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CMS Guidance on Telehealth for Rural Health, Substance Use Treatment

In an information bulletin, the Centers for Medicare & Medicaid Services’ (CMS’) Center for Medicaid and CHIP Services provides guidance on Medicaid services furnished via telehealth for rural health care and substance use disorder (SUD) treatment.

Guidance on Rural Health Services

The bulletin starts by providing background on barriers to care that rural communities face and how to leverage telehealth to provide needed care and services. Under Medicaid, states have broad flexibility in designing telehealth delivery systems, as long as all statutory requirements are met. States also can leverage these flexible options through contracting with managed care plans to encourage adoption of telehealth services. The bulletin gives guidance on payment for services provided via telehealth and when state plan amendments are necessary to incorporate telehealth services. Last, it summarizes national trends in Medicaid telehealth.

Guidance on SUD Treatment via Telehealth

The second part of the bulletin fulfills the SUPPORT for Patients and Communities Act (H.R. 6) requirement that CMS issue guidance to states on opportunities for Medicaid SUD treatment services via telehealth delivery systems and federal reimbursement for those services.

The bulletin summarizes the general services that states can provide via telehealth, including assessment, medication-assisted treatment, counseling, and medication management. Further, it provides guidance on providing services and treatment to high-risk individuals, such as American Indians and Alaska natives, beneficiaries with a history of overdose, and pregnant women.

States have significant flexibility in designing delivery system and payment models for telehealth services to beneficiaries with SUD. The bulletin gives examples of using hub-and-spoke models, managed care contracts, and administrative funds and provides guidance for offering SUD telehealth services in school-based health centers.

The bulletin includes a list of questions for states to consider when expanding telehealth services, as well as appendices with examples of how states are using telehealth for Medicaid beneficiaries with SUD and additional federal funding streams.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Zina Gontscharow is a former senior policy analyst for America's Essential Hospitals.

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