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Telehealth During COVID-19:Ensuring Reimbursement
© 2017, Telligen, Inc.© 2018, Telligen, Inc.
This material was prepared by Telligen, the Medicare Quality Innovation Network Quality Improvement Organization, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 12SOW-QIN-AIM5-03/18/20-3614
Telehealth During COVID-19: Ensuring ReimbursementGuest Speakers: Pam Nelson, RN, MSPH, CMPE, PhDNancy Enos, FACMPE, CPC-I, CPMA, CEMCApril 2, 2020 at 2:00 ET
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In Partnership
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Today’s content reflects the speakers’ best understanding as of 4/02/20. Information about telehealth is often updated; please continue to check with CMS, payors, and others for the most up-to-date guidance.
This material is for informational purposes only and does not constitute medical advice; it is not intended to be a substitute for professional medical advice, diagnosis or treatment.
Giving This Our Best Shot…
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Following this webinar, participants will be able to:
Understanding the telehealth benefit under the CMS 1135 waiver, a temporary and emergency measure.
Identify qualified and non-qualified providers eligible to bill telehealth codes.
Identify proper coding for telehealth services, and when to use telehealth modifiers.
Describe proper documentation for telehealth visits. Learn about telehealth benefits for Medicaid and commercial
payers
Objectives
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Pam NelsonRN, MSPH, CMPE, PhD
[email protected] Consulting Inc.
Introducing Today’s Speakers
Nancy EnosFACMPE, CPC-I, CPMA, CEMC
[email protected] Medical Coding
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Telehealth refers to the exchange of medical information from one site to another through electronic communication to improve a patient’s heath.
Telemedicine is the practice of medicine using technology to deliver care at a distance.
What is Telehealth/Telemedicine?
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COVID-19 Regulatory Changes
On March 17, 2020 the Centers for Medicare & Medicaid Services (CMS) issued guidance on Secretary Azar’s waiver authority that broadens access to Medicare telehealth services.
Effective March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, CMS will allow all qualified healthcare providers to care for patients remotely and bill Medicare and Medicaid, without meeting the existing requirements that will be covered in the following slides
Check with other payers as their policies will likely change in accordance with CMS
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The waiver temporarily eliminates the requirement that the originating site must be a physician’s office or other authorized healthcare facility and allows Medicare to pay for telehealth services when beneficiaries are in their homes or any setting of care.
Available to Patients in Their Home
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A covered health care provider that wants to use audio or video communication technology to provide telehealth to patients during the COVID-19 nationwide public health emergency can use any non-public facing remote communication product that is available to communicate with patients
– The waiver allows use of telephones that have audio and video capabilities (smart phones)
– Without video, use the telephone call CPT codes can be found in upcoming slides
Waiving Communication Restrictions
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Real-Time Communication
The provider must use an interactive audio and video telecommunications system that permits real-time communication between the distant site and the patient at home.
Both the provider and the patient must be able to communicate using audio and video. (E.g. Facetime)
Under this HHS Notice, however, Facebook Live, Twitch, TikTok, and similar video communication applications are public facing, and should not be used in the provision of telehealth by covered health care providers
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Geographic Restrictions
CMS guidance clarifies that it will not enforce this requirement, meaning that patients need not been billed under Medicare in the past three years by the provider or
practice.
CMS will not enforce the established relationship requirement codified in H.R. 6074. H.R. 6074 implemented an “established patient” requirement for telehealth services
furnished pursuant to any new waivers.
There are no geographic restrictions: Clinicians are permitted to furnish telehealth services to patients located in any geographic area (e.g., both non-rural and non-
health professional shortage areas (HPSAs).
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Covered health care providers may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype, to provide telehealth without risk that (office of civil rights) OCR might seek to impose a penalty for noncompliance with the HIPAA Rules related to the good faith provision of telehealth during the COVID-19 nationwide public health emergency.
Providers are encouraged to notify patients that these third-party applications potentially introduce privacy risks, and providers should enable all available encryption and privacy modes when using such applications.
