealth remote monitoring must be performed by one of the following licensed health-care professionals:
SOURCE: CO Revised Statutes 25.5-5-337 as proposed to be added by SB 24-168 (2024 Session). (Accessed Aug. 2024).
Home Health services are covered under Medicaid only when all of the following are met:
Reimbursement shall not be provided for purchase or lease of telemedicine equipment.
Continuous Glucose Monitor (CGM) Coverage
Refer to the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Billing Manual for CGM criteria with adherence to the member’s regimen and treatment plan. Providers must adhere to the following criteria:
Last updated 08/13/2024
The member must be present during any Telemedicine visit.
Telemedicine may be provided through interactive audio, interactive video, or interactive data communication, including but not limited to telephone, relay calls, interactive audiovisual modalities, and live chat as long as the technologies are compliant with HIPAA. The health care or mental health care services are subject to reimbursement policies developed pursuant to the medical assistance program. Reimbursement rate must be, at minimum, the same as a comparable in-person services.
Interim Therapeutic Restorations
In-person contact between a health care provider and a member is not required under the state’s medical assistance program for the diagnosis, development of a treatment plan, instruction to perform an interim therapeutic restoration procedure, or supervision of a dental hygienist performing an interim therapeutic restoration procedure. A health care provider may provide these services through telehealth, including store-and-forward transfer, and is entitled to reimbursement for the delivery of those services via telehealth to the extent the services are otherwise eligible for reimbursement under the program when provided in person. The services are subject to the reimbursement policies developed pursuant to the state medical assistance program.
SOURCE: CO Revised Statutes 25.5-5-321.5 as proposed to be amended by SB 24-176 (2024 Session). (Accessed Aug. 2024).
eConsults
Effective February 1, 2024, eConsults that meet the criteria below are a covered benefit.
An eConsult is defined as an asynchronous dialogue initiated by a Treating Practitioner seeking a Consulting Practitioner’s expert opinion without a face-to-face member encounter with the Consulting Practitioner.
Treating Practitioner is defined as a member’s treating physician or other qualified health care practitioner who is a primary care provider contracted with a Regional Accountable Entity to participate in the Accountable Care Collaborative as a Network Provider.
Consulting Practitioner is defined as a provider who has education, training, or qualifications in a specialty field other than primary care.
Providers can utilize the Department’s eConsult platform, Colorado Medicaid eConsult, or a third-party eConsult platform that meets the Department’s criteria.
Approved Third-party eConsult Platform Criteria
Treating practitioners can bill this service using Procedure Code 99452. Consulting practitioners can bill this service using Procedure Code 99451.
Treating Practitioner Reimbursement:
Consulting Practitioner Reimbursement:
A Treating Practitioner may request an eConsult with a Consulting Practitioner. eConsult services must:
eConsults that are not delivered, and responded to, through an eConsult Platform, are noncovered services.
Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs)
eConsult dialogues between Treating Practitioners and Consulting Practitioners do not meet the definition of an FQHC or RHC visit as defined in CCR 8.700. Costs associated with performing eConsults through an FQHC/RHC are considered allowable costs for the cost report and will be included in the calculation of the reimbursement rate for a patient visit at an FQHC/RHC.
Limited reimbursement allowed for an interim therapeutic restoration in teledentistry.
SOURCE: CO Revised Statutes 25.5-5-321.5 as proposed to be amended by SB 24-176 (2024 Session). (Accessed Aug. 2024).
No Reference Found
No Reference Found
Last updated 08/14/2024
See Medicaid Consent section for additional requirements applicable to Medicaid.
Colorado Medical Board
Appropriate informed consent should be obtained for a telehealth encounter including those elements required by law and generally accepted standards of practice.
Informed consents obtained in connection with an encounter involving telehealth technologies should also be filed in the medical record.
Colorado Mental Health Boards
Once a licensee, certificate holder, or registrant chooses to provide psychotherapy via electronic means, the licensee, certificate holder, or registrant is expected to carefully identify and address issues that involve implementing consent form(s) and proper disclosure(s) including, but not limited to the client’s knowledge regarding security issues, confidentiality, structure, etc.
Workers’ Compensation
All treatment provided through telemedicine shall comply with the applicable requirements found in the Colorado Medical Practice Act and Colorado Mental Health Practice Act, as well as the rules and policies adopted by the Colorado Medical Board and the Colorado Board of Psychologist Examiners and shall follow applicable laws, rules and regulations for informed consent.
