New Telehealth Services Medical Policy draft open for comment

HHSC has posted a new draft of its Telehealth Services Medical Policy, opening it up to feedback and public comment. The new draft proposes three major amendments to the policy related to SB 922, the 2017 piece of legislation related to Medicaid reimbursement for certain providers of telehealth services.

The first amendment adds a new “Telehealth in Schools” section to the policy to specify which provider types can be reimbursed for telehealth services. According to the new section, occupational therapists and speech-language pathologists may be reimbursed for telehealth services for children in school settings. The children who receive the services must be eligible through the Texas Health Steps Comprehensive Care Program. Schools that participate in the School Health and Related Services (SHARS) may also receive reimbursement for these services. Licensed professional counselors, clinical social workers, marriage/family therapists, and psychologists may be reimbursed for telehealth services provided in schools settings as well.

The new policy draft also adds the specific occupational and speech therapy procedure codes for telehealth reimbursement and details new prior authorization requirements for certain procedure codes. The proposed medical policy draft outlines the specific codes that require prior authorization, but does not detail what each specific code is for.

Feedback on the proposed changes to the telehealth policy should be sent to MCDMedicalBenefitsPolicyComment@hhsc.state.tx.us by August 15, 2018.