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DOH updates guidance on telehealth during state of emergency

Posted on May 1, 2020

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 Medicaid Update web page at https://www.health.ny.gov/health_care/medicaid/program/update/2020/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.