Veterinarians
A veterinary professional shall obtain consent from the client before providing veterinary services through telehealth and shall record the client’s consent in the medical record.
Recently Passed Legislation – Out-of-State Telehealth Providers
A registered provider providing health-care services through telehealth to a patient located in this state shall provide health-care services in compliance with the professional practice standards applicable to a licensee, certificate holder, or registrant who provides comparable in-person health-care services in this state. Professional practice standards and laws applicable to the provision of in-person health-care services in this state, including standards and laws relating to prescribing medication or treatment, identity verification, documentation, informed consent, confidentiality, disclosures, privacy, and security, apply to the provision of health-care services through telehealth in Colorado.
SOURCE: CO Revised Statutes 12-30-124 as proposed to be added by SB 24-141 (2024 Session). (Accessed Aug. 2024).
Last updated 08/14/2024
Recently Passed Legislation – Out-of-State Telehealth Providers
On and after January 1, 2026, an applicant who possesses an out-of-state credential may provide health-care services through telehealth to patients located in this state if the applicant is registered with a regulator, as applicable to the applicant’s practice, and provides health-care services within the scope of practice established under the laws and rules of this state that apply to the applicant’s practice.
A regulator may register an applicant who does not possess a license, certificate, or registration in this state as a registered provider under this section if the applicant satisfies certain conditions. See legislation for details and requirements.
A registered provider providing health-care services through telehealth to a patient located in this state shall provide health-care services in compliance with the professional practice standards applicable to a licensee, certificate holder, or registrant who provides comparable in-person health-care services in this state. Professional practice standards and laws applicable to the provision of in-person health-care services in this state, including standards and laws relating to prescribing medication or treatment, identity verification, documentation, informed consent, confidentiality, disclosures, privacy, and security, apply to the provision of health-care services through telehealth in Colorado.
A registered provider who provides telehealth services to a patient shall:
A registered provider shall not open an office in this state and shall not provide in-person health-care services to patients located in this state unless the registered provider obtains the license, certification, or registration that the applicable regulator requires for the performance of the relevant health-care services in this state.
A registered provider providing telehealth services to a patient in this state shall disclose the following information to the patient, as applicable:
See legislation for instances when an applicable regulator may take disciplinary action against a registered provider.
SOURCE: CO Revised Statutes 12-30-124 as proposed to be added by SB 24-141 (2024 Session). (Accessed Aug. 2024).
Mental Health Providers
Limited licensure exemptions exist in CO Revised Statutes for certain mental health providers, including out-of-state practitioners as follows:
A person who resides in another state and who is currently licensed or certified as a psychologist, marriage and family therapist, clinical social worker, professional counselor, or addiction counselor in that state to the extent that the licensed or certified person performs activities or services in this state, if the activities and services are:
Colorado Medical Board
Providers who evaluate, treat or prescribe through telehealth technologies are practicing medicine. The practice of medicine occurs where the patient is located at the time telehealth technologies are used. Therefore, a provider must be licensed to practice medicine in the state of Colorado in order to evaluate or treat patients located in Colorado utilizing telehealth technologies or otherwise.
Regulations regarding the licensure and practice of physician assistants states that, for physicians and physician groups entering into collaborating agreements, physicians must be actively practicing medicine in Colorado by means of a regular and reliable physical presence in Colorado. For purposes of this Rule, to practice medicine based primarily on telecommunication devices or other telehealth technologies does not constitute “actively practicing medicine in Colorado.”
In addition, for individuals who choose to delegate medical services, a delegating physician may utilize telehealth technologies, where appropriate, to satisfy the requirements for prompt personal consultation or follow-up care, but should not rely exclusively on such telehealth technologies to perform those services.
SOURCE: 3 CCR 713-1. (Accessed Aug. 2024).
Colorado Mental Health Boards
Providers who evaluate or treat through teletherapy technologies are practicing psychotherapy. The practice of psychotherapy occurs where the patient is located at the time teletherapy technologies are used. Therefore, a provider must be licensed, certified, or registered to practice psychotherapy in the state of Colorado in order to evaluate or treat patients located in Colorado utilizing teletherapy technologies or otherwise.
