Telehealth rules in West Virginia for 2026 — what changed and what stayed the same

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West Virginia has stronger reasons than most states to keep telehealth rules permissive. A large rural population, a significant behavioral health burden, an opioid crisis that has demanded flexible service delivery, and a Medicaid program covering roughly one in three residents all point toward telehealth as a structural necessity rather than a convenience. The 2026 framework reflects that reality.

What is in place for 2026

West Virginia’s telehealth statute is codified in West Virginia Code 33-15-4n and related sections. It requires state-regulated commercial health insurance plans to cover telehealth on a parity basis with in-person services. It does not restrict originating site for most service types — patients can receive covered telehealth from their home, and Mountain Health Trust MCOs accept Place of Service code 10 (patient in home) for claims.

The most significant 2025 update affecting 2026 billing: the West Virginia Bureau for Medical Services updated its telehealth provider manual to clarify coverage for audio-only behavioral health visits and to align POS code requirements across all four Mountain Health Trust MCOs. Previously, individual MCOs had inconsistent guidance on whether modifier 95 or GT was preferred. As of the updated manual, BMS specifies GT as the standard modifier for synchronous audio-video claims, with individual MCO billing guides taking precedence where they differ.

What Mountain Health Trust MCOs cover via telehealth in 2026

All four Mountain Health Trust MCOs — Aetna Better Health of West Virginia, The Health Plan, UnitedHealthcare Community Plan WV, and Unicare (Anthem) — cover synchronous audio-video telehealth for:

  • Primary care (CPT 99213, 99214)
  • Individual psychotherapy (CPT 90837, 90834)
  • Psychiatric evaluation and medication management
  • Substance use disorder counseling
  • MAT follow-up visits (medication-assisted treatment)
  • Certain remote patient monitoring services for chronic conditions

Audio-only behavioral health: BMS and all four MCOs reimburse audio-only (telephone) visits for mental health and substance use disorder services when the patient cannot access audio-video technology. This matters especially in rural McDowell, Mingo, Logan, and Wyoming counties where broadband access remains limited. ICD-10 codes F32.9 (depression) and F41.1 (anxiety) are reimbursable via audio-only under this provision.

Opioid use disorder (ICD-10 F11.20): Given West Virginia’s high rates of opioid use disorder treatment need, all four MCOs explicitly cover MAT follow-up visits via telehealth. Buprenorphine induction via telehealth is governed by federal DEA rules — providers should monitor DEA rulemaking on Schedule III–V controlled substance prescribing via telemedicine, as rule changes directly affect buprenorphine induction workflows.

CMS updates affecting West Virginia providers

CMS’s 2025 Physician Fee Schedule updates extended several Medicare telehealth provisions:

  • Rural originating-site waiver (home-based telehealth for Medicare patients in non-rural areas) extended through congressional action
  • Audio-only behavioral health coverage extended pending rulemaking
  • FQHCs and RHCs eligible as distant sites for Medicare telehealth — particularly relevant in Morgantown, Charleston, and Huntington FQHCs that serve large Medicare populations

West Virginia providers billing Medicare should review the CMS telehealth services list annually. New CPT codes enter the telehealth-eligible list each year through the PFS final rule, and codes can also be removed.

DEA and buprenorphine prescribing

West Virginia’s opioid crisis gives MAT prescribing particular importance. The DEA’s pandemic-era flexibilities for buprenorphine prescribing without an in-person visit have been extended under a series of temporary rules since 2020. The current status as of 2026 allows prescribing of Schedule III–V controlled substances via telemedicine under specific conditions, including a DEA-registered provider and a DEA-compliant platform.

Providers in West Virginia using telehealth for buprenorphine induction and maintenance should maintain current awareness of DEA rulemaking, as permanent rules are still being finalized. The DEA and SAMHSA publish joint guidance on opioid treatment program telehealth rules that is the authoritative source.

APRN telehealth and collaborative agreements

West Virginia APRNs require a collaborative physician agreement to practice. Telehealth delivery does not eliminate this requirement — the agreement must cover the scope of telehealth services the APRN provides. For a Morgantown-based APRN delivering behavioral health services via telehealth to patients in Randolph or Pocahontas counties, the agreement must reflect that scope and prescriptive authority.

Providers setting up telehealth-only practices serving West Virginia patients must hold a West Virginia license and, for APRNs, an active collaborative agreement.

What this means for West Virginia patients and providers

For patients: your Mountain Health Trust MCO covers both video and audio-only telehealth for behavioral health, and video telehealth for primary care, from your home. This is particularly important in counties like McDowell, Wirt, and Calhoun where traveling to a clinic is a significant barrier. Confirm your provider is credentialed with your specific MCO before booking a telehealth appointment.

For providers: billing telehealth correctly across four MCOs requires maintaining four MCO billing guides. The BMS provider manual sets the baseline, but each MCO has supplemental requirements. Modifier and POS errors are the most common source of telehealth claim denials — a review of each MCO’s telehealth addendum before the first claim submission prevents most problems.

Browse West Virginia telehealth-capable clinic listings.

This post was drafted by AI and reviewed by our editorial team. Last updated 2026-05-28.