Texas telehealth solutions<\/a> are governed by the Texas Telehealth Act, which was passed in 2017. The act allows for the provision of telemedicine services in a variety of settings, including hospitals, clinics, and patients’ homes. The act also sets forth certain requirements for Texas telehealth solutions, such as the need for providers to be licensed in the state and the need for patients to provide consent for the services.<\/p>\n\n\n\n Texas Medicaid<\/a> reimburses for live video and store-and-forward in some circumstances. Home telemonitoring is reimbursable for some conditions when a provider is approved to deliver those services.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n “Telehealth service” means a health service, other than a telemedicine medical service, that is delivered by a licensed or certified health professional acting within the scope of the health professional’s license or certification who does not perform a telemedicine medical service and that requires the use of advanced telecommunications technology, other than telephone or facsimile technology.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Synchronous audiovisual interaction is reimbursable under Texas Medicaid.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Click for a list of reimbursable services.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Click for a list of eligible distant site providers.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Click for a list of eligible originating sites.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n No reference found.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Patient-site providers that are enrolled in Texas Medicaid may only be reimbursed for the facility fee using procedure code Q3014. Procedure code Q3014 is payable to NP, CNS, PA, physicians, and outpatient hospital providers. Charges for other services that are performed at the patient site may be submitted separately. Procedure code Q3014 is not a benefit if the patient site is the client\u2019s home.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Asynchronous store and forward technology, including asynchronous store and forward technology in conjunction with synchronous audio interaction between the distant site provider and the patient in another location is reimbursable under Texas Medicaid.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n No reference found.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n No reference found.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n No reference found.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Texas Medicaid will reimburse for home telemonitoring in the same manner as their other professional services provided by a home health agency.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Click to see list of patient eligibility.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Providers must be enrolled and approved as home telemonitoring services providers.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Patients that meet the condition criteria must exhibit two or more of certain risk factors. Click to view the risk factors.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Click to see a list of risk factor criteria.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n No reimbursement for audio-only telephone consultation. Read More<\/a><\/p>\n\n\n\n Written or verbal consent must be obtained to allow any other individual (besides the distant site provider, patient site presenter or representative) to be present during a telemedicine or telehealth visit.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n An out-of-state physician who is a distant site provider may provide episodic telemedicine medical services without a Texas medical license as outlined in Texas Statute and Regulation.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Click for a list of miscellaneous requirements for Texas Medicaid.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n “Telehealth service” means a health service, other than a telemedicine medical service, delivered by a health professional licensed, certified, or otherwise entitled to practice in this state and acting within the scope of the health professional’s license, certification, or entitlement to a patient at a different physical location than the health professional using telecommunications or information technology.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Each issuer of a health benefit plan must adopt and display in a conspicuous manner on their website the policies and payment practices for telemedicine medical services and telehealth services. They, however, are not required to list payment rates.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Prohibits a health benefit plan from excluding from coverage a service delivered as a telemedicine medical service or a telehealth service solely because the service is not provided in-person. A health plan is not required to provide coverage for services provided by only synchronous or asynchronous audio interaction including audio-only telephone; email or facsimile.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Telehealth service means a health service, other than a telemedicine medical service, delivered by a health professional licensed, certified, or otherwise entitled to practice in this state and acting within the scope of the health professional\u2019s license, certification, or entitlement to a patient at a different physical location than the health professional using telecommunications or information technology.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Consent required prior to telemedicine or telehealth services.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n A valid practitioner-patient relationship is present between a practitioner providing a telemedicine medical service and a patient receiving the telemedicine medical service as long as the practitioner complies with the same standard of care as would apply in an in-person setting, and complies with specified standards.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n A telemedicine license may be issued for out of state providers.<\/p>\n\n\n\n Read More<\/a><\/p>\n\n\n\n Click for additional professional and health & safety requirements.<\/p>\n\n\n\nMedicaid Telehealth Reimbursement<\/h3>\n\n\n\n
Summary<\/h4>\n\n\n\n
Definitions<\/h4>\n\n\n\n
Live Video<\/h4>\n\n\n\n
Policy<\/h5>\n\n\n\n
Eligible Services\/Specialties<\/h5>\n\n\n\n
Eligible Providers<\/h5>\n\n\n\n
Eligible Sites<\/h5>\n\n\n\n
Geographic Limits<\/h5>\n\n\n\n
Facility\/Transmission Fee<\/h5>\n\n\n\n
Store-and-Forward<\/h4>\n\n\n\n
Policy<\/h5>\n\n\n\n
Eligible Services\/Specialties<\/h5>\n\n\n\n
Geographic Limits<\/h5>\n\n\n\n
Transmission Fee<\/h5>\n\n\n\n
Remote Patient Monitoring<\/h4>\n\n\n\n
Policy<\/h5>\n\n\n\n
Conditions<\/h5>\n\n\n\n
Provider Limitations<\/h5>\n\n\n\n
Other Restrictions<\/h5>\n\n\n\n
Email\/Phone\/Fax<\/h4>\n\n\n\n
No reimbursement for text-only email message.
No reimbursement for facsimile transmission.<\/p>\n\n\n\nConsent<\/h4>\n\n\n\n
Out of State Providers<\/h4>\n\n\n\n
Miscellaneous<\/h4>\n\n\n\n
Private Payer Laws<\/h3>\n\n\n\n
Definitions<\/h4>\n\n\n\n
Requirements<\/h4>\n\n\n\n
Parity<\/h4>\n\n\n\n
Professional Regulation\/Health & Safety<\/h3>\n\n\n\n
Definitions<\/h4>\n\n\n\n
Consent<\/h4>\n\n\n\n
Online Prescribing<\/h4>\n\n\n\n
Cross State Licensing<\/h4>\n\n\n\n
Miscellaneous<\/h4>\n\n\n\n