Provider Notice Issued 01/10/18

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Date: January 10, 2018                    

To:  All Medical Assistance Providers

Re:  Changes to Professional Claims for Telehealth Services

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This notice informs providers that the Department of Healthcare and Family Services (HFS) will continue to require use of the GT modifier (via interactive audio and video telecommunications systems) on professional claims for telehealth services after January 1, 2018. In addition, changes have been made to the requirement for a physician or other licensed health care professional to be physically present in the room with the patient receiving telehealth services.

The Centers for Medicare and Medicaid Services (CMS) has eliminated the requirement to use the GT modifier on professional claims for telehealth services beginning January 1, 2018. HFS is not implementing this policy at this time. The GT modifier requirement will continue to remain in effect on all professional claims for telehealth services submitted to HFS.

Effective with dates of service on and after January 1, 2018, the Department will no longer require a physician or other licensed health care professional to be physically present in the same room at all times while the patient is receiving telehealth services.

·       Telemedicine - A physician or other licensed health care professional must be present with the patient at the originating site when medically necessary as determined by the physician or practitioner at the distant site.

·       Telepsychiatry - A physician, licensed health care professional or other licensed clinician, mental health professional, or qualified mental health professional must be available at all times at the originating site.

Billing instructions for telehealth services can be found in Chapter 200 Practitioner Appendices, and Chapter 200 Encounter Clinic Services Appendices.

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565.

Felicia F. Norwood

Director