Provider Alert! Update: Delivery of Certain Behavioral Health Services through Synchronous Audiovisual or Synchronous Telephone (Audio-Only) Technology

Date: October 25, 2023

Attention: Behavioral Health Providers

Effective date: December 1, 2023

Call to action: The purpose of this communication is to offer information about updates to most of the behavioral health Medicaid benefits to clarify the delivery of those services through synchronous audiovisual or synchronous telephone (audio-only) technology.

How this impacts providers: The Texas Medicaid & Healthcare Partnership (TMHP) will update the Texas Medicaid Provider Procedures Manual (TMPPM), Behavioral Health and Case Management Services, effective December 1, 2023. Handbook (Vol. 2, Provider Handbooks) to clarify language for the delivery of the following:

• Mental health targeted case management (MHTCM)
• Mental health rehabilitative (MHR)
• Outpatient mental health
• Peer specialist, and substance use disorder (SUD) services through synchronous audiovisual or synchronous telephone (audio-only) technology

Additional clarifying information includes the following:

• In this update, references to provider, treating provider, or same provider will be replaced with billing provider or same billing provider, as applicable.
• Same billing provider will be defined as providers within the same entity or organization as identified by the entity’s or organization’s National Provider Identifier (NPI) number or numbers if the entity or organization has multiple locations.
• This update adds language to clarify the in-person or synchronous audiovisual 6-month and every rolling 12-month requirements for providing services through synchronous telephone (audio-only) technology. The updated language will specify:
• The MHTCM, MHR, outpatient mental health, peer specialist, and SUD services that may count toward the requirements.
• Another authorized professional or paraprofessional of the same billing provider as the one that renders services by synchronous telephone (audio-only) technology may deliver the requirements.

Next step for Providers: Information about outpatient mental health, MHTCM, MHR, peer specialist and SUD services is published in Behavioral Health and Case Management Services Handbook (Vol. 2, Provider Handbooks) in the TMPPM.

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

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