{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-3418.16.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-3418.16.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-3418.16.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-3418.16.html"}],"law_id":61286,"edition_id":1,"section_id":61286,"structure_id":14324,"section_number":"38.2-3418.16","catch_line":"Coverage for telemedicine services","history":"2010, c. 222; 2014, c. 814; 2015, cc. 32, 115; 2019, cc. 211, 219; 2020, Sp. Sess. I, cc. 44, 53; 2021, Sp. Sess. I, cc. 301, 302.","full_text":"A\n\nNotwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health care plan for health care services shall provide coverage for the cost of such health care services provided through telemedicine services, as provided in this section.B\n\nAs used in this section:\n\t\t\t“Originating site” means the location where the patient is located at the time services are provided by a health care provider through telemedicine services.\n\t\t\t“Remote patient monitoring services” means the delivery of home health services using telecommunications technology to enhance the delivery of home health care, including monitoring of clinical patient data such as weight, blood pressure, pulse, pulse oximetry, blood glucose, and other condition-specific data; medication adherence monitoring; and interactive video conferencing with or without digital image upload.\n\t\t\t“Telemedicine services” as it pertains to the delivery of health care services, means the use of electronic technology or media, including interactive audio or video, for the purpose of diagnosing or treating a patient, providing remote patient monitoring services, or consulting with other health care providers regarding a patient’s diagnosis or treatment, regardless of the originating site and whether the patient is accompanied by a health care provider at the time such services are provided. “Telemedicine services” does not include an audio-only telephone, electronic mail message, facsimile transmission, or online questionnaire. Nothing in this section shall preclude coverage for a service that is not a telemedicine service, including services delivered through real-time audio-only telephone.C\n\nAn insurer, corporation, or health maintenance organization shall not exclude a service for coverage solely because the service is provided through telemedicine services and is not provided through face-to-face consultation or contact between a health care provider and a patient for services appropriately provided through telemedicine services.D\n\nAn insurer, corporation, or health maintenance organization shall not be required to reimburse the treating provider or the consulting provider for technical fees or costs for the provision of telemedicine services; however, such insurer, corporation, or health maintenance organization shall reimburse the treating provider or the consulting provider for the diagnosis, consultation, or treatment of the insured delivered through telemedicine services on the same basis that the insurer, corporation, or health maintenance organization is responsible for coverage for the provision of the same service through face-to-face consultation or contact. No insurer, corporation, or health maintenance organization shall require a provider to use proprietary technology or applications in order to be reimbursed for providing telemedicine services.E\n\nNothing shall preclude the insurer, corporation, or health maintenance organization from undertaking utilization review to determine the appropriateness of telemedicine services, provided that such appropriateness is made in the same manner as those determinations are made for the treatment of any other illness, condition, or disorder covered by such policy, contract, or plan. Any such utilization review shall not require pre-authorization of emergent telemedicine services.F\n\nAn insurer, corporation, or health maintenance organization may offer a health plan containing a deductible, copayment, or coinsurance requirement for a health care service provided through telemedicine services, provided that the deductible, copayment, or coinsurance does not exceed the deductible, copayment, or coinsurance applicable if the same services were provided through face-to-face diagnosis, consultation, or treatment.G\n\nNo insurer, corporation, or health maintenance organization shall impose any annual or lifetime dollar maximum on coverage for telemedicine services other than an annual or lifetime dollar maximum that applies in the aggregate to all items and services covered under the policy, or impose upon any person receiving benefits pursuant to this section any copayment, coinsurance, or deductible amounts, or any policy year, calendar year, lifetime, or other durational benefit limitation or maximum for benefits or services, that is not equally imposed upon all terms and services covered under the policy, contract, or plan.H\n\nThe requirements of this section shall