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Information Letter No. 20-37: Telemedicine Flexibility for Face-to-Face Reassessments

Last updated on 8/5/2020

Information Letter No. 20-37: Telemedicine Flexibility for Face-to-Face Reassessments.

Addressed to: Medicaid Hospice Providers

The purpose of this information letter is to inform Medicaid hospice providers that HHSC is allowing face-to-face reassessments to be conducted as a telemedicine medical service for recertification of hospice services.

As we continue to protect individuals receiving Medicaid hospice services and the public's health, safety, and welfare in response to COVID-19, HHSC is adopting an emergency amendment to 40 Texas Administrative Code §30.14(e) to allow a hospice physician or hospice advanced practice registered nurse to conduct a face-to-face assessment of an individual as a telemedicine medical service, as defined in Texas Government Code§531.001(8), if the sole purpose of the assessment is for hospice recertification.

Medicaid Reimbursement

HHSC will reimburse hospice providers for face-to-face reassessments as a telemedicine medical service for recertification for dates of service beginning March 13, 2020, until the withdrawal or expiration of the emergency rule.

To document that the face-to-face reassessment was delivered remotely, providers can bill CPT codes, 99211-99215, with the 95 modifier as listed in the Long-term Care Bill Code Crosswalk. Additionally, providers should bill place of service code 79-clinic-other when submitting a telemedicine medical service claim.

Providers can refer to the Texas Medicaid Provider Procedures Manual, Telecommunication Services Handbook for additional information about Texas Medicaid telemedicine medical services and telehealth practices. For assistance with billing claims through TexMedConnect, providers can contact the Texas Medicaid and Healthcare Partnership at 800-626-4117, Option 1.

If you have any questions about this letter, please contact the HHSC Hospice Policy staff by email at HospicePolicy@hhsc.state.tx.us.