C.M.R. 10, 144, ch. 101, ch. I, § 144-101-I-4, subsec. 144-101-I-4.05

Current through 2024-46, November 13, 2024
Subsection 144-101-I-4.05 - NON-COVERED SERVICES AND LIMITATIONS
A. Except as set forth herein, services not otherwise covered by MaineCare are not covered when delivered via Telehealth Services.
B. Services covered under other MaineCare Sections but specifically excluded from Telehealth coverage include, but are not limited to the following:
1. Services that require direct physical contact with a Member by a Health Care Provider and that cannot be delegated to another Health Care Provider at the site where the Member is located are not covered;
2. Any service medically inappropriate for delivery through Telehealth Services - e.g. services that include providing medical procedures or administration of medications that must be conducted in person.
C. Except as set forth herein, reimbursement will not be provided for communications between Health Care Providers when the Member is not participating.
D. Except as set forth herein, reimbursement will not be provided for communications solely between Health Care Providers and Members when such communications would not otherwise be billable.
E. The Originating Site Fee may be paid only to a Health Care Provider.

C.M.R. 10, 144, ch. 101, ch. I, § 144-101-I-4, subsec. 144-101-I-4.05