apply to all insurance policies, contracts, and plans delivered, issued for delivery, reissued, or extended in the Commonwealth on and after January 1, 2021, or at any time thereafter when any term of the policy, contract, or plan is changed or any premium adjustment is made.I\n\nThis section shall not apply to short-term travel, accident-only, or limited or specified disease policies or contracts, nor to policies or contracts designed for issuance to persons eligible for coverage under Title XVIII of the Social Security Act, known as Medicare, or any other similar coverage under federal governmental plans.J\n\nThe coverage required by this section shall include the use of telemedicine technologies as it pertains to medically necessary remote patient monitoring services to the full extent that these services are available.K\n\nPrescribing of controlled substances via telemedicine shall comply with the requirements of § 54.1-3303 and all applicable federal law.","order_by":null,"text":{"0":{"id":223944,"text":"Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health care plan for health care services shall provide coverage for the cost of such health care services provided through telemedicine services, as provided in this section.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":223945,"text":"As used in this section:\n\t\t\t“Originating site” means the location where the patient is located at the time services are provided by a health care provider through telemedicine services.\n\t\t\t“Remote patient monitoring services” means the delivery of home health services using telecommunications technology to enhance the delivery of home health care, including monitoring of clinical patient data such as weight, blood pressure, pulse, pulse oximetry, blood glucose, and other condition-specific data; medication adherence monitoring; and interactive video conferencing with or without digital image upload.\n\t\t\t“Telemedicine services” as it pertains to the delivery of health care services, means the use of electronic technology or media, including interactive audio or video, for the purpose of diagnosing or treating a patient, providing remote patient monitoring services, or consulting with other health care providers regarding a patient’s diagnosis or treatment, regardless of the originating site and whether the patient is accompanied by a health care provider at the time such services are provided. “Telemedicine services” does not include an audio-only telephone, electronic mail message, facsimile transmission, or online questionnaire. Nothing in this section shall preclude coverage for a service that is not a telemedicine service, including services delivered through real-time audio-only telephone.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":223946,"text":"An insurer, corporation, or health maintenance organization shall not exclude a service for coverage solely because the service is provided through telemedicine services and is not provided through face-to-face consultation or contact between a health care provider and a patient for services appropriately provided through telemedicine services.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"3":{"id":223947,"text":"An insurer, corporation, or health maintenance organization shall not be required to reimburse the treating provider or the consulting provider for technical fees or costs for the provision of telemedicine services; however, such insurer, corporation, or health maintenance organization shall reimburse the treating provider or the consulting provider for the diagnosis, consultation, or treatment of the insured delivered through telemedicine services on the same basis that the insurer, corporation, or health maintenance organization is responsible for coverage for the provision of the same service through face-to-face consultation or contact. No insurer, corporation, or health maintenance organization shall require a provider to use proprietary technology or applications in order to be reimbursed for providing telemedicine services.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"E"},"4":{"id":223948,"text":"Nothing shall preclude the insurer, corporation, or health maintenance organization from undertaking utilization review to determine the appropriateness of telemedicine services, provided that such appropriateness is made in the same manner as those determinations are made for the treatment of any other illness, condition, or disorder covered by such policy, contract, or plan. Any such utilization review shall not require pre-authorization of emergent telemedicine services.