DOH: Updated Medicaid Guidance Regarding Telehealth, Including Telephonic, Services During the COVID-19 Emergency/Webinar May 5

Jackie Pappalardi and Nancy Leveille in Clinical & Quality

The Department of Health has released updated guidance for Medicaid providers regarding the use of Telehealth, including Telephonic, services during the COVID-19 State of Emergency. The accompanying Frequently Asked Questions document has also been updated. These documents are available on the Department of Health website at https://www.health.ny.gov/health_care/medicaid/covid19/index.htm, or via the links below.

Medicaid Update: https://www.health.ny.gov/health_care/medicaid/program/update/2020/no05_2020-03_covid-19_telehealth.htm

Frequently Asked Questions: https://www.health.ny.gov/health_care/medicaid/covid19/faqs.htm

A summary of the changes is provided below.

  • Clarification regarding payment parity for telehealth and telephonic services
  • Provides additional details regarding billing and coding instructions, including POS and Modifier codes to use in each of the telephonic billing lanes
  • Clarifies definitions of telehealth, telemedicine and telephonic services.
  • Clarifies billing rules for Article 28 services with a Professional Component
  • Revises billing rules for FQHCs to allow wrap payments for licensed practitioners providing services via telehealth or telephone
  • Clarifies requirements for Medicaid Managed Care Plans
  • Provides additional links to other resources

The intent of this guidance is to provide broad expansion for the ability of all Medicaid providers in all situations to use a wide variety of communication methods to deliver services remotely during the COVID-19 State of Emergency, to the extent it is appropriate for the care of the member.

Telehealth services will be reimbursed at parity with existing off-site visit payments (clinics) or face-to-face visits (i.e., 100% of Medicaid payment rates). This guidance relaxes rules on the types of clinicians, facilities, and services eligible for billing under telehealth rules.

Webinar Regarding Medicaid Telehealth Guidance During the COVID-19 Emergency

On Tuesday, May 5, 2020 from 10:30 AM to 12:00 PM, the Department of Health Office of Health Insurance Programs will host a webinar to review Comprehensive Guidance Regarding Use of Telehealth including Telephonic Services During the COVID-19 State of Emergency

To register for the Webinar please visit https://meetny.webex.com/meetny/onstage/g.php?MTID=e5f212ed128ffe5f173d478348226385e.

This webinar will provide an overview of the guidance and cover frequently asked questions. Additional questions will be addressed by webinar participants, as time permits. A recording of the webinar will be also made available on the Department’s website.

NYSHFA/NYSCAL CONTACTS:

Jackie Pappalardi, RN, BSN
Executive Director
518-462-4800 x16

Nancy Leveille, RN, MS
Director, Special Projects and Educational Development
518-462-4800 x20