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UPDATED HHS GUIDANCE: Claims for Telephonic Behavioral Health and Medical Services

Date: 02/28/22

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

To help ensure continuity of care during the COVID-19 (coronavirus) response, Texas Health and Human Services (HHS) is authorizing providers to submit claims for certain dates of service for behavioral health and medical services delivered by telephone (audio only). See details below:

HHS is authorizing providers to submit claims for dates of service March 20, 2020 through April 30, 2022*, for reimbursement of the following behavioral health services delivered by telephone (audio only).

 DESCRIPTION OF SERVICES

PROCEDURE CODES

 

Psychiatric Diagnostic Evaluation

90791, 90792

 

Psychotherapy

90832, 90834, 90837, 90846, 90847, 90853

 

Peer Specialist Services

H0038

 

Mental Health Rehabilitation

H0034, H2011, H2012, H2014, H2017

Note: Beginning February 1, 2022, HHS authorizes fee-for-service providers to submit claims for reimbursement for telephone (audio-only) for the following behavioral health service: Screening, Brief Intervention, and Referral to Treatment (SBIRT): H0049, G2011, 99408. See full article for details.

HHS is authorizing providers to submit claims for dates of service March 20, 2020 through April 30, 2022*, for reimbursement of the following medical services delivered by telephone (audio only).

 DESCRIPTION OF SERVICES

PROCEDURE CODES

Evaluation and Management (E/M)

99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215

Providers should continue to use the 95 modifier to indicate the occurrence of remote delivery.

Telemedicine and Telehealth During COVID-19

Superior HealthPlan has developed a Telemedicine Quick Reference Chart (PDF) to help providers navigate telemedicine and telehealth reimbursement.

This chart reflects Medicare’s waiver of the geographic and place of service restrictions for Medicare. Additionally, an emergency rule related to the payment of telemedicine has been implemented, allowing state-regulated plans to allow telemedicine visits to be paid at the same rate as in-office visits.

*Please note: This guidance has been updated. See previously posted article for details of past updates.