Effective for dates of service on or after December 1, 2024, additional telemedicine and telehealth services will be available for Texas Medicaid clients. Certain telemedicine and telehealth services may be provided if the Provider determines that the services are clinically appropriate and safe, and the client who is receiving services agrees to it. Whenever possible, the Texas Health and Human Services Commission (HHSC) encourages face-to-face interactions, such as an in-person visit, as well as the use of synchronous audiovisual technology over synchronous telephone (audio-only) technology of telemedicine and telehealth services.
Documentation for a service provided through telemedicine or telehealth must be the same as for a comparable in-person service. The documentation must accurately reflect the services and the method by which they were provided.
If services are delivered by synchronous telephone (audio-only) technology, providers must document the reason(s) for using this method by adding it in the client’s medical record. Services delivered using synchronous audiovisual technologies must be billed using modifier 95. Services delivered using synchronous telephone (audio-only) technologies must be billed using modifier 93.
Medical Nutritional Counseling Services
Beginning December 1, 2024, medical nutritional therapy (procedure codes 97802, 97803, and 97804) may be delivered by synchronous audiovisual technology for Texas Medicaid clients. These services and medical nutrition counseling (procedure code S9470) may also be delivered by synchronous telephone (audio-only) technology for Texas Medicaid clients, but Texas Medicaid will only cover the services during specific public health emergencies or natural disasters.
Renal Dialysis Services
Beginning December 1, 2024, the following physician service procedure codes for end-stage renal disease (ESRD) may be delivered by synchronous audiovisual technology:
Procedure Codes
| 90951 | 90952 | 90954 | 90955 | 90957 | 90958 | 90960 | 90961 |
Refer to the current Texas Medicaid Provider Procedures Manual, Telecommunication Services Handbook, for additional information about telemedicine services, and the Clinics and Other Outpatient Facility Services Handbook, subsection 6.2.1, “Physician Supervision,” for additional information about physician supervision of ESRD clients on dialysis.
Providers are encouraged to share this information with their staff. If you have any questions about this notice, please email Provider Relations at ProviderRelations@cfhp.com or call 210-358-6294. You can also contact your Provider Relations Representative directly.
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