Psychologists
In regard to licensed psychologists prescribing psychotropic medication for the treatment of mental health disorders, practice requirements for telemedicine include the prescribing psychologist being licensed in Colorado and having a Colorado prescription certificate to prescribe to a patient whose originating site is in Colorado as defined in section 10-16-123(4)(b), C.R.S., and adhering to the standards for care laid out for both telepsychology and psychology prescribing in Colorado and the state where the client is receiving treatment.
Prescribing psychologists licensed in Colorado must be in Colorado at the time services are provided and will only provide telemedicine services to clients whose originating site is in Colorado as defined in section 10-16-123(4)(b), C.R.S.
SOURCE: 3 CCR 721-1. (Accessed Aug. 2024).
Veterinarians
A person must be licensed to practice veterinary medicine in Colorado in order to practice telemedicine in Colorado.
Last updated 08/14/2024
“Telemedicine” means the delivery of medical services through technologies that are used in a manner that is compliant with HIPAA, including information, electronic, and communication technologies, remote monitoring technologies, and store-and-forward transfers, to facilitate the assessment, diagnosis, consultation, or treatment of a patient while the patient is located at an originating site and the person who provides the services is located at a distant site.
“Telehealth” means the delivery of medical services through technologies that are used in a manner that is compliant with HIPAA, including information, electronic, and communication technologies, remote monitoring technologies, and store-and-forward transfers, to facilitate the assessment, diagnosis, consultation, or treatment of a patient while the patient is located at an originating site and the person who provides the services is located at a distant site.
SOURCE: CO Revised Statutes 12-30-124 as proposed to be added by SB 24-141 (2024 Session). (Accessed Aug. 2024).
“Telepsychology” means the provision of psychological services using telecommunications technologies.
Colorado Medical Board
“Telehealth” means a mode of delivery of health care services through HIPAA-compliant telecommunications systems, including information, electronic, and communication technologies, remote monitoring technologies, and store-and-forward transfers, to facilitate the assessment, diagnosis, consultation, treatment, education, care management, or self-management of a covered person’s health care while the person is located at an originating site and the provider is located at a distant site.
“Telehealth” includes “Telemedicine” as defined in section 12-240-104(6), C.R.S. This policy defines “telehealth” for purposes of compliance with the Medical Practice Act. Telehealth may be defined differently in different statutory contexts, including but not limited to, insurance requirements or reimbursement.
“Telehealth technologies” means technologies and devices enabling secure electronic communications and information exchange between a licensee in one location and a patient in another location with or without an intervening healthcare provider.
Occupational Therapy
Telehealth means the use of electronic information and telecommunications technology to support and promote access to clinical health care, client and professional health-related education, public health and health administration.
Telerehabilitation or teletherapy means the delivery of rehabilitation and habilitation services via information and communication technologies, commonly referred to as “ telehealth ” technologies.
Behavioral Health Entities
Telehealth means delivery of services through telecommunications systems that are compliant with all federal and state protections of client privacy, to facilitate client assessment, diagnosis, consultation, treatment, and/or service planning/case management when the client and the individual providing BHE services are not in the same location. Telecommunications systems used to provide telehealth include information, electronic, and communication technologies.
General Hospitals
“Telehealth” means a mode of delivery of health care services through HIPAA-compliant telecommunications systems, including information, electronic, and communication technologies, remote monitoring technologies, and store-and-forward transfers, to facilitate the assessment, diagnosis, consultation, treatment, education, care management, or self-management of a person’s health care.
Nursing Care Facilities
“Telehealth” means a mode of delivery of health care services through telecommunication systems, including information, electronic, and communication technologies, to facilitate the assessment, diagnosis, consultation, treatment, education and care management of a resident’s health care when the resident and practitioner are located at different sites. Telehealth includes ‘telemedicine’ as defined in Section 12-36-102.5(8), C.R.S.”
Colorado Mental Health Boards
“Teletherapy” means a mode of delivery of mental health services through telecommunications systems, including information, electronic, and communication technologies, to facilitate the assessment, diagnosis, treatment, education, care management, or self-management of a person’s mental health care while the person is located at an originating site and the provider is located at a distant site. The term includes synchronous interactions and store-and-forward transfers.
This policy defines “telehealth” for purposes of compliance with the Mental Health Practice Act. Teletherapy may be defined differently in different statutory contexts, including but not limited to, insurance requirements or reimbursement.
