§ 4098b.
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/vt/title-8/chapter-107/4098bA research copy — for the controlling text, always check the official state or federal source. Not legal advice.
§ 4098b. Coverage of health care services delivered by audio-only telephone
(a)As used in this section, “health care provider” means a person, partnership, or corporation, other than a facility or institution, that is licensed, certified, or otherwise authorized by law to provide professional health care services in this State to an individual during that individual’s medical care, treatment, or confinement.
(b)(1) A health insurance plan shall provide coverage for all medically necessary, clinically appropriate health care services delivered remotely by audio-only telephone to the same extent that the plan would cover the services if they were provided through in-person consultation. Services covered under this subdivision shall include services that are covered when provided in the home by home health agencies.
(2)(A) A health insurance plan shall provide the same reimbursement rate for services billed using equivalent procedure codes and modifiers, subject to the terms of the health insurance plan and provider contract, regardless of whether the service was provided through an in-person visit with the health care provider or by audio-only telephone.
(B)The provisions of subdivision
(A)of this subdivision
(2)shall not apply in the event that a health insurer and health care provider enter into a value-based contract for health care services that include care delivered by audio-only telephone.
(c)A health insurance plan may charge an otherwise permissible deductible, co-payment, or coinsurance for a health care service delivered by audio-only telephone, provided that it does not exceed the deductible, co-payment, or coinsurance applicable to an in-person consultation.
(d)A health insurance plan shall not require a health care provider to have an existing relationship with a covered individual in order to be reimbursed for health care services delivered by audio-only telephone.
(e)This section shall apply to Medicaid, to the extent permitted by the Centers for Medicare and Medicaid Services, and any other public health care assistance program offered or administered by the State or by any subdivision or instrumentality of the State. (Recodified and amended 2025, No. 11, § 2, eff. September 1, 2025.)