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December 2016 Texas Medicaid Provider Procedures Manual

Telecommunication Services Handbook : 3 Services, Benefits, Limitations, and Prior Authorization : 3.1 Telemedicine Services : 3.1.1 Distant Site

A distant site is the location of the provider rendering the service. Distant-site telemedicine benefits include services that are performed by the following providers, who must be enrolled as a Texas Medicaid provider:
The following procedure codes, when billed with the GT modifier, are a benefit for distant-site telemedicine providers:
Note: Procedure codes for behavioral health services are subject to the benefits and limitations outlined in Chapter 29, “Outpatient Behavioral Health.” Procedure codes 90833, 90836, and 90838 are add-on codes and must be billed with a primary E/M procedure code in order to be reimbursed.

Texas Medicaid & Healthcare Partnership
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