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. 2024 Dec 9;26:e56699. doi: 10.2196/56699

Table 1.

Telehealth services covered by health insurance.

Region Provider Telehealth services
China Basic Health Insurance
  • Telehealth follow-up services

  • Remote consultation: single-discipline, multidisciplinary, synchronous, and asynchronous pathology consultation; traditional Chinese medicine syndrome differentiation; and treatment consultation

  • Remote monitoring: fetal heart monitoring, remote ECGa monitoring, pacemaker monitoring, and defibrillator monitoring

  • Remote diagnosis: imaging diagnosis, pathology diagnosis, ECG diagnosis, and ultrasonography diagnosis

United States Medicare, Medicaid, Private, Payer, and MAb plans
  • Medicare: remote physiologic monitoring and treatment management, care management services (transitional care and chronic care), interprofessional health record consultations, psychological therapy, diagnosis and treatment of kidney diseases, medication assessment and management, and stroke telehealth

  • Medicaid: store-and-forward (33 states), remote patient monitoring (34 states), audio-only calls (37 states and Washington, DC), live video (all 50 states and Washington, DC), and transmission or facility fee (35 states). Specific services limitations in some states

  • Private payers: telehealth services reimbursed similarly to in-person services under parity state laws. Some states expanding commercial reimbursement policies

  • MA plans: alternative to traditional Medicare, allowing private insurers an option to offer telehealth services under the PFSc and following PFS usage rules. In addition, MA plans provide coverage for services via telehealth beyond what is required in original Medicare as additional telehealth benefits (eg, remote monitoring services for urban patients with multiple chronic diseases)

Australia MBSd
  • 2006-2019: sequential introduction of telehealth services into MBS. Video consultations for remote areas, mental health support for drought and bushfire-affected communities and advanced care for aged, cancer, and palliative patients

  • COVID-19 epidemic: expansion of telehealth services in MBS. Early intervention, care for older people, pediatric, psychiatric, psychological, and dental diagnostic and treatment services

France Assurance Maladie
  • Remote consultation: no professional restrictions on telehealth services

  • Tele-expertise: a remote consultation among practicing physicians to remotely seek advice on patient treatment

  • Remote monitoring: use of follow-up, particularly for remote monitoring of organ transplant patients

Japan National health insurance
  • Remote consultation: among medical institutions and practicing physicians

aECG: electrocardiogram.

bMA: Medicare Advantage.

cPFS: Physician Fee Schedule.

dMBS: Medicare Benefits Schedule.