“Teletherapy technologies” means technologies and devices enabling secure electronic communications and information exchange between a licensed, certified, or registered mental health professional in one location and a patient in another location with or without an intervening mental health care provider.
Veterinarians
Telehealth means the use of telecommunications technology to provide veterinary services or to collect and deliver veterinary health information or education virtually and can encompass general veterinary services or patient-specific veterinary services. Telehealth may include tele-advice, teleconsulting, tele-education, telemedicine, telemonitoring, telereferral, telesupervision, teletriage (see statute for definitions of each) and other tools that help veterinary professionals deliver veterinary education and services virtually.
Telemedicine means the remote practice of veterinary medicine through the use of telecommunications technology that allows a licensed veterinarian with an established veterinarian-client-patient relationship to evaluate, diagnose, and treat a patient virtually.
Recently Passed Legislation – Social Work Licensure Compact
Telehealth means the application of telecommunication technology to deliver social work services remotely to assess, diagnose, and treat behavioral health conditions.
SOURCE: CO Revised Statutes 12-245-411 as proposed to be added by SB 24-1002 (2024 Session). (Accessed Aug. 2024).
Last updated 08/14/2024
Member of the Audiology and Speech-Language Interstate Compact.
Member of the Interstate Licensed Professional Counselor Compact.
Member of the EMS Compact.
SOURCE: EMS Compact Map. (Accessed Aug. 2024).
Member of the Interstate Medical Licensure Compact.
Member of the Nurse Licensure Compact.
Member of the Occupational Therapy Interstate Compact.
Member of the Physical Therapy Compact.
Member of the Physician Assistant Licensure Compact.
SOURCE: PA Compact Map. (Accessed Aug. 2024).
Member of the Interjurisdictional Psychology Compact.
Member of the Social Work Licensure Compact.
* See Compact websites for implementation and license issuing status and other related requirements.
Last updated 08/14/2024
Colorado law includes in its definition of “health care services” the rendering of the services through the use of telehealth, as defined in section 10-16-123 (4)(e).
Telehealth, telerehabilitation, and teletherapy are included within the practice of occupational therapy.
Specifies certain CPT codes that may be provided via telemedicine for Workers’ Compensation. It also sets reimbursement requirements for distant site and originating site providers.
Behavioral Health Entities may use telehealth methods for the provision of services except for services that specifically require in-person contact.
If the BHE uses telehealth methods, it shall develop and implement policies and procedures regarding telehealth services. Such policies may be for the BHE, a physical location, or an endorsement, as appropriate, and shall include, at a minimum, a requirement that telehealth services be provided only through synchronous, interactive audio-visual methods, not including voice-only or text-only methods such as telephone, text message, or email.
Services provided via telehealth methods shall be documented in the client record, consistent with documentation as required for in-person services.
Statewide Electronic Registry of Advance Directives: Considerations for Telehealth
If an Electronic Affidavit is not required a n individual or their authorized surrogate may elect to meet with a Qualified Provider to discuss Advance Care Planning in person or via telehealth, but it is not required.
If an individual or their authorized surrogate elects not to discuss their documents at a visit with a Qualified Provider, the Provider is responsible for uploading their documents to the registry in a timely manner. However, the individual or their authorized surrogate are responsible for ensuring that the provider has received their documents (electronically or in hard copy) and that their Provider has uploaded their documents to the Registry.
SOURCE: 5 CCR 1006-3, VIII. (Accessed Aug. 2024).
The practice of acupuncture includes the provision of acupuncture services through telehealth.
Legislation authorizes the Director to adopt rules regarding the ability of an acupuncture aide to perform specified tasks under the supervision of an acupuncturist, including rules establishing the appropriate use of telehealth to provide acupuncture services.
The scope of practice for a hearing aid provider includes prescribing, selecting and fitting appropriate hearing instruments and assistive devices, including appropriate technology, electroacoustic targets, programming parameters, and special applications, as indicated, whether in person or through the use of telehealth.
The Behavioral Health Administration (BHA) shall In collaboration with the department of regulatory agencies, establish workforce standards that strengthen the behavioral health-care provider workforce, including telehealth providers, and increase opportunities for peer support professionals and behavioral health aides. The BHA shall also other departments to address licensing and credentialing portability issues that affect the ability of children, youth, and adults to access behavioral health-care services.
