EFFECTIVE 2/1: Behavioral Health Services Delivered by Synchronous Audio-Visual or Telephone

Date: 01/28/22

Please Note: This information has been updated, please review: Update to HB4: Behavioral Health Services Delivered by Synchronous Audio-visual or Telephone (Audio-only) Interim Guidance

Texas Health and Human Services (HHS) is analyzing the clinical and cost effectiveness of COVID-19 Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), CHIP and STAR+PLUS Medicare-Medicaid Plan (MMP) telehealth flexibilities to align with House Bill (H.B.) 4 (87th Regular Legislative Session, 2021) requirements. H.B. 4 builds on Senate Bill 670 from the 86th Legislative Session which prohibits Medicaid health plans from denying reimbursement for audio-visual telemedicine or telehealth services solely because the service was delivered remotely. This notice will serve as interim guidance until the policy is codified in the Texas Administrative Code (TAC) through rule and future Texas Medicaid Provider Procedures Manual updates are finalized.

Beginning February 1, 2022, HHS authorizes fee-for-service providers to submit claims for reimbursement for the following behavioral health services delivered by audio-only and audiovisual modalities as specified below.

Audio-Visual Behavioral Health Modalities

Telephone (Audio-Only) Behavioral Health Modalities

Please Note: For all services listed above, per standards of care, the service modality must be clinically appropriate, safe and agreed to by the person receiving services or the Legally Authorized Representative (LAR). Providers must defer to the needs of the person receiving services, allowing the mode of service delivery to be accessible, person and family centered, and primarily driven by the person’s choice and not provider convenience. HHS encourages the use of synchronous audio-visual technology over telephone audio-only delivery of telemedicine and telehealth services whenever possible.