Counselors
Counselors are to follow ACA’s Code of Ethics.
Social Workers
We are not aware of any specific rules and regulations of the practice of telemental health services for Social Workers.
Marriage and Family Therapists
Marriage and Family Therapists are to follow AAMFT’s Code of Ethics.
Psychologists
We are not aware of any specific rules and regulations of the practice of telemental health services for Psychologists.
Psychiatrists
We are not aware of any specific rules and regulations of the practice of telemental health services for Psychiatrists.
Medicaid Telehealth Parity Law
Sources: SD Medicaid Billing and Policy Manual: Telemedicine, p. 7 (Jul. 2019)
¨Reimbursement
Providers must bill for services at their usual and customary charge. Providers are reimbursed the lesser of their usual and customary charge or the fee schedule rate. The maximum allowable reimbursement for distant site services is listed on the applicable fee schedule. The maximum allowable amount for services provided via telemedicine is the same as services provided in-person."
Refer to the source provided for all requirements and limitations.
Source: SD Medicaid Billing and Policy Manual: Telemedicine, p. 3 (Jul. 2019)
Originating Site Reimbursement:
Originating sites listed in the eligible provider section are eligible to receive a facility fee for each completed telemedicine transaction for a covered distant site telemedicine service. Sites not listed may also serve as an originating site but are not eligible for reimbursement. The originating site and distant site must not be located in the same community unless the originating site is a nursing facility. This applies regardless of whether the originating site is eligible for reimbursement from South Dakota Medicaid. Originating site are not reimbursed for any additional costs associated with equipment, technicians, technology, or personnel utilized in the performance of the telemedicine service.
Private Pay Telehealth Parity Law
Source: SD Codified Laws Ann. § 58-17-168. (SB – 137)
¨No health insurer may exclude a service for coverage solely because the service is provided through telehealth and not provided through in-person consultation or contact between a health care professional and a patient. Health care services delivered by telehealth must be appropriate and delivered in accordance with applicable law and generally accepted health care practices and standards prevailing at the time the health care services are provided, including rules adopted by the appropriate professional licensing board having oversight of the health care professional providing the health care services. Health insurers are not required to provide coverage for health care services that are not medically necessary.
Refer to the source provided for all requirements and limitations.
Payment Parity
We are not aware of any explicit payment parity.
*Clinicians who have had an experience with telehealth reimbursement in this state are invited to share their experiences in the comments section below: a) type of service provided; b) insurance provider; c) payment parity, payment issues, or insurance requirements.
Permission for the Temporary Practice of Clinicians Licensed Outside the State
We are not aware of any permission that allows for services delivered by out-of-state providers.
Social Workers
We are not aware of any specific rules and regulations of the practice of telemental health services for Social Workers.