Remote Patient Monitoring Washington

The Washington State Medicaid agency covers the delivery of home health services through telemedicine for clients with a high risk of sudden change in medical condition which could compromise health outcomes and prescription drug monitoring.

Source: WA State Health Care Authority, Medicaid Provider Guide, Home Health Svcs. (Acute Care Svcs.), p. 29 (Jul. 2019). (Accessed Aug. 2019). 

Conditions

Services are provided for clients who have been diagnosed with an unstable condition, and who may be at risk for hospitalization or a more costly level of care.
Coverage is limited to one telemedicine interaction, per patient, per day, based on the ordering licensed practitioner’s care plan.

Source: WA State Health Care Authority, Medicaid Provider Guide, Home Health Svcs. (Acute Care Svcs.), p. 29 (Jul. 2019). (Accessed Aug. 2019). 

Provider Limitations

Must be provided by a Registered Nurse or Licensed Practical Nurse.
The Medicaid agency does not require prior authorization for the delivery of home health services through telemedicine.

Source: WA State Health Care Authority, Medicaid Provider Guide, Home Health Svcs. (Acute Care Svcs.), p. 29-30 (Jul. 2019). (Accessed Aug. 2019). 

Other Restrictions

Eligible Services:

• Assessment and monitoring of clinical data including, but not limited to, vital signs, pain levels and other biometric measures specified in the plan of care;
• Assessment of response to previous changes in the plan of care;
• Detection of condition changes based on the telemedicine encounter that may indicate the need for a change in the plan of care;
• Implementation of a management plan.

Source: WA State Health Care Authority, Medicaid Provider Guide, Home Health Svcs. (Acute Care Svcs.), p. 30 (Jul. 2019). (Accessed Aug. 2019). 

Home health monitoring is not covered in Applied Behavior Analysis Program for clients Age 20 or younger.

Source: WA State Health Care Authority, Medicaid Provider Guide, Applied Behavior Analysis for Clients 20 and Younger, p. 36 (Jul. 2019). (Accessed Aug. 2019).