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Remote Patient Monitoring Indiana

Indiana Code requires Medicaid to reimburse providers for remote patient monitoring who are licensed as a home health agency for telehealth services.


Source: IN Code, 12-15-5-11(c). (Accessed Sept. 2019). 


Conditions


The member must be receiving services from a home health agency. Member must initially have two or more of the following events related to one of the conditions listed below within the previous twelve months:


• Emergency room visit
• Inpatient hospital stay


An emergency room visit that results in an inpatient hospital admission does not constitute two separate events.


Member must have one of the following conditions:


• Chronic obstructive pulmonary disease
• Congestive heart failure
• Diabetes


Source: IN Admin Code, Title 405, 5-16-3.1(d) & IN Medicaid Telemedicine and Telehealth Module, Mar. 14, 2019, p. 12. (Accessed Sept. 2019). 


Provider Limitations


Reimbursement for home health agencies under certain conditions. A registered nurse must perform the reading of transmitted health information provided from the member in accordance with the written order of the physician.


Source: IN Admin Code, Title 405, 5-16-3.1(d)(5) (Accessed Sept. 2019). 

Treating physician must certify the need for home health services and document that there was a face-to-face encounter with the individual.


Source: IN Admin Code, Title 405, 5-16-3.1(e) (Accessed Sept. 2019).


Prior authorization is required for all telehealth services and must be submitted separately from other home health service prior authorization requests. Services may be authorized for up to 60 days. See Telehealth Module for additional requirements.


Source: IN Medicaid Telemedicine and Telehealth Module, Mar. 14, 2019, p. 12. (Accessed Sept. 2019). 


Member must also be receiving or approved for other IHCP home health services. 


Source: IN Medicaid Telemedicine and Telehealth Module, Mar. 14, 2019, p. 12. (Accessed Sept. 2019).