Tennessee Code Title 71. Welfare § 71-5-168

Current as of January 02, 2024 | Updated by Findlaw Staff

(a) As used in this section, “CPT code” means the unique numerical designations established by the American Medical Association for various medical, surgical, and diagnostic services used in billing healthcare services.

(b) No later than December 31, 2024, the bureau of TennCare shall amend existing rules, or promulgate new rules, on fee-for-service and medicaid managed care plans regarding reimbursement to allow for the reimbursement of remote ultrasound procedures and remote fetal nonstress tests utilizing established CPT codes for such procedures when the patient is in a residence or other off-site location that is separate from the patient's provider and the same standard of care is met.

(1) A remote ultrasound procedure or remote fetal nonstress test is only reimbursable when the provider uses digital technology:

(A) To collect medical and other forms of health data from a patient and electronically transmit that information securely to a healthcare provider who is in a separate location for the purpose of interpretation and making recommendations;

(B) That is compliant with the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA)(42 U.S.C. § 1320d et seq.); and

(2) A fetal nonstress test is only reimbursable with a place of service modifier for at-home monitoring with remote monitoring solutions that are cleared by the federal food and drug administration for on-label use for monitoring fetal heart rate, maternal heart rate, and uterine activity.

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Cite this article: FindLaw.com - Tennessee Code Title 71. Welfare § 71-5-168 - last updated January 02, 2024 | https://codes.findlaw.com/tn/title-71-welfare/tn-code-sect-71-5-168/

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