As requested by the Texas Medical Association, the Health and Human Services Commission (HHSC) has extended some Medicaid and Children’s Health Insurance Program (CHIP) flexibilities through July 31.
The extensions have been enacted to help physicians safely and effectively care for all patients during the COVID-19 pandemic.
Specifically, physicians can temporarily use telemedicine for Texas Health Steps (THSteps) medical checkups of children older than 24 months through July 30, HHSC said. The guidance, which applies to both new and established patients, had been effective until June 30. It is applicable to both managed care and fee-for-service Medicaid.
CHIP will waive office visit copayments for all members for services provided from March 13 to July 31, HHSC said. CHIP does not require copayments for telemedicine services regardless of the waiver. The member’s health plan will pay the full rate for the service, including what would have been paid by the member through cost-sharing.
In addition, Medicaid will continue to cover telephone (audio-only) telemedicine visits, which physicians must continue to bill using designated evaluation and management (E&M) CPT codes with the -95 modifier. Medicaid and Medicaid MCOs also will pay for certain behavioral services provided over the telephone.
Changes to Medicaid such as these should be extended after the emergency period to ensure physicians can continue to provide care for Texas’ children and youth, TMA and several specialty societies said in a letter to HHSC earlier this month.
Beginning in early July, Texas Medicaid also will begin paying for reporting antigen testing to detect SARs-CoV-2. A payment rate for the code has not yet been set.
To help you understand all of the changes to telemedicine during the pandemic, TMA has published up-to-date information for each type of payer.
Stay up to date with the latest news, resources, and government guidance on the coronavirus outbreak by visiting TMA’s COVID-19 Resource Center regularly.
Last Updated On
June 29, 2020