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Model State Legislation for Private Insurance Coverage of Telemedicine

The federal government, all 50 states, and the District of Columbia have taken action to further insurance coverage of telemedicine since the beginning of the COVID-19 public health emergency. With states reopening, there have been concerns that some of these positive changes such as payment parity with in-person visits, might be revoked.

APA listened to the needs of members and patients and developed model telemedicine language for states which:

  • Requires private insurers to cover telehealth and reimburse at same rate as in-person
  • Requires coverage of audio only in certain circumstances
  • Updates definitions to incorporate recent technological advances
  • Prohibits stricter forms of utilization review for telehealth
  • Prohibits insurers from requiring that a particular telehealth vendor or technology platform be used
  • Prohibits insurers from placing restrictions on prescribing through telehealth that are stricter than what is allowed under state and federal law

Download the Model Legislation Here (.docx)

APA is already working closely with many District Branches on telemedicine legislation ahead of the 2021 legislative session. If your District Branch is also interested in pursuing this or similar legislation in your state, please contact APA Government Relations at [email protected]. APA can provide you with legislative language tailored to your state’s existing statutes, as well as talking points and other advocacy assistance.

APA Telemedicine Advocacy in the States

APA is working closely with other physician organizations in support of telemedicine. APA led sign on letters which were sent to governors, insurance commissioners, the National Governors Association, the National Council of State Legislatures, and the National Association of Insurance Commissioners.

APA joined other behavioral health clinicians in supporting telehealth in the states.

Learn More About Telemedicine

APA is advocating at the federal and state levels to increase access to care via telemedicine. Visit APA's Telepsychiatry Blog to learn more about changing telemedicine requirements and our continued advocacy efforts at the federal level.

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