Under this Notice, however, Facebook Live, Twitch, TikTok, and similar video communication applications are public facing, and should not be used in the provision of telehealth by covered health care providers.
This exercise of discretion applies to telehealth provided for any reason, regardless of whether the telehealth service is related to the diagnosis and treatment of health conditions related to COVID-19.
HIPAA Compliance
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Privacy Issues Using FaceTime
The HHS.gov Health Information Privacy Notice can be viewed on their websitePlease note HIPAA still applies to all other practice functions.
Telehealth services need to be agreed to by the patient; however, practitioners may educate beneficiaries on the availability of the service prior to patient agreement. Verbal consent documents in patients’ chart is
acceptable.
OCR will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the
good faith provision of telehealth during the COVID-19 nationwide public health emergency. This notification is effective immediately.
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Copays Can Be Waived
The HHS Office of Inspector General (OIG) is providing flexibility for healthcare providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare programs.
The use of telehealth does not change the out of pocket costs for beneficiaries with Original Medicare. Beneficiaries are generally liable for their deductible and coinsurance; however, the HHS Office of Inspector General (OIG) is providing flexibility for healthcare providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare programs.
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In order to deliver telehealth services, a clinician must still be a Medicare “qualified provider.”
CMS has temporarily waived the requirements that physicians or other healthcare professionals hold licenses in the state in which they provide services if they have an equivalent license from another state.
Eligible Providers
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A range of providers, such as doctors, nurse practitioners, physician assistants, nurse midwives, certified nurse anesthetists, clinical psychologists, licensed clinical social workers, registered dietitians and nutrition professionals will be able to offer telehealth to their patients.
Recognized, licensed providers may vary, check your State regulations.
Eligible Providers
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A range of providers, such as doctors, nurse practitioners, physician assistants, nurse midwives, certified nurse anesthetists, clinical psychologists, licensed clinical social workers, registered dietitians and nutrition professionals will be able to offer telehealth to their patients.
Recognized, licensed providers may vary, check your State regulations. Certain clinicians are not included as a provider type that can furnish telehealth as a covered service to Medicare beneficiaries under this legislation.
Clinicians who may not independently bill for evaluation and management visits, for example – physical therapists, occupational therapists, speech language pathologists, clinical psychologists.
However, they can provide these online visits which represent patient-initiated email or patient portal communication and bill the following codes.
Non-Clinician Eligible Providers
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Patient question clinical decision: G2061: Qualified non-physician healthcare professional receive
email or portal question and they provide a clinical decision that otherwise would have been provided in the office for an established patient, they can spend 5-10 minutes over a period of seven days, the cumulative time during the 7 days; 5–10 minutes no longer.
G2062 11–20 minutes G2063: 21 or more minutes
Non-Clinician Eligible Providers
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Medicare telehealth services are generally billed as if the service had been furnished in-person.
For Medicare telehealth services, the claim should reflect the designated Place of Service (POS) code 02-Telehealth, to indicate the billed service was furnished as a professional telehealth service from a distant site.
Billing for Telehealth services
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Medicare pays the same amount for telehealth services as it would if the service were furnished in person.
For services that have different rates in the office versus the facility (the site of service payment differential), Medicare uses the facility payment rate when services are furnished via telehealth.
Billing for Telehealth services
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The codes 99201-99205, 99211 - 99215, the consultation codes 99241-9945 and others can be reported with the telemedicine modifiers GT or 95 depending on the payer.
The American Academy of Family Physicians has an article on their website that discusses Telemedicine Reimbursement and Licensure– https://www.aafp.org/dam/AAFP/documents/advocacy/health_it/teleh
ealth/BKG-Telemedicine.pdf
Telemedicine Codes
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Reimbursement will be allowed for any telehealth- covered CPT code even if unrelated to treatment of a COVID-19 diagnosis, screen or treatment
There are 101 CPT codes designated as eligible for telehealth payment.– Office or other outpatient visits– Subsequent hospital and nursing facility care visits– Psychotherapy– Health and behavioral assessment and interventions– End-stage renal disease services– Preventive Medicine visits are not covered, for any age
Covered Codes
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CMS will now pay for more than 80 additional services when furnished via telehealth.
