Telehealth can be used to provide continuity of care for individuals in their homes, and for patients with suspected or confirmed coronavirus (COVID-19) infections.

On March 13, 2020, DHCF notified providers that it modified reimbursement policies to allow telehealth services for Medicaid services that can be delivered following a reasonable standard of care.

DHCF’s “Telemedicine Provider Guidance” document from March 19, 2020 includes the following types of services that it will reimburse for telehealth visits:

• Evaluation and management
• Consultation
• Behavioral health
• Speech therapy

DHCF’s rule does not specify what the standard of care is, leaving the determination to provider discretion for what services and encounters are appropriately delivered via telehealth.

Sources:
March 13, 2020 Transmittal #20-07 from Melissa Byrd, Senior Deputy Director/State Medicaid Director

DHCF’s Telemedicine Provider Guidance (March 19, 2020); Appendix A

According to DHCF’s “Telemedicine Provider Guidance” document from March 19, 2020, during the public health emergency, providers should document patient consent to receive services via telehealth through a detailed service note that describes (1) the beneficiary’s verbal consent for telehealth services and (2) the reason why written consent was not available at the time of the service.

eHealthDC recommends this language be placed in the Chief Complaint section of the Progress Note. It can usually be configured in a telehealth visit type in most EHRs. eCW users can access the eHealthDC guide to document patient consent in eCW.

Source:
DHCF’s Telemedicine Provider Guidance (March 19, 2020); Section III – Participant Eligibility

Telehealth visits reimbursed by DHCF are required to meet technology requirements for camera, audio, and internet bandwidth that equip a provider to make a telehealth visit functionally equivalent to a face-to-face encounter. Refer to page 6 of DHCF’s Telemedicine Provider Guidance.

Source:
DHCF’s Telemedicine Provider Guidance (March 19, 2020); Section X – Technical Requirements

Yes, as long as the services fit all requirements under DHCF’s Telemedicine Guidance, including meeting the standard of care for the service delivered, documenting the patient’s consent for a telehealth visit, and placing the GT modifier on the claim with the patient’s Place of Service noted.

Appendix A of DHCF’s Telemedicine Provider Guidance lists most, but not all codes on the DHCF fee schedule that can appropriately be delivered and reimbursed as telemedicine services. According to DHCF, individual MCOs may cover additional services at their discretion.

The DHCF Telehealth Guidance also notes that providers must be certified to deliver services in the location where their patient is located. In a Telehealth Townhall on March 25, 2020 hosted by the Medical Society of DC, DHCF asked providers delivering telemedicine services remotely to check local licensure and certification requirements.

Source:
DHCF’s Telemedicine Provider Guidance (March 19, 2020); Section IV Provider Site Eligibility

Yes, for the duration of the public health emergency declared by the Mayor of the District of Columbia and 60 days after the end of the public health emergency declared by the Mayor, DHCF will reimburse telehealth services provided to Medicaid beneficiaries via audio-only. 60 days after the end of the public health emergency, DHCF will no longer reimburse providers for services conducted with audio-only.

DHCF’s guidance states that it will not reimburse for services delivered over email and/or fax transmission.

Source:
DHCF’s Telemedicine Provider Guidance (March 19, 2020); Section II – Telemedicine Service Model