Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.
Beginning August 1, 2018, TMHP will update the Texas Medicaid Provider Procedures Manual, Telecommunication Services Handbook within the Telemedicine and Telehealth sections. Telehealth distant site services may not include family members when billing with procedure codes 90832, 90834, and 90837. The asterisk has been removed from these procedure codes in the table of section 3.3.1, “Distant Site.”
The Texas Department of Aging and Disability Services (DADS) will be replaced with the Health and Human Services Commission (HHSC), and the Health and Safety Code will be updated in sections 3, “Services, Benefits, Limitations, and Prior Authorization,” section 3.2.2, “Patient Site,” and 3.3.2, “Patient Site.”
The following is the revised and updated statements for telemedicine and telehealth patient site 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 Health and Human Services Commission (HHSC) established policies.
A state-supported living center, which is a state-supported and structured residential facility operated by HHSC to provide to 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 591.003(14).
For more information, call the TMHP Contact Center at 800-925-9126.