TMA Pushes to Increase Telemedicine Use in Medicaid
By Joey Berlin


It’s time for Texas to hit the accelerator on fostering more telemedicine use in Medicaid, the Texas Medical Association and several other organizations are telling the Texas Health and Human Services Commission (HHSC).


In a letter to Stephanie Muth, deputy executive commissioner for Medicaid and CHIP services at HHSC, TMA urged the state to expedite the use of CPT codes for which telemedicine services might be appropriately provided in Medicaid. The letter also requests guidance on “the extent to which Medicaid managed care organizations may provide payment for telemedicine medical services” outside the services HHSC already recognizes.

Telemed_Letter_MuthMeanwhile, one of medicine’s staunchest allies in the Texas House of Representatives has authored a bill to help make sure physicians get paid for telemedicine encounters as part of Medicaid. House Bill 870 by Rep. Four Price (R-Amarillo) seeks to reduce red tape related to Medicaid reimbursement for telemedicine medical services.

Joining TMA in the letter to Ms. Muth were the Texas Association of Health Plans, Texas Association of Community Health Plans, Texas Hospital Association, Texas Pediatric Society, and Texas Academy of Family Physicians.

“Telemedicine is not currently used through Medicaid to the extent we believe it could be, at least in part because HHSC’s restrictive payment policy makes it difficult for physicians to use telemedicine to provide patients access to medical services,” the letter said.

In 2017, 527 physicians billed for telemedicine services in Medicaid — the majority of them in metropolitan areas rather than rural settings — according to the letter.

TMA’s letter also noted that current Texas Medicaid policy on telemedicine “recognizes only a discrete and narrow list of CPT codes” for which a physician can get paid for telemedicine, which is inconsistent with Texas law. The lack of clarity on payment is another barrier to increased patient use of telemedicine, said the organizations wrote.

“The Medicaid managed care plans are restricted by their contract to pay only for codes outlined in the Texas Medicaid Provider Procedures Manual. Thus, we also seek written clarification that Medicaid managed care organizations do have discretion to pay for any service provided via telemedicine so long as the service is covered by Texas Medicaid,” the letter said.

This letter and Representative Price’s bill serve as follow-ups to the passage of Senate Bill 1107 in 2017, a measure that clarified the framework for providing telemedicine services in Texas.

Last Updated On

February 08, 2019

Originally Published On

February 08, 2019

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