Medicaid to Pay Telehealth Visits Originating from Home

By Tom Lacock
Wyoming Medical Society

Wyoming Medicaid Medical Director James Bush, MD says he hopes by the end of summer all the pieces will be put in place to allow the state to pay for telehealth visits by Wyoming Medicaid patients which originate from the patient’s home.

Currently, the Centers for Medicare and Medicaid Services (CMS) have rules on the Medicare side requiring telehealth visits originate from specific sites such as physician offices, nursing facilities and hospitals. Bush said he has found language from other state Medicaid programs that could allow Wyoming patients to see providers from their home and still allow the provider to be paid, as long as they are an enrolled Wyoming Medicaid provider.

Along the way, he hopes to save the state money in two ways. The first is by saving the $25 per visit cost the state pays to originating offices for telehealth visits when a patient comes to their office to originate a telehealth visit. He also hopes to reduce the over $1 million a year the state pays for Medicaid patients to travel to see specialists face-to-face. This strategy should also help address indirect costs to the patients who often time have to leave work or school for a day to travel to see a specialist.

Bush hopes to send notification that the state is ready to pay for telemedicine visits originating from a patient’s home sometime this summer, if not fall. Physicians interested in participating in the program should sign up through the Wyoming Telehealth Network ( or call 766-2948), which will give the provider a free license to use the Zoom teleconference tool. Physicians may then send a meeting invitation through Zoom to a patient. This is the same Telehealth Network many physicians are already using to see patients around the state. Bush adds he will not limit the uses for telehealth visits.

“If there is any code not open that a doc wants to use for telemedicine, they just need to tell me what it is and we open it up,” says Bush. “The world is rapidly changing and the doc has to make determination that it is medically appropriate to provide this service via telehealth. If it is, I won’t stand in the way. If it isn’t the physician is risking their license, so I think the physicians will be conservative.”