These include emergency department visits, initial nursing facility and discharge visits and home visits.
PCMS is allowing telehealth to fulfill face-to-face visit requirements for clinicians to see patients in inpatient rehabilitation facilities; hospice and home health.
Virtual Check-in services can be provided to both new and established patients.
March 30, 2020 Expansion
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Modifier 95 Synchronous Telemedicine Service Rendered Via a Real-Time Interactive Audio and Video Telecommunications System
Synchronous telemedicine service is defined as a real-time interaction between a physician and a patient who is located at a distant site.
The totality of the communication of information exchanged must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction.
Telemedicine Modifier
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The new rules do not enforce the established relationship requirement that a patient have seen a provider within the last three years.
New patients may be problematic when you have to document 3/3 elements (History, Exam and MDM) in order to bill a new patient code 99201-99205
Documentation to support the level of service, or time, must be considered
Patient Status
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Even before the availability of this waiver authority, CMS made several related changes to improve access to virtual care in 2019.
Virtual Check-ins (G2012) – For established patients, providers may bill for virtual check-ins, which allow for a 5-10-minute conversation with a patient via telephone or other telecommunications device to evaluate whether an in-office visit is necessary.
Virtual check-ins are not limited to rural settings or certain locations. Virtual check-ins can be conducted with a broader range of communication methods, unlike Medicare telehealth visits, which require audio and visual capabilities for real-time communication.
Virtual Check-In
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G2010 Store and Forward: Remote evaluation of recorded video and/or images submitted by an established patient, including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment (same as for G2012)
CMS is currently waiving all Telemedicine modifiers. Modifier GT would be appropriate for other payers
Remote Check -In
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Clinicians who may not independently bill for evaluation and management visits (for example – physical therapists, occupational therapists, speech language pathologists, clinical psychologists) can also provide these visit types and bill the following codes:
G2061: Qualified non-physician healthcare professional online assessment and management, for an established patient, for up to seven days, cumulative time during the 7 days; 5–10 minutes
G2062: Qualified non-physician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11–20 minutes
G2063: Qualified non-physician qualified healthcare professional assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes.
Billing Codes for Clinicians Who May Not Bill E&M Independently
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CodeAvg
Payment Description
99421 $13.35Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes
99422 $27.43Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes
99423 $43.67Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes
These codes are for patient-initiated communications and may be billed by clinicians who may independently bill an E/M service. They may not be used for work done by clinical staff or for clinicians who do not have E/M services in their scope of practice.
Online Digital Evaluation and Management
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Online Digital Evaluation and Management
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A virtual check-in pays professionals for brief (5-10 min) communications that mitigate the need for an in-person visit, whereas a visit furnished via Medicare telehealth is treated the same as an in-person visit, and can be billed using the code for that service, using place of service 02 to indicate the service was performed via telehealth.
An e-visit is when a beneficiary communicates with their doctors through online patient portals.
How is Telemedicine Different from Virtual Check-ins and E-visits?
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For calls without video capability, you can report:
99441 telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
99442 … 11-20 minutes of medical discussion 99443 … 21-30 minutes of medical discussion
Summarize discussion and document time spent
Provider Telephone Services
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98966 Telephone assessment and management service provided by a qualified nonphysician health care professional (e.g., Nurse) to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment;5-10 minutes of medical discussion ($14.44)
98967 … 11-20 minutes of medical discussion ($28.15) 98968 … 21-30 minutes of discussion ($41.14)
Summarize the discussion and document time spent
Non-physician Telephone Services
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Summary of Medicare Telemedicine ServicesType of service CPT Code What is the service?
