Missouri Telepractice Requirements for Audiologists and Speech-Language Pathologists

The information below is collected from state licensure boards or regulatory agencies responsible for regulating the professions of audiology and/or speech-language pathology. The information is reviewed on an annual basis. Please be advised that laws, regulations, and policies may change at any time, so always check with your state for the most up-to-date information.

Telepractice State Licensure Board Requirements

This state has no licensure laws or regulations for telepractice. The absence of laws or regulations does not imply telepractice is allowed. Please contact the board for further information.

Telesupervision State Licensure Board Laws and Regulations

Telesupervision is permitted for support personnel with approval. This state has no laws or regulations for telesupervision of clinical fellows or student interns.

Support Personnel

Telesupervision permitted with approval for support personnel.

Speech-Language Pathology Assistant

Supervision Requirements

(6) The supervising speech-language pathologist shall directly supervise the assistant’s initial contact with each patient/client/student. Thereafter, direct supervision shall be provided for each assistant supervised a minimum of one (1) hour per week or one (1) out of every three (3) sessions for each patient/client/student. Direct supervision is defined as realtime observing and viewing the assistant and patient/client/student when the treatment is being provided. If an alternative arrangement is necessary, the supervising speech-language pathologist must submit a proposed plan of supervision for the review of the advisory commission and board to determine if the supervision plan is acceptable. Supervision shall be distributed across the patient/client/student caseload as appropriate to ensure adequate oversight.

Citation: Mo. Code Regs. Tit. 20, § 2150-4.201 [PDF]

Clinical Fellow

No regulations.

Student Intern

No regulations.  

Telepractice Reimbursement Laws and Regulations

Telepractice Private Insurance

The law is not clearly defined indicating that any healthcare provider and service may be covered. It is left up to interpretation and/or will be determined by the payers. Clinician will have to contact payer sources to determine if and how telepractice is covered.

Definitions – telehealth services authorized when

(4) "Health care provider", as that term is defined in section 376.1350;

(5)  "Originating site", a site at which a patient is located at the time health care services are provided to him or her by means of telemedicine.  For the purposes of asynchronous store-and-forward transfer, originating site shall also mean the location at which the health care provider transfers information to the distant site;

(6) "Telehealth" or "telemedicine", the delivery of health care services by means of information and communication technologies which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient's health care while such patient is at the originating site and the health care provider is at the distant site.  Telehealth or telemedicine shall also include the use of asynchronous store-and-forward technology.

2.  Any licensed health care provider shall be authorized to provide telehealth services if such services are within the scope of practice for which the health care provider is licensed and are provided with the same standard of care as services provided in person.  This section shall not be construed to prohibit a health carrier, as defined in section 376.1350, from reimbursing nonclinical staff for services otherwise allowed by law.

3.  In order to treat patients in this state through the use of telemedicine or telehealth, health care providers shall be fully licensed to practice in this state and shall be subject to regulation by their respective professional boards.

Citation: Mo. Rev. Stat. § 191.1145 

Definitions – reimbursement for telehealth services, when

2.  Each health carrier or health benefit plan that offers or issues health benefit plans which are delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2014, shall not deny coverage for a health care service on the basis that the health care service is provided through telehealth if the same service would be covered if provided through face-to-face diagnosis, consultation, or treatment.

3.  A health carrier may not exclude an otherwise covered health care service from coverage solely because the service is provided through telehealth rather than face-to-face consultation or contact between a health care provider and a patient.

4.  A health carrier shall not be required to reimburse a telehealth provider or a consulting provider for site origination fees or costs for the provision of telehealth services; however, subject to correct coding, a health carrier shall reimburse a health care provider for the diagnosis, consultation, or treatment of an insured or enrollee when the health care service is delivered through telehealth on the same basis that the health carrier covers the service when it is delivered in person.

5.  A health care service provided through telehealth shall not be subject to any greater deductible, co-payment, or coinsurance amount than would be applicable if the same health care service was provided through face-to-face diagnosis, consultation, or treatment.

6.  A health carrier shall not impose upon any person receiving benefits under this section any co-payment, coinsurance, or deductible amount, 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 health benefit plan.

7.  Nothing in this section shall preclude a health carrier from undertaking utilization review to determine the appropriateness of telehealth as a means of delivering a health care service, provided that the determinations shall be made in the same manner as those regarding the same service when it is delivered in person.

8.  A health carrier or health benefit plan may limit coverage for health care services that are provided through telehealth to health care providers that are in a network approved by the plan or the health carrier.

9.  Nothing in this section shall be construed to require a health care provider to be physically present with a patient where the patient is located unless the health care provider who is providing health care services by means of telehealth determines that the presence of a health care provider is necessary.

Citation: Mo. Rev. Stat. § 376.1900 

Telepractice Medicaid

The law includes speech-language pathology services in health care settings.

Telehealth Services  

(1)(B) Definitions

9. Health care provider means a:

A. Missouri licensed physician;

B. Missouri licensed advanced registered nurse practitioner;

C. Missouri licensed dentist or oral surgeon;

D. Missouri licensed psychologist or provisional licensee;

E. Missouri licensed pharmacist; or

F. Missouri licensed speech, occupational, or physical therapist.

16. Telehealth means the use of medical information exchanged from one (1) site to another via electronic communications to improve the health status of a patient. Telehealth means the practice of health care delivery, evaluation, diagnosis, consultation, or treatment using the transfer of medical data, audio visual, or data communications that are performed over two (2) or more locations between providers who are physically separated from the patient or from each other.

(5) Reimbursement

(A) Reimbursement to the health care provider delivering the medical service at the distant site is made at the same amount as the current fee schedule for the service provided without the use of a telecommunication system

Citation: Code Regs. Tit. 13, § 70-3.190 (1)(B) [PDF]

ASHA Guidance

Telepractice State Licensure

  • Obtain a license from the state in which you reside and from the state in which the patient/client resides.
  • If a state has not established regulations on telepractice, then contact the licensure board for further guidance and ask for written verification.
  • It is the responsibility of the clinician to review the regulations on the state licensure board website in their entirety and regularly for updates or changes.

Telesupervision

If a state has not established regulations on telesupervision, then contact the licensure board for further guidance and ask for written verification.

Reimbursement for Telepractice Services

Audiologists and speech-language pathologists should keep in mind that while a state may have passed telepractice reimbursement laws and/or regulations, this does not guarantee that payers will reimburse for these services. Learn more about considerations for audiologists and speech-language pathologists.  

Resources

For further information on telepractice requirements for audiologists and speech-language pathologists, please visit these websites:

Questions regarding state advocacy issues? Call ASHA at 800-498-2071 and ask for the State Advocacy Team. 

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