UPDATED: HHS Notice: Claims for Telephonic Behavioral Health and Medical Services
Date: 03/30/20
Note: Please view UPDATED: HHS Notice: Claims for Telephonic Behavioral Health and Medical Services for an updated end date for this 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 dates of service March 20, 2020, through April 30, 2020, 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 (updated 4/20/2020) 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*
To aid Rural Health Clinics (RHCs) in delivering care to individuals in response to COVID-19, RHCs may be reimbursed as telemedicine and telehealth distant site providers statewide for service dates from March 24, 2020 through April 30, 2020.
When submitting an encounter for a RHC service delivered through telehealth or telemedicine, the existing RHC procedure codes T1015 and 99381 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