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6.3.65.2 Patient Site
A patient site is where the client is physically located while the service is rendered. Patient-site providers must be located in a rural or underserved area.
• A rural area is defined as a county that is not included in a metropolitan statistical area as defined by the U.S. Office of Management and Budget (OMB) according to the most recent United States Census Bureau population estimates.
•An underserved area is an area that meets the U.S. Department of Health and Human Services (DHHS) Index Primary Care Underservice criteria.
Patient-site services may only be provided by one of the following Texas Medicaid enrolled providers: physicians, physician assistants, nurse practitioner, clinical nurse specialist, and outpatient hospitals.
Patient-site providers must use procedure code Q3014 for the facility fee.
A telepresenter who meets one of the qualifications listed below must be at the patient site when the service is provided via telemedicine:
•An individual who is licensed or certified in Texas to perform health-care services and who presents or is delegated tasks and activities only within the scope of the individual's licensure or certification
•A qualified mental health professional (QMHP) as defined in 25 TAC §412.303(48)
All patient sites must maintain documentation for each service, including the following:
•Date of the service
•Name of the client
•Name of the distant-site provider
The patient site that bills for the service must maintain records that document the following:
•Name of the referring or requesting provider
•Name of the telepresenter
A patient site that does not bill for the patient-site service must still capture this information if it is available.
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