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Medical Nutrition Counseling Policy Updated to Allow Procedure Code S9470 Through Synchronous Telephone (Audio-Only) Technologies Delivery

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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, precertification, 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 September 1, 2022, procedure code S9470, when billed with modifier 93, may be authorized for delivery through synchronous telephone (audio-only) technology during a declaration of a state of disaster if clinically appropriate and safe, as determined by the provider and agreed upon by the person receiving the services.

The use of a synchronous audiovisual platform to deliver procedure code S9470 is a current benefit of Texas Medicaid. Services provided by synchronous audiovisual technology must be billed using modifier 95.

Declaration of a State of Disaster

During a declaration of a state of disaster, the Texas Health and Human Services Commission (HHSC) may issue direction to providers regarding the use of an audio-only service to include the use of a synchronous telephone (audio-only) platform to provide covered services outside the allowances described herein to the extent permitted by Texas law.

A declaration of a state of disaster occurs when an executive order or proclamation is issued by the governor declaring a state of disaster in accordance with Section 418.014 of the Texas Government Code.

Whenever possible, HHSC encourages face-to-face interactions, such as an in-person visit, as well as the use of synchronous audiovisual technology over synchronous telephone (audio-only) technology for telemedicine and telehealth services.

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