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Medicaid Telehealth Coverage Summary (Northeast States)

Maine (MaineCare)

Policy links:


Coverage summary:

  • Covers telehealth for most MaineCare-covered services when:
    • Member is eligible
    • Service is medically appropriate
    • Comparable quality to in-person care [maine.gov]
  • Modalities:
    • Live video
    • Audio-only
    • Store-and-forward (defined; reimbursement more limited/conditional) [maine.gov]
    • Remote patient monitoring (for qualifying conditions) [maine.gov]
  • Patient location flexible (home and non-clinical sites allowed) [cchpca.org]
  • Payment parity:
    • Operational parity in MaineCare (same codes/rates as in-person) [maine.gov]
    • CCHP notes no universal statutory parity requirement across all payers [mtelehealth.com]

New Hampshire

Policy links:


Coverage summary:

  • Covers telehealth for any Medicaid-covered service within provider scope of practice [gc.nh.gov]
  • Modalities:
    • Live video
    • Audio-only
    • Store-and-forward (defined; reimbursement more limited/conditional)
    • Remote patient monitoring (for qualifying conditions) [cchpca.org]
  • Patient home allowed as originating site [gc.nh.gov]
  • Payment parity: Required (statute + HB 1623 expands parity broadly) [nhmtscenter.org]
  • Some services require medical necessity and may have coding limitations

Vermont

Policy links:


Coverage summary:

  • Covers telehealth when medically necessary and clinically appropriate [humanservices.vermont.gov]
  • Modalities:
  • Home and non-clinical sites permitted
  • Payment parity: Yes [cchpca.org]
  • Strong statutory support (18 V.S.A. § 9361; HCAR 3.101)

New York

Policy links:


Coverage summary:

  • Covers broad services: assessment, diagnosis, treatment, care management, education [irp.cdn-website.com]
  • Modalities:
  • Available under Fee-for-Service and Managed Care
  • Payment parity: Generally required through April 1, 2026 (subject to policy updates) [health.ny.gov]
  • Increasing restrictions on audio-only for some services

Connecticut

Policy links:


Coverage summary:

  • Medicaid covers telehealth for services that are:
    • Clinically appropriate
    • Cost-effective
    • Improve access [manatt.com]
  • Modalities:
  • Payment parity: Yes (state law) [law.justia.com]
  • Only approved CPT codes billable via telehealth (strict telehealth fee table)

Massachusetts (MassHealth)

Policy links:


Coverage summary:

  • Covers a broad range of services across all programs [cchpca.org]
  • Modalities:
    • Live video
    • Audio-only
    • Asynchronous (store-and-forward) [cchpca.org]
  • No geographic/originating site restrictions (home allowed) [mass.gov]
  • Payment parity: Yes (especially strong for behavioral health; broader parity continues via policy) [cchpca.org]
  • Member choice required (must allow in-person alternative)

Rhode Island

Policy links:


Coverage summary:

  • Covers telehealth services when medically necessary [legalclarity.org]
  • Modalities:
    • Live video
    • Audio-only
    • Store-and-forward (limited, e.g., teledentistry) [eohhs.ri.gov]
    • RPM not broadly covered [eohhs.ri.gov]
  • Payment parity: Yes [eohhs.ri.gov]
  • Requires consent and HIPAA compliance
  • Modality coverage is more limited than neighboring states (especially RPM)

Key Takeaways

  • All seven states cover core telehealth modalities (video + audio) under Medicaid.
  • Parity is broadly established across the region, though NY parity has time-bound provisions, Maine does not require private payer parity, and CT applies code-based limits.
  • RPM coverage varies significantly (strong in NH/VT/NY/MA/ME; limited in CT/RI).
  • Home as originating site is universally allowed across these states.

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