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December 2016 Texas Medicaid Provider Procedures Manual

Telecommunication Services Handbook : 3 Services, Benefits, Limitations, and Prior Authorization

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Telemedicine and telehealth services must be provided in compliance with standards established by the respective licensing or certifying board of the professional providing the services.
Only those services that involve direct face-to-face interactive video communication between the client and the distant-site provider constitute a telemedicine or telehealth service. Telephone conversations, chart reviews, electronic mail messages, and fax transmissions alone do not constitute a telemedicine or telehealth interactive video service and will not be reimbursed as telemedicine or telehealth services.
Use of telemedicine and telehealth services within Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID) or State Supported Living Centers is subject to the policy established by the Department of State Health Services (DSHS) and the Texas Department of Aging and Disability Services (DADS) established policies.
The audio and visual fidelity and clarity, and field of view of the telemedicine or telehealth service must be functionally equivalent to an evaluation performed on a client when the provider and client are both at the same physical location or the client is at an established medical site.
More than one medically necessary telemedicine or telehealth service may be reimbursed for the same date and same place of service if the services are billed by providers of different specialties.
Providers may not disclose any medical information revealed by the client or discovered by a provider in connection with the treatment of the client through telemedicine or telehealth without proper authorization from the patient.
All confidentiality and Health Insurance Portability and Accountability Act (HIPAA) standards apply to telemedicine and telehealth transmissions.
Refer to:
Subsection 1.6.4, “Release of Confidential Information” in Section 1: Provider Enrollment and Responsibilities (Vol.1, General Information) for more information about confidentiality standards.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2014 American Medical Association. All rights reserved.