In response to the COVID-19 public health emergency (PHE), the Texas Health and Human Services Commission (HHSC) has allowed CPW services, including comprehensive visits, to be completed by telephone (audio-only telecommunications) since April 1, 2020, and this flexibility will remain in place until HHSC provides further direction. Community First will allow this flexibility until HHSC provides further direction.

Effective September 1, 2022, CPW comprehensive visits and follow-up visits completed through the use of synchronous audiovisual technology is a benefit of Texas Medicaid.

  • CPW services, including comprehensive visits, may be completed by telephone (audio-only telecommunications)
  • When submitting a new prior authorization (CM-01) for a comprehensive visit to be completed using telephone (audio-only telecommunications), the Provider must include “telephone comprehensive visit will be completed due to COVID-19” within the psychosocial section of the prior authorization request form 
  • Providers should also note that Modifier 93 must be included on the claim form when the comprehensive visit or follow-up visit is completed using telephone (audio-only) telecommunications 

Resources:

July 18, 2022 – TMHP Bulletin: Changes to Case Management for Children and Pregnant Women, Including Teleservices

January 17, 2023 – TMHP Notice: Update on Case Management for Children and Pregnant Women (CPW) Policy Changes and COVID-19 Flexibilities

Contact:

Email ProviderRelations@cfhp.com or call 210-358-6294.

Beginning September 1, 2024 Community First Health Plans, Inc. will be adding STAR+PLUS to its line of health care products.

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