Reimbursement varies significantly by state as well as by payer, which means there are no hard and fast rules to help organizations determine if– and how much – they may be reimbursed for telepsychiatry services. While the federal Medicare program guidelines apply across the U.S., Medicaid programs are administered at the state level, which means each state can set its own criteria and telepsychiatry coverage. Each state can also determine whether private payers must offer reimbursement for telemedicine, causing significant variations in payments to clinicians and healthcare facilities.