The Division of Professions and Occupations shall, on or before September 1, 2022 make recommendations to expand the portability of existing credentialing requirements through statutory changes, including the adoption of interstate compacts in order to facilitate for mental health and behavioral health-care providers the use of telehealth to practice in multiple jurisdictions.
A peer support professional may provide services on behalf of a Recovery Support Services Organization in a variety of clinical and nonclinical settings, that may include but are not limited to Services delivered via telehealth.
For individuals who choose to delegate medical services, a delegating physician may utilize telehealth technologies, where appropriate, to satisfy the requirements for prompt personal consultation or follow-up care, but should not rely exclusively on such telehealth technologies to perform those services.
SOURCE: 3 CCR 713-1. (Accessed Aug. 2024).
For purposes of Certificates of Veterinary Inspection, virtual or telemedicine inspection is not accepted.
SOURCE: 8 CCR 1201-19. (Accessed Aug. 2024).
Last updated 08/14/2024
Colorado Medical Board
Provider-patient relationships may be established using telehealth technologies so long as the relationship is established in conformance with generally accepted standards of practice. Where an existing provider-patient relationship is not present, a provider must take appropriate steps to establish a provider-patient relationship consistent with the guidelines identified in Board Policy 40-3 and listed below.
The Board defines “Provider” to include licensees regulated by the Board and the “Provider-Patient Relationship” as the mutual understanding, between a provider and patient, of the shared responsibility for the patient’s healthcare. This relationship is established when:
A “Provider-Patient Relationship” has not been established when either the identity of the provider is unknown to the patient, or the identity of the patient is not known to the provider.
It is the position of the Colorado Medical Board that it is unprofessional conduct for a provider to provide treatment and consultation recommendations, including issuing a prescription, via any means, unless a provider-patient relationship, as defined in Board Policy 40-3, has been established.
Prescribing for a patient whom the provider has not personally examined may or may not be suitable under certain circumstances. Such circumstances may include, but are not limited to, admission orders for a newly hospitalized patient, prescribing for a patient of another provider for whom the provider is taking call, or continuing medication on a short-term basis for a new patient prior to the patient’s first appointment. Providers of medical care through telehealth technologies should adhere to the guidelines articulated in Board Policy 40-27.
An appropriate medical evaluation and review of relevant clinical history, commensurate with the presentation of the patient to establish diagnoses and identify underlying conditions and/or contra-indications to the treatment recommended/provided, should be performed prior to providing treatment, including issuing prescriptions, electronically or otherwise. Treatment and consultation recommendations made in an online setting, including issuing a prescription via electronic means, will be held to the same standards of appropriate practice as those in traditional (encounter in person) settings. Treatment, including issuing a prescription based solely on an online questionnaire, does not constitute an acceptable standard of care.
Prescribing medications, in-person or via telehealth technologies, is at the professional discretion of the provider. The indication, appropriateness, and safety considerations for each telehealth visit prescription must be evaluated by the provider in accordance with current standards of practice and consequently carry the same professional accountability as prescriptions delivered during an encounter in person. However, where such measures are upheld, and the appropriate clinical consideration is carried out and documented, providers may exercise their judgment and prescribe medications as part of telehealth encounters.
The recommendation of medical marijuana via telehealth technologies is prohibited.
Pharmacists
A pharmacist shall not dispense a prescription drug if the pharmacist knows or should know that the order for such drug was issued without a valid preexisting patient-practitioner relationship. Such relationship need not involve an in-person encounter between the patient and practitioner if otherwise permissible under Colorado law. A pharmacist may, in good faith, dispense an opiate antagonist pursuant to an order that was issued without a valid preexisting patient-practitioner relationship that is approved by the Federal Food and Drug Administration for the treatment of a drug overdose.
Medical Marijuana Program
“Bona fide physician-patient relationship”, for purposes of the medical marijuana program, means:
A physician and a patient have a treatment or counseling relationship, in the course of which the physician has completed a full in-person assessment of the patient’s medical history, including an assessment of the patient’s medical and mental health history to determine whether the patient has a medical or mental health issue that could be exacerbated by the use of medical marijuana and reviewing a previous diagnosis for a debilitating or disabling medical condition, and current medical condition, including an appropriate personal physical examination. If the physician is not the patient’s primary care physician, the recommending physician shall review the existing records of the diagnosing physician or licensed mental health provider. This does not require a mental health examination prior to making a recommendation per requirements established in § 25.1.5-106, C.R.S.
