TELEHEALTH PERTAINING TO MEDICAID AND MENTAL HEALTH
Executive Order No. 2020-29D was signed on 7/16/20 and remains in effect until November 16, 2020. For additional information or updates, click here
Governor DeWine’s executive order expands telehealth and introduces more flexibility into the healthcare system. If a service does require in-person care (surgery, procedure, test), then the use of telehealth is most likely appropriate.
Ohio Department of Medicaid
Telehealth can either be:
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Live, synchronous, interactive, and real-time electronic communications using both audio and video; or
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Asynchronous activities that might not have audio and video (for example: phone calls, emails, images through fax)
Eligible Providers – as it relates to nurses:
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The following nurses are able to provide telehealth services reimbursable by Medicaid: Clinical nurse specialist, certified nurse-midwife, certified nurse practitioner, and private duty registered nurse or licensed practical nurse in a home health or hospice setting
Provider types eligible to bill for services rendered through telehealth
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- Any practitioner
- Professional medical group
- Professional dental group
- FQHC/RHC
- Ambulatory health care clinics
- Outpatient hospitals
- Private duty nurses
- Home health and hospice agencies
- Behavioral health providers
Requirements
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- Must comply with current HIPAA guidance from Office of Civil Rights
- Practitioner site (doctor’s office/clinic) responsible for maintaining appropriate documentation
- Patient and practitioner sites should be consistent with CPT and HCPCS guidelines for the service being provided
Ohio Department of Mental Health and Addiction Services
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Telehealth means real-time audiovisual communications with quality to permit accurate and meaningful interactions and includes asynchronous modalities that do not have both audio and video elements.
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Originating site (client) and distant site (provider) are where each are located at the time of service
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No initial in person visit is necessary to initiate services using telehealth
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Prior to initiating services, a provider must inform the patients of potential risks of telehealth and document that the patient understood and agrees to those risks (clinical aspects, security considerations and confidentiality considerations)
Services:
o General services
o CPST
o Therapeutic behavioral services and psychosocial rehabilitation
o Peer recovery
o SUD case management
o Crisis intervention
o ACT
o IHBT
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Provider must have a physical location in Ohio or have access to a physical location in Ohio where individuals may opt to receive services that are being provided by telehealth modalities.