Medicare Telehealth Visits 99201-99215 A visit with a provider that uses real-time audio and video
telecommunications systems between a provider and a patient
Virtual Check-In G2012 G2010
A brief check in with a provider with a telephone or other telecommunication device to decide whether an office visit is
warranted OR a remote evaluation of recorded video or images submitted by a patient.
E-Visits
99421 9942299423 G0261 G0262 G0263
Communication between a patient and their provider through an online portal (based on cumulative time spent over 7 day period)
Telephone only
99441 99442 99443 98966 98967 98968
Telephone evaluation by a physician or non-physician (based on time spent)
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Documentation Guidelines and key components of E/M Services: History Exam Medical Decision Making; OR Time-based E/M Services
Documentation Requirements for Telemedicine
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E & M Level of Service Breakdown
S Level of HistoryO Level of Exam A P Level of Decision Making
Level of Service
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CMS is not requiring additional or different modifiers associated with telehealth services furnished under these waivers.
However, consistent with current rules, there are three scenarios where modifiers are required on Medicare telehealth claims:
1. In cases when a telehealth service is furnished via asynchronous(store and forward) technology as part of a federal telemedicine demonstration project in Alaska and Hawaii, the GQ modifier is required.
2. When a telehealth service is billed under CAH Method II, the GTmodifier is required.
3. When telehealth service is furnished for purposes of diagnosis and treatment of an acute stroke, the G0 modifier is required.
Telehealth Modifiers
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Check with payers to verify their requirements for modifiers
Telehealth Modifiers
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On January 30, 2020, the World Health Organization (WHO) declared the 2019 Novel Coronavirus (2019-nCoV) disease outbreak a public health emergency of international concern. As a result of the declaration, the WHO Family of International Classifications (WHOFIC) Network Classification and Statistics Advisory Committee (CSAC) convened an emergency meeting on January 31, 2020 to discuss the creation of a specific code for this new Coronavirus.
U07.1, COVID-19 (test confirmed)* Without a positive test
– Z71.84 Encounter for Health counseling related to Travel – Z71.1 Person with feared health complaint in whom no diagnosis is made
*Effective October 1, 2020
ICD-10 Coding for Coronavirus
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Question: Should CPT code 87635, a HCPCS Level II code, or both be reported if the test for COVID-19 is performed?
Answer: The appropriate code to be reported is dependent upon the payer to which the claim is being submitted. If the claim is submitted to a payer that requires CPT codes, then code 87635 should be reported. Conversely, if the payer requires use of the HCPCS Level II code, the HCPCS Level II code should be reported. CPT and HCPCS codes should not both be reported on the same claim. Contact your local third-party payer directly to determine their specific reporting guidelines.
CPT Assistant - Coronavirus
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Question: Codes already exist in the Pathology and Laboratory section of the CPT code set for coronavirus. What is the difference between the new
code 87635 and the other CPT codes that state coronavirus in their descriptor (i.e., 87631, 87632, 87633, 0098U, 0099U, 0100U)?
Answer: Existing codes 87631, 87632, and 87633 are used for nucleic acid assays that detect multiple respiratory viruses in a multiplex reaction (ie, single procedure with multiple results). Similarly, proprietary laboratory analyses (PLA) codes 0098U, 0099U, and 0100U are used to identify multiple types or subtypes of respiratory pathogens. In contrast, code 87635 is for the detection of SARS-CoV-2 (COVID-19) and any pan-coronavirus types or subtypes, and it can be reported with tests from multiple manufacturers using the stated technique.
CPT Assistant - Coronavirus
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Effective for services starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for Medicare telehealth services furnished to patients in broader circumstances.
These visits are considered the same as in-person visits and are paid at the same rate as regular in-person visits.
Starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for professional services furnished to beneficiaries in all areas of the country in all settings.
Key Takeaways
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While they must generally travel to or be located in certain types of originating sites such as a physician’s office, skilled nursing facility or hospital for the visit, effective for services starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for Medicare telehealth services furnished to beneficiaries in any healthcare facility and in their home.
