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Telehealth Services Will Become a Benefit for Early Childhood Intervention Providers Effective March 1, 2020

Last updated on 1/6/2020

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.

Effective for dates of service on or after March 1, 2020, telehealth services delivered remotely to children who are eligible for the Early Childhood Intervention (ECI) Program and Medicaid will become a benefit for ECI providers.

Telehealth services may be reimbursed to ECI providers for services rendered in the office, home and other location settings.

Reimbursement

The following procedure codes may be reimbursed for services rendered as telehealth services through the ECI program:

Procedure Codes

92507

92508

92521

92522

92523

92524

92526

92610

97110

97112

97150

97165

97166

97167

97168

97530

97535

S9152

T1027

         

Procedure Codes Billed With Modifiers

The procedure codes in the table below should be billed with the following modifiers:

  • Modifier GO for Occupational Therapy Services (OT)
  • Modifier GN for Speech Therapy Services (ST)
  • Modifier AT for acute OT or ST services
  • Procedure code T1027 should be billed with the U1 modifier.

Procedure Codes

92507

92508

92521

92522

92523

92524

92526

92610

97112

97150

97165

97166

97167

97168

97530

97530

S9152

 

Documentation

ECI providers are not required to provide the patient’s primary care physician with a treatment summary.

For more information, call the TMHP Contact Center at 800-925-9126.