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Hello everyone,

The California Department of Managed Health Care is now requiring all health insurance plans to reimburse for telemedicine visits, whether delivered by video or phone during the current COVID-19 emergency.  While we now expect to get reimbursed for all visits, we must maintain clinical standards in doing so, and we should only schedule phone visits in circumstances where video visits are not possible.

 

Please ensure you are following the below clinical guidelines:

We should make every attempt to schedule video visits with our patients as it allows for better assessment capability and meets the standard of care.

At this time, we believe conducting initial psychiatric evaluations by phone to be suboptimal and recommend use of telemedicine for initial evaluations.

That said, we should prioritize getting follow up patient care in whatever way patients can access it rather than delaying the care if there is a barrier to video visits.

For phone visits, documentation should be done in our regular follow up templates in NextGen and your notes should reflect that the visit was rendered via telemedicine, whether done by video or phone.

For phone telemedicine, please document that a phone visit was conducted and that video was not available given the circumstances.

Documentation for telemedicine visits, whether rendered via video or phone, should mirror documentation for visits rendered in-person. You are still responsible for selecting the appropriate CPT code for telemedicine visits based on time or level of service criteria.

We have made significant changes in the way we practice over the last few days and I’m glad to see that we are seeing support from our payers to increase access to care. I hope this eases some of the concerns raised in recent days about not being able to see all patients through this difficult time.

 

As always, please reach out to me if you have any questions or concerns.

Priyanka

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