The growth of telemedicine in the past couple of years has been significant; however, there are still several obstacles to widespread acceptance and adoption of this practice.
State laws are the main determinants of reimbursement policies for telemedicine services provided within that state, as well as any restrictions in this regard. If a state has passed a telemedicine parity law, for example, private payers based in that state will be required to reimburse telemedicine consultations just as they would with a traditional in-person consultation.

A large number of states have passed telemedicine parity laws – however, bringing about a change in legislation at the state level is a lengthy and often complicated process, which has major ramifications for the practice of telemedicine in that state.

Obtaining reimbursement for services provided through telemedicine is not as simple a process as the one for healthcare provided via traditional medical practice. The state policies for telemedicine are constantly changing, and this has a direct impact on the rules and regulations regarding reimbursement via state Medicaid programs and private payers.

Currently, Medicaid does offer reimbursement for the real-time provision of care through telemedicine; however, there are restrictions involving which providers meet the criteria for reimbursement, where the patient is located, the medical procedures that qualify for reimbursement, etc.

Its steady rise indicates that telemedicine now provides a larger variety of options and more cost-effective solutions. However, in the initial stages, telemedicine programs do require some investment and expenses, in the shape of purchasing and setting up new equipment, and training staff members on how to use this new technology. This means that some independent practices that operate on a small scale might find that they are unable to accommodate telemedicine in their budgets.

Numerous health care providers are already strained on new budgets for technology and training of staff members for EHR systems, which has been made mandatory by the Meaningful Use program.

Currently, as per the law, healthcare providers are granted medical licenses for a particular state, which means they can practice legally in that state alone. For example, as per medical licensing rules, a doctor based in Colorado cannot legally take on a patient located in New Mexico.

This law presents an obstacle for telemedicine, the aim of which is to overcome geographical boundaries in order to allow providers to offer care to patients regardless of location.