*Effective July 1, 2022* Telehealth visits provided through audio and real time video communication may be used to satisfy the face-to-face requirement for reimbursement under the payment methods that apply to federally qualified health centers, rural health centers, Indian Health Service and 638 Tribal clinics, and certified community behavioral health centers. This change extends the current telehealth reimbursement policy for these provider types beyond the federal public health emergency.
*Effective July 1, 2021* The omnibus bill HF33, which includes a revised Minnesota Telehealth Act (2021), enacted several changes for private and state health payers and providers. A document describing these changes alongside the text of the legislation can be downloaded below. Significant changes for MEDICAID include:
Audio-only telehealth services are covered at parity until July 1, 2023
Medical Assistance clients may consent verbally to treatment plans for mental health and substance use disorder services
Mental health case management & targeted case management services can be delivered via telehealth in most situations
Coverage for telehealth is expanded to include the services of peer and family specialists, mental health rehabilitation workers, behavioral health aides, treatment coordinators, alcohol and drug counselors, and recovery peer specialists.
The previous limit of three telehealth visits per enrollee per week for Medical Assistance enrollees has been removed.
Pilot studies and reports on the use of audio-only telehealth in Medical Assistance programs were initiated.
For mental health centers: Many home and community based services (case management, disability services, home-based services, etc) were extended by waivers under the state peacetime emergency. DHS is evaluating the extent to which they can keep many of these waivers in place between state and federal authority.
TELEHEALTH DEFINITION: “The delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site.”
SERVICE PARITY: “A health carrier shall not exclude a service for coverage solely because the service is provided via telemedicine and is not provided through in-person consultation or contact between a licensed health care provider and a patient.”
PAYMENT PARITY: “A health carrier shall reimburse the distant site licensed health care provider for covered services delivered via telemedicine on the same basis and at the same rate as the health carrier would apply to those services if the services had been delivered in person by the distant site licensed health care provider.” Payment parity for audio-only telehealth services is required until July 1, 2023.
REMOTE MONITORING: MHCP covers telemonitoring services for MHCP members in fee-for-service programs. Assessment and monitoring of the data must be performed by one of the following providers: physician, physician assistant, advanced practice registered nurse, registered nurse, podiatrist, respiratory therapist, a licensed professional working under the supervision of a medical director (for example, an LPN). MHCP covers telemonitoring services for members in high-risk, medically complex patient populations. These members have medical conditions like congestive heart failure, chronic obstructive pulmonary disease (COPD) or diabetes.
ORIGINATING SITES: A site at which a patient is located at the time health care services are provided to the patient by means of telehealth. Minnesota health care programs do not pay an originating site facility fee.
ELIGIBLE PROVIDERS: Physician, NP, PA, Nurse midwife, clinical nurse specialist, RD/nutrition professional, dentist/hygienist/therapist, mental health professional, pharmacists, certified genetic counselor, podiatrist, ST, OT, PT, audiologist, public health nursing organization
PREREQUISITES TO TELEHEALTH: Providers must complete the Provider Assurance Statement for Telemedicine
PROVIDER REQUIREMENTS: Providers must document “the provider's basis for determining that telemedicine is an appropriate and effective means for delivering service to the recipient”
NON-COVERED SERVICES: Connections using non-HIPAA compliant technology, Prescription renewals, Scheduling a test or appointment, Clarification of issues from a previous visit, Reporting test results, Non-clinical communication, Communication via telephone, email or fax, Day treatment, Partial hospitalization programs, Residential treatment services, Case management face-to-face contact
FQHCs & RHCs:
MHCP reimburses for interactive audio/visual communications & asynchronous store-and-forward (to send information to a reviewing physician)
Physician services may be delivered by telemedicine to provide intensive residential treatment services
Tele-home care is covered under the Elderly Waiver (EW) and Alternative Care (AC) Programs
Telemedicine delivery of mental health services
COVERED SERVICES: Mental health services covered by medical assistance as direct face-to-face services may be provided via telehealth and are covered by MHCP.
ELIGIBLE PROVIDERS: Mental health professionals who are qualified under Minnesota Statute 245.462 Subd. 18 (qualified in psychiatric nursing, clinical social work, psychology, psychiatry, marriage and family therapy, licensed professional counseling, or allied fields), Mental health practitioners working under the supervision of a mental health professional, Mental health certified peer specialists, Mental health certified family peer specialists, Mental health rehabilitation workers, Mental health behavioral aides
Telemedicine delivery of substance use disorder services
COVERED SERVICES: Comprehensive assessments, individual and group treatment services, peer recovery support services
ELIGIBLE PROVIDERS: Providers currently authorized to provide services may conduct the same services via telehealth.
Teledentistry: “Reimbursement for teledentistry is the same as face-to-face encounters. The distant site can bill for the services provided by a licensed dentist.”
Early intensive developmental and behavioral intervention: MHCP does not reimburse for connection charges or origination, set-up, or site fees
Additional originating sites for SUD treatment services: Drug court office, Correctional facility-based office (including jails), Substance abuse disorder treatment facility (residential or outpatient), Withdrawal management facility