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D","next_prefix":"F"},"5":{"id":223949,"text":"An insurer, corporation, or health maintenance organization may offer a health plan containing a deductible, copayment, or coinsurance requirement for a health care service provided through telemedicine services, provided that the deductible, copayment, or coinsurance does not exceed the deductible, copayment, or coinsurance applicable if the same services were provided through face-to-face diagnosis, consultation, or treatment.","type":"section","prefixes":["F"],"prefix":"F","entire_prefix":"F","prefix_anchor":"F","level":1,"prior_prefix":"E","next_prefix":"G"},"6":{"id":223950,"text":"No insurer, corporation, or health maintenance organization shall impose any annual or lifetime dollar maximum on coverage for telemedicine services other than an annual or lifetime dollar maximum that applies in the aggregate to all items and services covered under the policy, or impose upon any person receiving benefits pursuant to this section any copayment, coinsurance, or deductible amounts, or any policy year, calendar year, lifetime, or other durational benefit limitation or maximum for benefits or services, that is not equally imposed upon all terms and services covered under the policy, contract, or plan.","type":"section","prefixes":["G"],"prefix":"G","entire_prefix":"G","prefix_anchor":"G","level":1,"prior_prefix":"F","next_prefix":"H"},"7":{"id":223951,"text":"The requirements of this section shall apply to all insurance policies, contracts, and plans delivered, issued for delivery, reissued, or extended in the Commonwealth on and after January 1, 2021, or at any time thereafter when any term of the policy, contract, or plan is changed or any premium adjustment is made.","type":"section","prefixes":["H"],"prefix":"H","entire_prefix":"H","prefix_anchor":"H","level":1,"prior_prefix":"G","next_prefix":"I"},"8":{"id":223952,"text":"This section shall not apply to short-term travel, accident-only, or limited or specified disease policies or contracts, nor to policies or contracts designed for issuance to persons eligible for coverage under Title XVIII of the Social Security Act, known as Medicare, or any other similar coverage under federal governmental plans.","type":"section","prefixes":["I"],"prefix":"I","entire_prefix":"I","prefix_anchor":"I","level":1,"prior_prefix":"H","next_prefix":"J"},"9":{"id":223953,"text":"The coverage required by this section shall include the use of telemedicine technologies as it pertains to medically necessary remote patient monitoring services to the full extent that these services are available.","type":"section","prefixes":["J"],"prefix":"J","entire_prefix":"J","prefix_anchor":"J","level":1,"prior_prefix":"I","next_prefix":"K"},"10":{"id":223954,"text":"Prescribing of controlled substances via telemedicine shall comply with the requirements of § 54.1-3303 and all applicable federal law.","type":"section","prefixes":["K"],"prefix":"K","entire_prefix":"K","prefix_anchor":"K","level":1,"prior_prefix":"J"}},"ancestry":[{"id":14324,"edition_id":1,"name":"Mandated Benefits","identifier":"2","label":"article","depth":3,"order_by":1,"parent_id":12993,"metadata":{},"date_created":"2026-06-26 03:47:45","date_modified":"2026-06-26 03:47:45","permalink":{"id":215143,"object_type":"structure","relational_id":14324,"identifier":"2","token":"38.2\/34\/2","url":"\/38.2\/34\/2\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12993,"edition_id":1,"name":"Provisions Relating to Accident and Sickness 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physicians","url":"\/38.2-3408\/","token":"38.2\/34\/2\/38.2-3408","metadata":false},{"id":55621,"structure_id":14324,"section_number":"38.2-3409","catch_line":"Coverage of dependent children","url":"\/38.2-3409\/","token":"38.2\/34\/2\/38.2-3409","metadata":false},{"id":68501,"structure_id":14324,"section_number":"38.2-3410","catch_line":"Construction of policy generally; words \"physician\" and \"doctor\" to include dentist","url":"\/38.2-3410\/","token":"38.2\/34\/2\/38.2-3410","metadata":false},{"id":76551,"structure_id":14324,"section_number":"38.2-3411","catch_line":"Coverage of newborn children required","url":"\/38.2-3411\/","token":"38.2\/34\/2\/38.2-3411","metadata":false},{"id":71629,"structure_id":14324,"section_number":"38.2-3411.1","catch_line":"Coverage for child health supervision services","url":"\/38.2-3411.1\/","token":"38.2\/34\/2\/38.2-3411.1","metadata":false},{"id":70694,"structure_id":14324,"section_number":"38.2-3411.2","catch_line":"Coverage of adopted children required","url":"\/38.2-3411.2\/","token":"38.2\/34\/2\/38.2-3411.2","metadata":false},{"id":77817,"structure_id":14324,"section_number":"38.2-3411.3","catch_line":"Coverage for childhood immunizations","url":"\/38.2-3411.3\/","token":"38.2\/34\/2\/38.2-3411.3","metadata":false},{"id":86598,"structure_id":14324,"section_number":"38.2-3411.4","catch_line":"Coverage for infant hearing screening and related diagnostics","url":"\/38.2-3411.4\/","token":"38.2\/34\/2\/38.2-3411.4","metadata":false},{"id":63024,"structure_id":14324,"section_number":"38.2-3412","catch_line":"Repealed","url":"\/38.2-3412\/","token":"38.2\/34\/2\/38.2-3412","metadata":false},{"id":84153,"structure_id":14324,"section_number":"38.2-3412.1","catch_line":"Coverage for mental health and