Key Takeaways
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The Medicare coinsurance and deductible would generally apply to these services. However, the HHS Office of Inspector General (OIG) is providing flexibility for healthcare providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare programs.
To the extent the 1135 waiver requires an established relationship, HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during this public health emergency.
Key Takeaways
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Nancy M Enos, FACMPE, CPMA, CPC-I, CEMC
About the Speaker
Nancy M Enos, FACMPE, CPMA, CPC-I, CEMC is an independent consultant with the MGMA Health Care Consulting Group and a principal of Enos Medical Coding. Mrs. Enos has 40 years of experience in the practice management field. Nancy was a practice manager for 18 years before she joined LighthouseMD in 1995 as the Director of Physician Services and Compliance Officer. In July 2008 Nancy established an independent consulting practice, Nancy Enos Medical Coding (www.nancyenoscoding.com)
As an Approved PMCC and ICD-10 Instructor by the American Academy of Professional Coders, Nancy provides coding certification courses, outsourced coding services, chart auditing, coding training and consultative services and seminars in CPT and ICD-9and ICD-10 Coding, Evaluation and Management coding and documentation, and Compliance Planning. Nancy frequently speaks on coding, compliance and reimbursement issues to audiences including National, State and Sectional MGMA conferences, and at hospitals in the provider community specializing in primary care and surgical specialties.
Nancy is a Fellow of the American College of Medical Practice Executives. She serves as a College Forum Representative for the American College of Medical Practice Executives.
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Pamela Ballou-Nelson, RN, MSPH, CMPE, PhD
About the Speaker
Pamela Ballou-Nelson, RN, MSPH, CMPE, PhD, has more than 30 years of experience in healthcare management, focusing on practice process transformation, PCMH, workflow analysis, quality measures, including PQRS, HRSA, Medicaid and CMS outcome measures, care management, population health and patient activation, across the continuum of care. Dr. Nelson has worked with both provider and payer organizations working toward alternative care and payment models.
Dr. Nelson has provided training, advising, and mentoring for over 80 practices in various levels of readiness preparing them for value-based payment reform, process improvement, improved quality outcomes, and increased efficiency through PCMH recognition, and, more recently, Dr. Nelson is providing practices with education, training, and implementation for MACRA QPP: MIPS and APM.
Dr. Nelson has a BSN from University of Utah, an MA from Wheaton College, and an MS and PhD in Public Health from Walden University.
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Resources: Covered codes by provider and service type
Type of Service What is the Service? Who is the Provider? HPCS/CPT Code Patient relationship with Provider
MEDICARE Telehealth Visits A visit with a provider that uses telecommunication systems between a provider and a patient.
Physicians and other Qualified Health care Professional
Common telehealth services include: 99201-99215 (Office or other outpatient visits) G0425-G0427 (Telehealth consultations, emergency department or initial inpatient) G0406-G0408 (Follow-up inpatient telehealth consultations furnished to beneficiaries in hospitals or SNFs)
For new* or established patients.*To the extent the 1135 waiver requires an established relationship, HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during this public health emergency
Virtual check-in or Telephone call
A brief (5-10 minutes) check in with your practitioner via telephone or other telecommunications device to decide whether an office visit or other service is needed. A remote evaluation of recorded video and/or images submitted by an establish patient.
Physicians and other Qualified Health care Professional
HCPCS code G2012 (brief check-in) HPCPS code G2010 (store and forward data)
For established patients.
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Resources: Continued: Covered codes by provider and service type
Type of Service What is the Service? Who is the Provider?
HPCS/CPT Code Patient relationship with Provider
Telephone E/M Service
Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment
Physicians and other Qualified Health care Professional
99441 – 5-10 minutes 99442 – 11-20 minutes 99443 – 21-30 minutes
For established patients.
Telephone assessment and management service provided by a qualified nonphysician health care professional not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment
Qualified nonphysician health care professional
98966 – 5-10 minutes 98967 – 11-20 minutes 98968 – 21-30 minutes
For established patients.
