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December 2016 Texas Medicaid Provider Procedures Manual

Telecommunication Services Handbook : 3 Services, Benefits, Limitations, and Prior Authorization : 3.2 Telehealth Services : 3.2.2 Patient Site

3.2.2
A patient site is where the client is physically located while the service is rendered. The patient-site must be one of the following:
Established health site—A location where clients will present to seek a health service. There must be a patient-site presenter and sufficient technology and medical equipment to allow for an adequate physical evaluation or assessment, as appropriate for the client’s presenting complaint. A defined health provider-client relationship is required. A client’s private home is not considered an established health site.
State mental health facility—A hospital with an inpatient component funded or operated by DSHS.
State-supported living center—A state-supported and structured residential facility operated by DADS to provide individuals with intellectual and developmental disabilities a variety of services, including medical treatment, specialized therapy, and training in the acquisition of personal, social, and vocation skills, as defined at Health and Safety Code 431.002(17).
The facility fee (procedure code Q3014) is not a benefit for telehealth services. Charges for other services that are performed at the patient site may be submitted separately.
All patient sites must maintain documentation for each service, including:
A patient-site presenter must introduce the client to the distant-site provider for examination and must perform any tasks and activities that are delegated by the distant-site provider. A patient-site provider must be at least one of the following:
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
For telehealth services, the patient-site presenter must be readily available.
Note:
Readily available means in the same room or (at the discretion of the licensed or certified professional that is providing the service) not in the same room as the client, but within a proximity determined by the licensed or certified professional who is providing the telehealth service.
If the telehealth services relate only to mental health, a patient-site presenter does not have to be readily available unless the client is a danger to himself/herself or to others.
The patient-site presenter must maintain the records created at the distant site unless the distant-site provider maintains the records in an electronic-health-record format.

Texas Medicaid & Healthcare Partnership
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