substance use disorders","url":"\/38.2-3412.1\/","token":"38.2\/34\/2\/38.2-3412.1","metadata":false},{"id":75255,"structure_id":14324,"section_number":"38.2-3412.1:01","catch_line":"Repealed","url":"\/38.2-3412.1_01\/","token":"38.2\/34\/2\/38.2-3412.1_01","metadata":false},{"id":67892,"structure_id":14324,"section_number":"38.2-3413","catch_line":"Repealed","url":"\/38.2-3413\/","token":"38.2\/34\/2\/38.2-3413","metadata":false},{"id":81885,"structure_id":14324,"section_number":"38.2-3414","catch_line":"Optional coverage for obstetrical services","url":"\/38.2-3414\/","token":"38.2\/34\/2\/38.2-3414","metadata":false},{"id":74497,"structure_id":14324,"section_number":"38.2-3414.1","catch_line":"Obstetrical benefits; coverage for postpartum services","url":"\/38.2-3414.1\/","token":"38.2\/34\/2\/38.2-3414.1","metadata":false},{"id":58957,"structure_id":14324,"section_number":"38.2-3415","catch_line":"Exclusion or reduction of benefits for certain causes prohibited","url":"\/38.2-3415\/","token":"38.2\/34\/2\/38.2-3415","metadata":false},{"id":69898,"structure_id":14324,"section_number":"38.2-3416","catch_line":"Repealed","url":"\/38.2-3416\/","token":"38.2\/34\/2\/38.2-3416","metadata":false},{"id":59007,"structure_id":14324,"section_number":"38.2-3417","catch_line":"Deductibles and coinsurance options required","url":"\/38.2-3417\/","token":"38.2\/34\/2\/38.2-3417","metadata":false},{"id":81514,"structure_id":14324,"section_number":"38.2-3418","catch_line":"Coverage for victims of rape or incest","url":"\/38.2-3418\/","token":"38.2\/34\/2\/38.2-3418","metadata":false},{"id":85746,"structure_id":14324,"section_number":"38.2-3418.1","catch_line":"Coverage for mammograms","url":"\/38.2-3418.1\/","token":"38.2\/34\/2\/38.2-3418.1","metadata":false},{"id":86304,"structure_id":14324,"section_number":"38.2-3418.10","catch_line":"Coverage for diabetes","url":"\/38.2-3418.10\/","token":"38.2\/34\/2\/38.2-3418.10","metadata":false},{"id":87414,"structure_id":14324,"section_number":"38.2-3418.11","catch_line":"Coverage for hospice care","url":"\/38.2-3418.11\/","token":"38.2\/34\/2\/38.2-3418.11","metadata":false},{"id":81464,"structure_id":14324,"section_number":"38.2-3418.12","catch_line":"Coverage for hospitalization and anesthesia for dental procedures","url":"\/38.2-3418.12\/","token":"38.2\/34\/2\/38.2-3418.12","metadata":false},{"id":82972,"structure_id":14324,"section_number":"38.2-3418.13","catch_line":"Coverage for the treatment of morbid obesity","url":"\/38.2-3418.13\/","token":"38.2\/34\/2\/38.2-3418.13","metadata":false},{"id":85731,"structure_id":14324,"section_number":"38.2-3418.14","catch_line":"Coverage for lymphedema","url":"\/38.2-3418.14\/","token":"38.2\/34\/2\/38.2-3418.14","metadata":false},{"id":71964,"structure_id":14324,"section_number":"38.2-3418.15","catch_line":"Coverage for prosthetic devices and components","url":"\/38.2-3418.15\/","token":"38.2\/34\/2\/38.2-3418.15","metadata":false},{"id":57543,"structure_id":14324,"section_number":"38.2-3418.15:1","catch_line":"Coverage for prosthetic devices and components","url":"\/38.2-3418.15_1\/","token":"38.2\/34\/2\/38.2-3418.15_1","metadata":false},{"id":61286,"structure_id":14324,"section_number":"38.2-3418.16","catch_line":"Coverage for telemedicine services","url":"\/38.2-3418.16\/","token":"38.2\/34\/2\/38.2-3418.16","metadata":false},{"id":81144,"structure_id":14324,"section_number":"38.2-3418.17","catch_line":"Coverage for autism spectrum disorder","url":"\/38.2-3418.17\/","token":"38.2\/34\/2\/38.2-3418.17","metadata":false},{"id":60567,"structure_id":14324,"section_number":"38.2-3418.18","catch_line":"Coverage for formula and enteral nutrition products as 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holder","url":"\/38.2-3419\/","token":"38.2\/34\/2\/38.2-3419","metadata":false},{"id":57559,"structure_id":14324,"section_number":"38.2-3419.1","catch_line":"Report of costs and utilization of mandated benefits","url":"\/38.2-3419.1\/","token":"38.2\/34\/2\/38.2-3419.1","metadata":false}],"previous_section":{"id":57543,"structure_id":14324,"section_number":"38.2-3418.15:1","catch_line":"Coverage for prosthetic devices and components","url":"\/38.2-3418.15_1\/","token":"38.2\/34\/2\/38.2-3418.15_1","metadata":false},"next_section":{"id":81144,"structure_id":14324,"section_number":"38.2-3418.17","catch_line":"Coverage for autism spectrum disorder","url":"\/38.2-3418.17\/","token":"38.2\/34\/2\/38.2-3418.17","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-3418.16\/","history_text":"

