For more information about this blog post, please contact Ryan L. O’Neill, Labinot Alexander Berlajolli, Jessica T. Osterlof or Samantha T. Baccaro.

The New Jersey telehealth reimbursement parity extensions were set to expire on December 31, 2023. On December 21, 2023, amended legislation was passed which extends the State’s telehealth parity flexibilities to December 31, 2024. Bill Number A5757/S4127 (“Bill”) extends the requirement that a health benefits plan provide coverage and payment for healthcare services delivered to a covered person through telemedicine or telehealth at a provider reimbursement rate that equals the provider reimbursement rate that is applicable for an in-person visit. There are two exceptions to this requirement.

First, the parity requirement does not apply to a healthcare service provided by a telemedicine or telehealth organization that does not provide the healthcare service on an in-person basis in New Jersey. Second, it does not apply to a healthcare service that was provided through real-time, two-way audio without a video component, including through audio-only telephone conversations, in which case the reimbursement rate has to be at least 50% of the contract rate for an in-person visit, but this does not apply to a behavioral healthcare service. In other words, audio-only telemedicine visits for behavioral health services should be reimbursed at the same rate as an in-person visit.

The full text of the Bill may be accessed here.