Medicaid Update Special Edition – Telehealth and Telephonic Services UPDATE

March 24, 2020

The New York State Department of Health issued a Medicaid Update Special Edition today updating guidance featuring Comprehensive Guidance Regarding Use of Telehealth including Telephonic Services During the COVID-19 State of Emergency which now includes clarifications for FQHC billing as well as billing for home care providers. This guidance was originally issued on March 21, 2020.

The Department will be scheduling a webinar shortly to walk through this guidance and a set of FAQs for Medicaid telehealth are under development.

Billing pathways were updated for telephonic encounters for health care and health care support utilizing the usual provider billing structure.

Changes include:

Assessment and Patient Management

  • Home care aides, RNs, therapists and other home care workers were added as applicable providers
  • FQHCs, Day Programs and Home Care Providers were added as Historical Settings
  • Notes: Broadly billable by a wide range of provider types including FQHCs, Day Programs and Home Care (e.g., aide supervision, aid orientation, medication adherence, patient check-ins).
Other Services (not eligible to bill other categories)
  • Home Care and HCBS were added to provider types
  • Notes: LHCSA and CHHA assessments, evaluations and RN visits were added.
Background
During the state of emergency, all Medicaid provider types are eligible to provide telehealth, but services should be appropriate for telehealth and should be within the provider’s scope of practice.
  • Telehealth services will be reimbursed at parity with existing off-site visit payments or face-to-face visits (i.e., 100% of Medicaid payment rates). Specific billing guidance is included, as well as a directive for Medicaid Managed Care plans to follow the telehealth billing policy included in this guidance.
  • The guidance also addresses some technological barriers to telehealth by allowing healthcare organizations to bill for telephonic services if they cannot provide the audiovisual technology traditionally referred to as “telemedicine”.
This document will be updated frequently so please continue to check the COVID-19 Guidance for Medicaid Providers webpage and the Medicaid Update webpage for updates and amendments.

HCP Staff is Remote, but Available

HCP staff is working remotely as directed by Governor Cuomo in his Executive Order. You can still reach staff by email and telephone.  Our telephone extensions are forwarded to our remote telephones. If you reach our voice mail and leave a message, we can access the message through our email system.

Kathy Febraio, President, ext. 809 febraio@nyshcp.org   

Kevin Kerwin, Vice President of Public Policy, ext. 806  kerwin@nyshcp.org  

Mary Dworakowski, Senior Director of Administration & Finance, ext. 804 dworakowski@nyshcp.org 

Dena Collins, Director of Information Systems, ext.815 collins@nyshcp.org
 
Marissa Crary, Director of Marketing & Education, ext. 824 crary@nyshcp.org  

Cora Smith, Associate for Marketing & Education, ext. 825 smith@nyshcp.org

COVID-19 Resources

To keep track of the resources available to home care agencies, please visit HCP’s Coronavirus Resource page.