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Type of Service
What is the Service? Who is the Provider? HPCS/CPT Code Patient relationship with Provider
E-Visits
On-line medical evaluation services are non-face-to-face encounters originating from the established patient to the physician or other qualified health care professional for evaluation or management of a problem utilizing internet resources. The service includes all communication, prescription, and laboratory orders with permanent storage in the patient's medical record. The service may include more than one provider responding to the same patient and is only reportable once during seven days for the same encounter. Do not report these codes if the online patient request is related to an E/M service that occurred within the previous seven days or within the global period following a procedure.
Physicians and other Qualified Health care Professional
99421 99422 99423
For established patients.
Qualified nonphysician health care professional online assessment, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes, 11-20 minutes and 21 or more
Clinicians who may not independently bill for evaluation and management visits (ex. Physical therapists, occupational therapists, speech language pathologists, clinical psychologists) can bill G2061-G2063
G2061 G2062G2063
For established patients.
Resources: Continued: Covered codes by provider and service type
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Additional Resources
• COVID-19 State of Emergency Changes to Telemedicine Services for Medicaid
https://www.colorado.gov/pacific/hcpf/provider-telemedicine
• Respond to Coronavirus (COVID-19)
https://www.aafp.org/patient-care/emergency/2019-coronavirus.html?intcmp=nCoV_car_2019-nCoV_promo_pos1
• Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19
https://www.cms.gov/newsroom/press-releases/cms-announces-relief-clinicians-providers-hospitals-and-facilities-participating-quality-reporting
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The CDC site devoted to COVID-19 information, updates, information for providers, community resources, and frequently asked questions http://coronavirus.gov/.
CMS fact sheet announcing expansion of telehealth services on March 17th
https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet.
Health Information Privacy Notice https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth
FAQ posted by CMS Frequently Asked Questions
Special (FREE) edition of CPT Assistant with guidance on the new CPT code https://www.ama-assn.org/system/files/2020-03/cpt-assistant-guide-coronavirus.pdf
Additional Resources
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Additional resources: Medicaid info by state Colorado Medicaid: https://www.colorado.gov/pacific/hcpf/provider-telemedicine
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Iowa Medicaid https://dhs.iowa.gov/ime/providers/faqs/covid19 Iowa Medicaid COVID-19 Provider Toolkit - Printable PDF (Updated 3/27/20)
Can providers provide telehealth service from their home?The IME, in collaboration with our Managed Care partners, is working to develop additional guidance for providers around the waivers requested by the State that will expand the application of technology to service delivery for our members during the duration of the COVID-19 emergency. The Department intends for providers to utilize technology to facilitate appropriate care reimbursable within the Medicaid program during this public health emergency. Part of this emergency provision will allow services that are direct contact services and are typically rendered in person to be rendered via telehealth when clinically appropriate and necessary to preserve the health and safety of our Medicaid member. Providers must practice within the scope of their practice and are reminded that services must be documented in accordance with applicable documentation standards.
What is meant by telephonic contact – only video?Telephonic contact refers to contact relating to or happening by means of a telephone system. It does not mean video only. For the duration of the current emergency, services that typically require direct or face-to-face contact may be rendered via telehealth when clinically appropriate to the member’s condition and needs and when provided within the clinician’s scope of practice. Nothing in this statement otherwise effects a provider’s responsibility to bill only for service performed and to comply with legal authority related to proper billing, claims submission, cost reporting or related conduct.
Additional Resources: Medicaid info by state
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Illinois Medicaid Telehealth and COVID 19 Illinois Medicaid:
https://www.illinois.gov/hfs/MedicalProviders/notices/Pages/prn200320b.aspx
Oklahoma Medicaid The Oklahoma Health Care Authority is allowing expanded use of
telehealth beginning March 16, 2020 through April 30, 2020 for services that can be safely provided via secure telehealth communication devices for all SoonerCare members.
https://okhca.org/providers.aspx?id=10014 https://okhca.org/providers.aspx?id=24604
Additional Resources: Medicaid info by state
