Category: CoVID-19

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From Molina March 23,2020:

All MCOs:

Claims for Telephone (Audio-Only) Medical Services

Background: Providers may bill codes 99201-99205 and 99211-99215 for dates of service of March 20, 2020, through April 30, 2020, to receive Medicaid reimbursement for telephone (audio-only) medical services.

Key Details: To help ensure continuity of care during the COVID-19 (coronavirus) response, HHSC is authorizing providers to bill codes 99201-99205 and 99211-99215 for telephone (audio-only) medical (physician delivered) evaluation and management services delivered on March 20, 2020, through April 30, 2020.

Providers should continue to use the 95 modifier to indicate that remote delivery has occurred.

Telephonic evaluation and management services are not to be billed if clinical decision-making dictates a need to see the patient for an in-person or telemedicine (video) office visit within 24 hours or at the next available appointment. In those circumstances, the telephone service shall be considered a part of the subsequent office visit.

If the telephone call follows an office visit performed and reported within the past seven calendar days for the same diagnosis, then the telephone services are considered part of the previous office visit and are not separately billed.

Additional Information:

Providers can refer to the Texas Medicaid Provider Procedures Manual, Telecommunication Services Handbook for additional information about the Texas Medicaid telemedicine services benefit.

Resources: http://www.tmhp.com/Pages/Medicaid/Medicaid_Publications_

ProviderManual_Curr ent.aspx

Contact: [email protected]​[embeddoc url=”https://community.poetllc.org/wp-content/uploads/2020/03/Molina-03232020.pdf” download=”all” viewer=”google”]

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