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Flexibilities Extended for Claims for Telemedicine and Telehealth Services for HTW Plus

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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.

The Healthy Texas Women Plus telemedicine and telehealth services have been extended through January 21, 2021 or through January 31, 2021, if the federal public health emergency continues beyond January 21, 2021.

Telemedicine and telehealth flexibilities apply to the following procedure codes:

Description of Service

Procedure Codes

Psychotherapy

90832, 90834, 90837, 90847, 90853

Peer Specialist Services

H0038

Screening, Brief Intervention, and Referral to Treatment (SBIRT)

99408, H0049

Substance Use Disorder Services

H0001, H0004, H0005

To indicate use of the telemedicine or telehealth modality and that remote delivery occurred, providers should use the 95 modifier when submitting claims. The telemedicine or telehealth services must also meet applicable state statutory and rule scope-of-practice requirements.

Providers can refer to the Texas Medicaid Provider Procedures Manual, “Behavioral Health and Case Management Services Handbook,” for additional information about Texas Medicaid behavioral health benefits and the “Telecommunication Services Handbook,” for additional information about Texas Medicaid telemedicine and telehealth services.

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