Original Source: Center for Connected Health Policy
CCHP Provides Resources to Navigate CA Medicaid’s New Telehealth Policy
Last month the California Department of Health Care Services (DHCS) released its finalized telehealth policy update for Medi-Cal (CA Medicaid) fee-for-service, as well as a few other programs (including Indian Health Services, Memorandum of Agreement (IHS-MOA), Federally Qualified Health Centers/Rural Health Clinics (FQHCs/RHCs), Family Planning, Access, Care, and Treatment (PACT), Local Education Agency (LEA) and Vision Care). An All Plan Letter was also distributed to Managed Care plans on the changes. The most significant changes to the fee-for-service policy included allowing providers to decide what modality, live video or store-and-forward, will be used to deliver eligible services to a Medi-Cal enrollee as long as the service is covered by Medi-Cal and meets all other Medi-Cal guidelines and policies, can be properly provided via telehealth and meets the procedural and definition components of the appropriate CPT or HCPCS code. Additionally, the home now qualifies as an originating site with no requirement that a provider be present with the patient at the time services are rendered. DHCS has also opened up one code for e-consult, considered a subset of store-and-forward. Finally, DHCS has specified that in order for a provider to qualify for reimbursement, they must be licensed in CA, enrolled as a Medi-Cal rendering provider or non-physician medical practitioner and affiliated with an enrolled Medi-Cal provider group. The enrolled Medi-Cal provider group must be located in California or a border community.
The program specific manuals (for example, IHS-MOAs, and FQHCs/RHCs) do have additional requirements and restrictions. CCHP has created a factsheet and comparison chart between the programs that outlines the various changes to the revised Medi-Cal policies.
To learn more, visit CCHP’s California webpage for all the latest developments in CA telehealth policy.