This law was first created in 2010. The record of its establishment is cataloged in chapter 222<\/a> of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. It has been modified 3 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 2014, chapter 814<\/a>; in 2015, chapters 32<\/a> and 115<\/a>; in 2019, chapters 211<\/a> and 219<\/a>.<\/p>","references":[{"id":76872,"section_number":"32.1-122.03:1","catch_line":"Statewide Telehealth Plan","order_by":null,"url":"\/32.1-122.03_1\/"},{"id":77747,"section_number":"32.1-325","catch_line":"Board to submit plan for medical assistance services to U.S. Secretary of Health and Human Services pursuant to federal law; administration of plan; contracts with health care providers","order_by":null,"url":"\/32.1-325\/"},{"id":67952,"section_number":"38.2-4319","catch_line":"Statutory construction and relationship to other laws","order_by":null,"url":"\/38.2-4319\/"},{"id":83528,"section_number":"54.1-2901","catch_line":"Exceptions and exemptions generally","order_by":null,"url":"\/54.1-2901\/"},{"id":64164,"section_number":"54.1-2957","catch_line":"Licensure and practice of advanced practice registered nurses; certified nurse midwives; independent practice of certified nurse midwives","order_by":null,"url":"\/54.1-2957\/"},{"id":85347,"section_number":"54.1-3303","catch_line":"Prescriptions to be issued and drugs to be dispensed for medical or therapeutic purposes only","order_by":null,"url":"\/54.1-3303\/"},{"id":86967,"section_number":"54.1-3303.1","catch_line":"Initiating of treatment with and dispensing and administering of controlled substances by pharmacists","order_by":null,"url":"\/54.1-3303.1\/"},{"id":85227,"section_number":"54.1-3501","catch_line":"Exemption from requirements of licensure","order_by":null,"url":"\/54.1-3501\/"},{"id":86296,"section_number":"54.1-3601","catch_line":"Exemption from requirements of licensure","order_by":null,"url":"\/54.1-3601\/"},{"id":78374,"section_number":"54.1-3701","catch_line":"Exemption from requirements of licensure","order_by":null,"url":"\/54.1-3701\/"}],"refers_to":[{"id":66144,"section_number":"38.2-3419","catch_line":"Additional mandated coverage made optional to group policy or contract holder","order_by":null,"url":"\/38.2-3419\/"},{"id":85347,"section_number":"54.1-3303","catch_line":"Prescriptions to be issued and drugs to be dispensed for medical or therapeutic purposes only","order_by":null,"url":"\/54.1-3303\/"}],"permalink":{"id":215249,"object_type":"law","relational_id":61286,"identifier":"38.2-3418.16","token":"38.2\/34\/2\/38.2-3418.16","url":"\/38.2-3418.16\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-3418.16\/","token":"38.2\/34\/2\/38.2-3418.16","dublin_core":{"Title":"Coverage for telemedicine services","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-3418.16","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> Notwithstanding the provisions of § 38.2-3419<\/a>, each insurer<\/span> proposing to issue<\/span> individual or group accident and sickness insurance policies<\/span> providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts<\/span>; and each health maintenance organization providing a health care plan for health care services shall provide coverage for the cost of such health care services provided through telemedicine services<\/span>, as provided in this section. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> As used in this section:\n\t\t\t“Originating site<\/span>” means the location where the patient is located at the time services are provided by a health care provider through telemedicine services<\/span>.\n\t\t\t“Remote patient monitoring services<\/span>” means the delivery of home health services using telecommunications technology to enhance the delivery of home health care, including monitoring of clinical patient data such as weight, blood pressure, pulse, pulse oximetry, blood glucose, and other condition-specific data; medication adherence monitoring; and interactive video conferencing with or without digital image upload.\n\t\t\t“Telemedicine services<\/span>” as it pertains to the delivery of health care services, means the use of electronic technology or media, including interactive audio or video, for the purpose of diagnosing or treating a patient, providing remote patient monitoring services<\/span>, or consulting with other health care providers regarding a patient’s diagnosis or treatment, regardless of the originating site<\/span> and whether the patient is accompanied by a health care provider at the time such services are provided. “Telemedicine services<\/span>” does not include an audio-only telephone, electronic mail message, facsimile transmission, or online questionnaire. Nothing in this section shall preclude coverage for a service that is not a telemedicine service, including services delivered through real-time audio-only telephone. