Does Tennessee require telehealth payment parity?

Generally, yes. Tennessee law requires health insurers to reimburse covered telehealth services at the same rate as the same service in person (Tenn. Code Ann. § 56-7-1002), with conditions in the statute. Self-funded ERISA plans generally aren't subject to state law.

How can I tell if telehealth is being paid less?

Compare what each payer allows for a telehealth visit with what it allows for the same code in person. Owed does this automatically from your remittances.

Telehealth paid less.

A telehealth gap is a telehealth service paid below the same payer's in-person rate for the same code and clinician tier.

Why it happens

Some payers still pay telehealth visits less than office visits. Tennessee generally requires health insurers to pay for telehealth at the same rate as in-person care for the same service (Tenn. Code Ann. § 56-7-1002).

How Owed checks

01
Owed recognizes telehealth lines by their modifiers (95, GT, GQ, FQ, 93).
02
For commercial claims with no contracted rate on file, it compares the allowed amount with the payer's typical in-person rate for the same code and tier over the preceding 180 days, and flags gaps of at least $2 and 3%.
03
It cites the parity statute when the state has one.
04
State insurance law reaches fully insured plans, not self-funded employer plans (ERISA) or Medicare and Medicaid plans. You tell Owed how each payer's plans are funded: it leaves the finding out for payers you've marked self-funded or government, says so when you've confirmed a payer is fully insured, and marks it unconfirmed otherwise.

What you'll see

The in-person typical rate and how many lines it's based on
The telehealth allowed amount and the difference
The parity statute, where it applies

Rules decide, never AI: the same file always gives the same findings, and every finding shows its math.

What to do

Review the telehealth terms of your provider agreement and dispute rates below the in-person amount where the agreement or state law requires equal payment.

Questions

Does Tennessee require telehealth payment parity?: Generally, yes. Tennessee law requires health insurers to reimburse covered telehealth services at the same rate as the same service in person (Tenn. Code Ann. § 56-7-1002), with conditions in the statute. Self-funded ERISA plans generally aren't subject to state law.
How can I tell if telehealth is being paid less?: Compare what each payer allows for a telehealth visit with what it allows for the same code in person. Owed does this automatically from your remittances.