Policy Clarification – Medical Cannabis Office Visits

Medical cannabis products are not a covered benefit under New York State Medicaid. However, practitioner office visits related to patient evaluation and certification for medical cannabis are Medicaid reimbursable services.

Practitioners who participate with Medicaid are prohibited from requesting payment for medical cannabis certification from the member, regardless of whether the certification is provided during the initial office visit or subsequent to the initial visit. Patients insured with Medicaid who use out-of-network or non-Medicaid providers for evaluation and certification may still be charged a fee for the evaluation and certification visit. To avoid confusion, patients are advised to verify that their evaluating and certifying practitioner participates with Medicaid prior to their appointment.



In addition, The New York State Department of Financial Services (DFS) recently issued guidance to health insurers regarding coverage for office visits related to medical cannabis.