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> An insurer<\/span>, corporation, or health maintenance organization shall not exclude a service for coverage solely because the service is provided through telemedicine services<\/span> and is not provided through face-to-face consultation or contact between a health care provider and a patient for services appropriately provided through telemedicine services<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> An insurer<\/span>, corporation, or health maintenance organization shall not be required to reimburse the treating provider or the consulting provider for technical fees or costs for the provision of telemedicine services<\/span>; however, such insurer<\/span>, corporation, or health maintenance organization shall reimburse the treating provider or the consulting provider for the diagnosis, consultation, or treatment of the insured delivered through telemedicine services<\/span> on the same basis that the insurer<\/span>, corporation, or health maintenance organization is responsible for coverage for the provision of the same service through face-to-face consultation or contact. No insurer<\/span>, corporation, or health maintenance organization shall require a provider to use proprietary technology or applications in order<\/span> to be reimbursed for providing telemedicine services<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> Nothing shall preclude the insurer<\/span>, corporation, or health maintenance organization from undertaking utilization review to determine the appropriateness of telemedicine services<\/span>, provided that such appropriateness is made in the same manner as those determinations are made for the treatment of any other illness, condition, or disorder covered by such policy, contract<\/span>, or plan. Any such utilization review shall not require pre-authorization of emergent telemedicine services<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

F.<\/span> An insurer<\/span>, corporation, or health maintenance organization may offer a health plan containing a deductible, copayment, or coinsurance requirement for a health care service provided through telemedicine services<\/span>, provided that the deductible, copayment, or coinsurance does not exceed the deductible, copayment, or coinsurance applicable if the same services were provided through face-to-face diagnosis, consultation, or treatment. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

G.<\/span> No insurer<\/span>, corporation, or health maintenance organization shall impose any annual or lifetime dollar maximum on coverage for telemedicine services<\/span> other than an annual or lifetime dollar maximum that applies in the aggregate to all items and services covered under the policy, or impose upon any person<\/span> receiving benefits pursuant to this section any copayment, coinsurance, or deductible amounts, or any policy year, calendar year, lifetime, or other durational benefit limitation or maximum for benefits or services, that is not equally imposed upon all terms and services covered under the policy, contract<\/span>, or plan. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

H.<\/span> The requirements of this section shall apply to all insurance policies<\/span>, contracts<\/span>, and plans delivered, issued for delivery, reissued, or extended in the Commonwealth on and after January 1, 2021, or at any time thereafter when any term of the policy, contract<\/span>, or plan is changed or any premium adjustment is made. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

I.<\/span> This section shall not apply to short-term travel, accident-only, or limited or specified disease policies or contracts<\/span>, nor to policies or contracts<\/span> designed for issuance to persons<\/span> eligible for coverage under Title XVIII of the Social Security Act, known as Medicare<\/span>, or any other similar coverage under federal governmental plans. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

J.<\/span> The coverage required by this section shall include the use of telemedicine technologies as it pertains to medically necessary remote patient monitoring services<\/span> to the full extent that these services are available. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

K.<\/span> Prescribing of controlled substances via telemedicine shall comply with the requirements of § 54.1-3303<\/a> and all applicable federal law<\/span>. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nCOVERAGE FOR TELEMEDICINE SERVICES (\u00a7 38.2-3418.16)\n\nA. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to\nissue individual or group accident and sickness insurance policies providing\nhospital, medical and surgical, or major medical coverage on an expense-incurred\nbasis; each corporation providing individual or group accident and sickness\nsubscription contracts; and each health maintenance organization providing a\nhealth care plan for health care services shall provide coverage for the cost of\nsuch health care services provided through telemedicine services, as provided in\nthis section.\n\nB. As used in this section:\n\t\t\t“Originating site” means the location where the patient is\nlocated at the time services are provided by a health care provider through\ntelemedicine services.\n\t\t\t“Remote patient monitoring services” means the delivery of home\nhealth services using telecommunications technology to enhance the delivery of\nhome health care, including monitoring of clinical patient data such as weight,\nblood pressure, pulse, pulse oximetry, blood glucose, and other\ncondition-specific data; medication adherence monitoring; and interactive video\nconferencing with or without digital image upload.