UPDATED: HHS Notice: Claims for Telephonic Behavioral Health and Medical Services
Date: 09/28/21
Please Note: This article has been updated. Please review the new article for details.
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 dates of service March 20, 2020 through January 31, 2022*, for reimbursement of the following behavioral health and medical services delivered by telephone (audio only):
Behavioral Health Services
DESCRIPTION OF SERVICES | PROCEDURE CODES |
|---|---|
Psychiatric Diagnostic Evaluation | 90791, 90792 |
Psychotherapy | 90832, 90834, 90837, 90846, 90847, 90853 |
Peer Specialist Services | H0038 |
Screening, Brief Intervention, and Referral to Treatment (SBIRT) | 99408, G2011, H0049 |
Substance Use Disorder Services | H0001, H0004, H0005 |
Mental Health Rehabilitation | H0034, H2011, H2012, H2014, H2017 |
Medical Services
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) (Updated December 30, 2021) 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.
Rural Health Clinics as Telehealth and Telemedicine Sites
Effective December 1, 2020, Federally Qualified Health Centers (FQHCs) may be reimbursed as telemedicine and telehealth distant site provider as permanent policy change per S.B. 670, Texas Legislature, Regular Session, 2019.
When submitting an encounter for a Rural Health Center (RHC) service delivered through telehealth or telemedicine, the existing RHC procedure code T1015 should be used, with the modifier 95 added to indicate use of the telehealth or telemedicine modality.
Claims Information
For full details regarding Telemedicine and Telehealth claims, please reference the following Texas Medicaid and Healthcare Partnership articles:
- Claims for Telephone (Audio Only) Behavioral Health Services
- Claims for Telephone (Audio Only) Medical Services
*Please note: Previously, the end date for this guidance was April 30, 2020, then extended to May 31, June 30, July 31, October 23, November 30, December 31, 2020, January 31, February 28, March 31, April 30, May 31, June 30, July 31, August 31, September 30, 2021 and December 31, 2021. This notice is extended until January 31, 2022.