Medicaid Telehealth Expansion
What is telehealth?
Telehealth is audio and video contact with your doctor or health care provider using your phone, computer, or tablet. It may include:
- Health care services
- Getting a diagnosis
- Consultations to discuss your treatment
- Treatment for your medical condition
Medicaid will pay your doctor for telehealth services when they are provided to you in a way that is “functionally equivalent” to the services you would get during an in-person visit. This means you can see and hear your doctor as well as you can in person. Also, the visit should be just as safe and effective.
What services are included?
The Wisconsin Department of Health Services (DHS) has expanded the telehealth policy to provide more flexibility for Wisconsin Medicaid members to make it easier to receive health care.
Services available through telehealth for Wisconsin Medicaid members include:
General health care
Many services that are equal to the in-person service, for example:
- Doctor’s visits: A visit with a healthcare provider to discuss a medical or behavioral health problem you have
- Medication therapy management: Consultations with a pharmacist to review medications you are taking
School-based services
Health care services documented in a child’s Individual Education Program.
Dentistry
Consultation and care for teeth and mouth conditions.
Targeted case management
Services delivered by a county agency or health department to help you gain access to and coordinate medical, social, educational, vocation, and other services.
Therapies
- Occupational therapy
- Physical therapy
- Speech therapy
Behavioral health
Services for mental health, substance abuse, and behavioral treatment.
Keep in touch
- Join our email list to receive information about Medicaid telehealth expansion.
- If you are a Medicaid member with questions, you can contact Member Services at 800-362-3002
- If you are a Medicaid provider with questions, you can contact Provider Services at 800-947-9627
Resources
Members
- FAQs about telehealth are available.
- Join our email list for the most up-to-date information.
Providers
- Visit the ForwardHealth Portal for more information about the telehealth policy expansion.
- Visit the ForwardHealth Online Handbook for telehealth policy requirements.
How does it work?
There are a few ways you can receive services through telehealth:
Health care is delivered using communication technology, like a phone, computer, or tablet that allows two-way, real-time interaction. This may include "audio-visual" or "audio-only" communication.
Example: You talk to your doctor on the computer where you can see and hear each other. Or you talk to your doctor on the phone, where you can hear each other but not see each other.
Two or more people exchange information but not at the same time. One type of asynchronous service is “store-and-forward” software that allows information to be sent and received at different times.
Wisconsin Medicaid will now cover specific asynchronous services.
Example: You have an X-ray performed, which is then sent to your doctor to read later.
Technology is used to collect your medical and health data and electronically send that information securely to your health care provider for assessment and recommendations.
Wisconsin Medicaid will now cover additional remote patient monitoring services, such as remote physiologic monitoring.
Example: A scale you have at home automatically sends your weight to your doctor.
What about things like immunizations that cannot be done through telehealth?
While you can get many services through telehealth, there are some, like recommended immunizations, that need to happen in person. The easiest way to get immunizations for yourself and your children is by making an appointment with your doctor or calling your health maintenance organization. You may also be able to get shots at your local pharmacy, local health department, or at a community-based health care center. DHS can help find an appointment near you.