Texas Insurance Department Extends Telemedicine Coverage Rule

June 24, 2020

An emergency rule requiring insurers in Texas to cover telemedicine services has been extended into September, the Texas Department of Insurance (TDI) said.

Covered telemedicine services include mental health visits at the same rate as in-person visits.

The emergency rule was originally put in place in March in an effort to help doctors across Texas treat their patients and limit the spread of COVID-19.

“This extension will help protect patients and our state’s health-care professionals while maintaining access to care,” said Insurance Commissioner Kent Sullivan.

Under the emergency rule, state-regulated health insurers and health maintenance organizations must:

  • Pay in-network health professionals at least the same rate for telemedicine services as for in-person services, including covered mental health services.
  • Cover telemedicine services using any platform permitted by state law.
  • Not require more documentation for telemedicine services than they require for in-person services.

In March, Governor Greg Abbott suspended a law limiting coverage for medical services and consultations provided by phone. The suspension remains in place and means insurers must pay for covered visits or consultations provided over the phone.

The original emergency rule took effect March 17 and was set to expire July 14. With the extension, the rule will remain in effect through September 12.

State-regulated plans, including those purchased through Healthcare.gov, cover about 15% of the Texas market. The insurance cards for state-regulated plans have either “DOI” (for department of insurance) or “TDI” (Texas Department of Insurance) printed on them.

The rule does not apply to Medicaid, Medicare, state employee or teacher retirement systems or self-funded employer-sponsored health plans.

Source: TDI

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