Psychologists
In regard to licensed psychologists prescribing psychotropic medication for the treatment of mental health disorders, practice requirements for telemedicine include:
SOURCE: 3 CCR 721-1. (Accessed Aug. 2024).
Veterinarians
“Veterinarian-client-patient relationship” means the relationship established when:
A veterinarian-client-patient relationship established according to the above may extend to other licensed veterinarians working out of the same physical practice location as the veterinarian who established the veterinarian-client-patient relationship if the other licensed veterinarians have access to and have reviewed the patient’s medical records.
Only a licensed veterinarian may establish a veterinarian-client-patient relationship in this state. A veterinarian-client-patient relationship must be established by an in-person, physical examination of the animal or timely visits to the premises where the animal is kept. A veterinary specialist may use telecommunications technology to see a patient under another veterinarians previously established veterinarian-client-patient relationship pursuant to 12-315-306. An established veterinarian-client-patient relationship may be maintained through examinations that occur using telecommunications technology in between appropriate in-person physical examinations or visits to the premises where the patient is kept.
A licensed veterinarian shall not recommend treatment of care for an animal based solely on a client’s responses to an online questionnaire.
Only a licensed veterinarian with an established veterinarian-client-patient relationship may prescribe medication through telemedicine.
A licensed veterinarian who does not have an established veterinarian-client-patient relationship with an animal and its owner may use telemedicine to administer, distribute, or dispense a prescription drug that has been prescribed by another licensed veterinarian who has an established veterinarian-client-patient relationship.
Telereferral – A veterinarian with an established veterinarian-client-patient relationship may refer a patient to a veterinary specialist. A veterinary specialist to whom a patient is referred may provide veterinary services using telecommunications technology for the patient and client under the referring veterinarian’s veterinarian-client-patient relationship. A veterinary specialist to whom a patient is referred shall not prescribe medications to the patient unless the veterinary specialist establishes a veterinarian-client-patient relationship through an in-person, physical examination of the patient.
See legislation for additional information applicable to veterinarian use of telehealth.
Recently Passed Legislation – Out-of-State Telehealth Providers
A registered provider providing health-care services through telehealth to a patient located in this state shall provide health-care services in compliance with the professional practice standards applicable to a licensee, certificate holder, or registrant who provides comparable in-person health-care services in this state. Professional practice standards and laws applicable to the provision of in-person health-care services in this state, including standards and laws relating to prescribing medication or treatment, identity verification, documentation, informed consent, confidentiality, disclosures, privacy, and security, apply to the provision of health-care services through telehealth in Colorado.
A registered provider shall not prescribe a controlled substance, as defined in section 12-280-402 (1).
SOURCE: CO Revised Statutes 12-30-124 as proposed to be added by SB 24-141 (2024 Session). (Accessed Aug. 2024).
Last updated 08/14/2024
Colorado Medical Board
Evaluation and Treatment of the Patient: An appropriate medical evaluation and review of relevant clinical history, commensurate with the presentation of the patient to establish diagnoses and identify underlying conditions and/or contra-indications to the treatment recommended/provided, should be performed prior to providing treatment, including issuing prescriptions, electronically or otherwise. Treatment and consultation recommendations made in an online setting, including issuing a prescription via electronic means, will be held to the same standards of appropriate practice as those in traditional (encounter in person) settings. Treatment, including issuing a prescription based solely on an online questionnaire, does not constitute an acceptable standard of care.
Continuity of Care: Physicians should adhere to generally accepted standards of medical practice as it relates to continuity and coordination of care.
Referrals for Emergency Services: An emergency plan should be provided by the provider to the patient when the care provided using telehealth technologies indicates that a referral to an acute care facility or Emergency Department for treatment is necessary for the safety of the patient.
Medical Records: The medical record should include, if applicable, copies of all patient-related electronic communications, including patient-provider communication, prescriptions, laboratory and test results, evaluations and consultations, records of past care, and instructions obtained or produced in connection with the utilization of telehealth technologies. Informed consents obtained in connection with an encounter involving telehealth technologies should also be filed in the medical record. The patient record established during the use of telehealth technologies must be accessible and documented for both the provider and the patient, consistent with all established laws and regulations governing patient healthcare records.