\n\t\t\t“Telemedicine services” as it pertains to the delivery of health\ncare services, means the use of electronic technology or media, including\ninteractive audio or video, for the purpose of diagnosing or treating a patient,\nproviding remote patient monitoring services, or consulting with other health\ncare providers regarding a patient’s diagnosis or treatment, regardless of\nthe originating site and whether the patient is accompanied by a health care\nprovider at the time such services are provided. “Telemedicine\nservices” does not include an audio-only telephone, electronic mail\nmessage, facsimile transmission, or online questionnaire. Nothing in this\nsection shall preclude coverage for a service that is not a telemedicine\nservice, including services delivered through real-time audio-only telephone.\n\nC. An insurer, corporation, or health maintenance organization shall not exclude\na service for coverage solely because the service is provided through\ntelemedicine services and is not provided through face-to-face consultation or\ncontact between a health care provider and a patient for services appropriately\nprovided through telemedicine services.\n\nD. An insurer, corporation, or health maintenance organization shall not be\nrequired to reimburse the treating provider or the consulting provider for\ntechnical fees or costs for the provision of telemedicine services; however,\nsuch insurer, corporation, or health maintenance organization shall reimburse\nthe treating provider or the consulting provider for the diagnosis,\nconsultation, or treatment of the insured delivered through telemedicine\nservices on the same basis that the insurer, corporation, or health maintenance\norganization is responsible for coverage for the provision of the same service\nthrough face-to-face consultation or contact. No insurer, corporation, or health\nmaintenance organization shall require a provider to use proprietary technology\nor applications in order to be reimbursed for providing telemedicine services.\n\nE. Nothing shall preclude the insurer, corporation, or health maintenance\norganization from undertaking utilization review to determine the\nappropriateness of telemedicine services, provided that such appropriateness is\nmade in the same manner as those determinations are made for the treatment of\nany other illness, condition, or disorder covered by such policy, contract, or\nplan. Any such utilization review shall not require pre-authorization of\nemergent telemedicine services.\n\nF. An insurer, corporation, or health maintenance organization may offer a\nhealth plan containing a deductible, copayment, or coinsurance requirement for a\nhealth care service provided through telemedicine services, provided that the\ndeductible, copayment, or coinsurance does not exceed the deductible, copayment,\nor coinsurance applicable if the same services were provided through\nface-to-face diagnosis, consultation, or treatment.\n\nG. No insurer, corporation, or health maintenance organization shall impose any\nannual or lifetime dollar maximum on coverage for telemedicine services other\nthan an annual or lifetime dollar maximum that applies in the aggregate to all\nitems and services covered under the policy, or impose upon any person receiving\nbenefits pursuant to this section any copayment, coinsurance, or deductible\namounts, or any policy year, calendar year, lifetime, or other durational\nbenefit limitation or maximum for benefits or services, that is not equally\nimposed upon all terms and services covered under the policy, contract, or plan.\n\nH. The requirements of this section shall apply to all insurance policies,\ncontracts, and plans delivered, issued for delivery, reissued, or extended in\nthe Commonwealth on and after January 1, 2021, or at any time thereafter when\nany term of the policy, contract, or plan is changed or any premium adjustment\nis made.\n\nI. This section shall not apply to short-term travel, accident-only, or limited\nor specified disease policies or contracts, nor to policies or contracts\ndesigned for issuance to persons eligible for coverage under Title XVIII of the\nSocial Security Act, known as Medicare, or any other similar coverage under\nfederal governmental plans.\n\nJ. The coverage required by this section shall include the use of telemedicine\ntechnologies as it pertains to medically necessary remote patient monitoring\nservices to the full extent that these services are available.\n\nK. Prescribing of controlled substances via telemedicine shall comply with the\nrequirements of § 54.1-3303 and all applicable federal law.\n\nHISTORY: 2010, c. 222; 2014, c. 814; 2015, cc. 32, 115; 2019, cc. 211, 219;\n2020, Sp. Sess. I, cc. 44, 53; 2021, Sp. Sess. I, cc. 301, 302.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}