Provider Alert! COVID-19 Guidance: UPDATE ALERT #5 Telehealth Services: Targeted Case Management through remote delivery

Attention: Behavioral Health, OB/GYN, and ECI Providers
Effective Date: April 24, 2020

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.

Call to action:  TCHP supports Texas Medicaid Healthcare Partnership (TMHP) guidance on Targeted Case Management. This service may be delivered through synchronous audio-visual technologies or telephone (audio-only). Providers should bill procedure code T1017 using the 95 modifier to indicate that remote delivery occurred.

How this impacts providers: This direction applies to the following services.

• Mental Health Targeted Case Management (MHTCM)
• Targeted Case Management for Early Childhood Intervention (ECI)

Update for effective date April 24, 2020: For case management providers in other programs, utilize existing billing codes and modifiers along with the 95 modifier to indicate that remote delivery occurred including:

• Intellectual or developmental disability (IDD) case management
• Case Management for Blind and Visually Impaired Children (BVIC)
• Case Management for Children and Pregnant Women (CPW)

Next steps for providers: Providers are reminded to use appropriate coding as defined by Medicaid, or in the above specified guidance for billing of Telehealth services.

References:

4/24/2020 Correction to ‘COVID-19 Guidance: Targeted Case Management Through Remote Delivery’

COVID-19 Guidance: Targeted Case Management Through Remote Delivery

Providers can reference previously released Provider Alerts on this topic at the links provided below:

http://www.thecheckup.org/2020/03/20/provider-alert-anywhere-care-telemedicine-how-to-become-a-participating-provider/

http://www.tmhp.com/manuals_pdf/tmppm/tmppm_living_manual_current/2_Telecommunication_Srvs.pdf for additional information.

http://www.thecheckup.org/2020/03/18/provider-alert-update-telemedicine-telehealth-services-and-covid-19/

http://www.thecheckup.org/2020/03/31/provider-alert-update-alert-3-telehealth-services-ptotst-fqhcrhc-providers-and-covid-19/

If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.

For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.