Privacy and Security of Patient Records & Exchange of Information: Providers should meet or exceed applicable federal and state legal requirements of medical/health information privacy, including compliance with the Health Insurance Portability and Accountability Act (HIPAA) and state privacy, confidentiality, security, and medical record retention rules. Written policies and procedures should be maintained at the same standard as traditional in person encounters for documentation, maintenance, and transmission of the records of the encounter using telehealth technologies.
Parity of Professional and Ethical Standards: A provider’s professional discretion as to the diagnoses, scope of care, or treatment should not be limited or influenced by non-clinical considerations of telehealth technologies, and provider remuneration or treatment recommendations should not be materially based on the delivery of patient-desired outcomes (i.e. a prescription or referral) or the utilization of telehealth technologies.
Exemptions from Policy 40-27 Guidelines for the Appropriate Use of Telehealth Technologies in the Practice of Medicine: The Colorado Medical Board recognizes the challenges during a public health emergency. The Food and Drug Administration (“FDA”) guidelines for testing in times of a public health emergency shall guide Colorado policy for the purposes of Policy 40-27: Guidelines for the Appropriate Use of Telehealth Technologies in the Practice of Medicine.
Colorado Mental Health Boards Teletherapy Policy
Evaluation and Treatment of the Patient: An appropriate mental health evaluation and review of relevant clinical history, commensurate with the presentation of the patient to establish diagnoses and identify underlying conditions, should be performed prior to providing treatment. Treatment and consultation recommendations made in an online setting will be held to the same standards of appropriate practice as those in traditional (encounter in person) settings.
Mandatory Disclosure Statement: Appropriate mandatory disclosure statement should be obtained for a teletherapy encounter including those elements required by law and generally accepted standards of practice.
Continuity of Care: Licensees, certificate holders, and registrants should adhere to generally accepted standards of mental health practice as it relates to continuity and coordination of care.
Referrals for Emergency Services: An emergency plan should be provided by the provider to the patient when the care provided using teletherapy technologies indicates that a referral to an Emergency Department for treatment is necessary for the safety of the patient.
Mental Health Records: The mental health record should include, if applicable, copies of all patient-related electronic communications, including patient-provider communication, evaluations and consultations, records of past care, and instructions obtained or produced in connection with the utilization of teletherapy technologies. Mandatory disclosure statements obtained in connection with an encounter involving teletherapy technologies should also be filed in the mental health record. The patient record established during the use of teletherapy technologies must be accessible and documented for both the provider and the patient, consistent with all established laws and regulations governing patient healthcare records.
Privacy and Security of Patient Records & Exchange of Information: Providers should meet or exceed applicable federal and state legal requirements of mental health information privacy, including compliance with the Health Insurance Portability and Accountability Act (HIPAA) and state privacy, confidentiality, security, and medical record retention rules. Written policies and procedures should be maintained at the same standard as traditional in-person encounters for documentation, maintenance, and transmission of the records of the encounter using teletherapy technologies.
Disclosures and Functionality for Providing Online Services: Disclosures and advertising should be made in accordance with state and federal law. Parity of Professional and Ethical Standards. There should be parity of ethical and professional standards applied to all aspects of a provider’s practice. A provider’s professional discretion as to the diagnoses, scope of care, or treatment should not be limited or influenced by non-clinical considerations of teletherapy technologies, and provider remuneration or treatment recommendations should not be materially based on the delivery of patient-desired outcomes or the utilization of teletherapy technologies.
When listed, certified, registered, or licensed and treating clients within the State of Colorado, it is at the discretion of the licensee, certificate holder, or registrant as to the type of modality of treatment format that is appropriate for the client. Regardless of the modality chosen, the licensee, certificate holder, or registrant must comply with all provisions as outlined in the Mental Health Practice Act, Title 12 Article 43.
Once a licensee, certificate holder, or registrant chooses to provide psychotherapy via electronic means, the licensee, certificate holder, or registrant is expected to carefully identify and address issues that involve:
The licensee, certificate holder, or registrant may encounter specific challenges while providing psychotherapy through electronic means. The licensee, certificate holder, or registrant must realize that these challenges may include, but are not limited to:
Disclaimer: This policy applies only to mental health professionals who are certified, registered, or licensed, and treating clients within the State of Colorado.
Veterinarians
Recently passed legislation includes telehealth practice requirements for veterinarians and authorizes the Board of Veterinary Medicine to promulgate rules regarding the use of telehealth to provide veterinary services in Colorado.
