Chapter 6Medicaid Billing

The passage of House Bill 15-1029 (Health Care Delivery Via Telemedicine Statewide) on March 20, 2015 expanded telehealth services statewide and required insurance carriers to reimburse providers for the delivery of health care services via telehealth. This bill includes dental in the definition of healthcare services. The bill precludes a health benefit plan from requiring in-person care delivery when telemedicine is appropriate, regardless of the geographic location of the health care provider and the recipient of care. A provider need not demonstrate that a barrier to in-person care exists for coverage of telemedicine under a health benefit plan to apply.

The telehealth bill made Virtual Dental Home models, like the SMILES Dental Project®, financially beneficial to both dental providers and communities. Reducing barriers to oral health care for Coloradans expands access and saves money by reducing the need for costly procedures and emergency room visits that often result from chronic and advanced dental disease.

The resources and links in this chapter include Medicaid billing guidelines and additional documents on fee schedules and billing.