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Telehealth

General Information

HMSA has always been a leader in telehealth, having been the first health plan to offer a telehealth platform to our members in 2009. HMSA has supportive telehealth policies that allows our network of providers (both medical and behavioral health providers) to deliver care via telehealth in compliance with state and federal telehealth regulations and laws. 

Telehealth:

  • Can help improve access to services from providers and increase convenience for members
  • Visits have the potential to decrease providers’ risk of exposure to infectious agents that are potentially introduced during a visit in a public health setting
  • Creates appointment scheduling flexibility
  • May attract patients who prefer access to providers outside traditional business hours
  • Can help establish and build better relationships between providers and members, making it easier to coordinate care

Medical Policy & Coding Guidelines

Refer to our HMSA’s medical policy for guidance on telehealth coverage. Please refer to CMS for Medicare guidance and the Hawaii State Med-QUEST division provider memos for Medicaid coverage guidance.

Audio-Only Visits

For Medicare Advantage members, audio-only visits are covered for behavioral/mental health telehealth services when furnished in their homes. Effective 10/1/2025, physicians and practitioners may use two-way, real-time audio-only communication technology for any telehealth service furnished to a patient in their home, provided that the furnishing physician or practitioner is technically capable of using audio-video communication technology and that the beneficiary is not capable of or does not consent to using audio-video communication technology. Audio-only can be used for both new and established patients. Refer to CMS guidelines.

For QUEST Integration members, audio-only visits are covered for certain services until December 31, 2025. Please refer to Med QUEST Division for specific guidance.

For commercial plan and some self-insured plan members, audio-only visits are covered for the diagnosis, evaluation, and treatment of certain mental health conditions until Dec. 31, 2025. Reimbursement rates for audio-only visits will be paid at 80% of the standard in-person rate. Providers will be required to meet specific criteria to be reimbursed for audio-only visits.

Refer to the following for more information:

Provider Eligibility

There isn’t a special credentialing process to become a covered telehealth provider with HMSA. Contracted and credentialed providers may deliver telehealth services in accordance with their HMSA participating contracts, HMSA’s policies and in compliance with all federal and state laws and regulations.

If you would like to use HMSA’s Online Care® to deliver telehealth services, you must have a PPO contract.

Telehealth Offered Via HMSA’s Online Care

As a benefit to our in-network providers, we provide complimentary usage of our telehealth platform, HMSA’s Online Care, to render telehealth services to your patients. You must be PPO credentialed in order to use Online Care.

Click here for more information on HMSA’s Online Care.

HMSA members can use Online Care at a cost of $0 to $15 depending on their health plan. For non-HMSA members, the cost will depend on the type of provider they choose.

Resources:

HMSA is not affiliated with any of the resource sites listed above. These links are provided as a resource for your convenience. HMSA has not independently verified the information contained on these websites. The links were updated as of April 25, 2023.

Refer to HHIN+ to check your patient’s plan benefits.

CURRENT AS OF 08/03/2026

Revision History

Date Nature of Revision
08/03/2026 Migrated to new platform.