ARTICLE
16 January 2024

New Jersey Extends Telemedicine Payment Parity

RD
Riker Danzig LLP

Contributor

Riker Danzig LLP has served the business community for 140 years, with offices in Morristown and Trenton, New Jersey and in Midtown Manhattan. Riker Danzig is regional counsel, national defense counsel, and deal counsel to clients ranging from Fortune 500 corporations to middle-market businesses.
The New Jersey telehealth reimbursement parity extensions were set to expire on December 31, 2023. On December 21, 2023, amended legislation was passed which extends...
United States Food, Drugs, Healthcare, Life Sciences
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The New Jersey telehealth reimbursement parity extensions were set to expire on December 31, 2023. On December 21, 2023, amended legislation was passed which extends the State's telehealth parity flexibilities to December 31, 2024. Bill Number A5757/S4127 ("Bill") extends the requirement that a health benefits plan provide coverage and payment for healthcare services delivered to a covered person through telemedicine or telehealth at a provider reimbursement rate that equals the provider reimbursement rate that is applicable for an in-person visit. There are two exceptions to this requirement.

First, the parity requirement does not apply to a healthcare service provided by a telemedicine or telehealth organization that does not provide the healthcare service on an in-person basis in New Jersey. Second, it does not apply to a healthcare service that was provided through real-time, two-way audio without a video component, including through audio-only telephone conversations, in which case the reimbursement rate has to be at least 50% of the contract rate for an in-person visit, but this does not apply to a behavioral healthcare service. In other words, audio-only telemedicine visits for behavioral health services should be reimbursed at the same rate as an in-person visit.

The full text of the Bill may be accessed here.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

ARTICLE
16 January 2024

New Jersey Extends Telemedicine Payment Parity

United States Food, Drugs, Healthcare, Life Sciences

Contributor

Riker Danzig LLP has served the business community for 140 years, with offices in Morristown and Trenton, New Jersey and in Midtown Manhattan. Riker Danzig is regional counsel, national defense counsel, and deal counsel to clients ranging from Fortune 500 corporations to middle-market businesses.
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