The state of telemedicine

Small hospitals and health centers are closing across the country, causing concern for the millions that live in rural areas of the United States. As this trend continues, telemedicine is likely to become an important tool in delivering high-quality, affordable healthcare to consumers nationwide, especially in the field of cardiology.

More and more frequently, cardiologists are utilizing technology to provide care, whether through virtual check-ups, consultations, or 24/7 monitoring using an expanding collection of implantable or wearable diagnostic devices. These innovative new tools are allowing cardiologists to extend their reach across county and even state lines, allowing them to detect cardiac problems before they become life-threatening. But as with any new form of care, there are still hurdles to overcome.


Until recently, cardiologists were required to complete separate licensing applications for each state they planned to practice in, whether in person or virtually. Because of the variation in processes from state to state, it’s always been a time-consuming and expensive process.

The rise of telemedicine has led to the creation of new licensing options for cardiologists looking to practice across state lines. There’s the Interstate Medical Licensure Compact, which provides an expedited path to licensure in any of the 22 member states/territories, Special Purpose Licenses, and Reciprocity, but none of these provide licensing avenues for all 50 states.


Despite the growing utilization of telehealth for cardiology, there are a number of inconsistencies in regards to policy and reimbursement. According to a recent report from the Center for Connected Health Policy, the current state of Medicaid reimbursement is as follows:

  • 48 states and Washington DC provide reimbursement for some form of live video in Medicaid fee-for-service
  • 15 states reimburse for store and forward delivered services
  • 21 states reimburse for remote patient monitoring (RPM)
  • 9 states reimburse for all three
  • 32 states provide a transmission and/or facility fee

Even with a significant number of states reimbursing for live video telehealth, restrictions are still prevalent. As of October 2017, 6 of the 48 states providing reimbursement have some form of geographic/rural restriction in place and 23 limit reimbursement to a specific list of facilities.

As the push for more accessible and affordable cardiology care continues to grow, so too does the movement to expand and improve telemedicine services across the country. In fact, legislation related to telemedicine is pending in 40 states, Washington, D.C., and at the federal level.

If you’re looking to become a telecardiology provider, The National Telehealth Resource CenterThe National Telehealth Resource Center offers a range of resources to help you get started. For more information on current and pending telehealth legislation, visit the Center for Connected Health Policy.