SB 56
Allowing reimbursement for remote ultrasound procedures and fetal nonstress tests
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- Passed Senate
- Passed House of Delegates
- To Governor
- Became Law
Bill overview
This bill would allow West Virginia Medicaid to reimburse for remote ultrasound procedures and fetal nonstress tests. It requires the Department of Human Services to cover these services when a patient is located outside of their provider’s office, as long as the same standard of care is maintained. The bill outlines specific technological requirements for these remote procedures, including HIPAA compliance and FDA approval. It also removes a previous requirement for a 30-day gap between informed consent and the procedure.
Key provisions
- Allows reimbursement for remote ultrasound procedures.
- Allows reimbursement for remote fetal nonstress tests.
- Reimbursement is permitted when the patient is not at their provider’s office.
- Requires adherence to the same standard of care as in-person procedures.
- Specifies technological requirements: HIPAA compliance, FDA approval, and digital data transmission.
- CPT Code 59025 for fetal nonstress tests requires a place of service modifier for at-home monitoring.
- Removes the 30-day consent gap requirement.
- The Department of Human Services will issue guidance on implementation.
Who is affected
- West Virginia Medicaid recipients
- Pregnant women in West Virginia
- Healthcare providers offering remote ultrasound and fetal nonstress tests
- The Department of Human Services
Notable changes
- Expands Medicaid coverage to include remote ultrasound and fetal nonstress tests.
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