See manual for full lists. A distant site provider who provides telemedicineservices to a patient that is not present at an established treatment site shall ensure that a proper provider-patient relationship is established, which at a minimum includes all of the following: Evaluation, treatment, and consultation recommendations made in a telemedicinesetting, including issuing a prescription via electronic means, shall be held to the same standards of appropriate practice as those in traditional in-person clinical settings. Medicaid will continue to allow audio-only telecommunications to be reimbursed at parity for dates of services rendered throughSeptember 30, 2023. 111, Pg. (Accessed Jun. 2023). (Accessed Jun. Licensees are expected to adhere to all federal and state statutes regarding the prescribing of controlled substances and all Alabama Board of Medical Examiners Rules regarding the prescribing of controlled substances. AL Medicaid Management Information System Provider Manual, Physician Services (28-17), Apr. 111, Pg. Facility/Transmission Fee AL Medicaid reimburses providers for origination site fees for covered telemedicine services. (Accessed Jun. Apr. SOURCE:AL Medicaid Management Information System Provider Manual, Rehabilitative Services DMH, DHR, DYS, DCA (105, p. 11). (Accessed Jun. A physician has the same duty to exercise reasonable care, diligence, and skill whether providing services in-person or via telehealth. Services rendered via telecommunication system must be provided by a provider who is licensed, registered, or otherwise authorized to engage in his or her healthcare profession in the state where the patient is located. For the purposes of this section 13.08(1), a state of emergency means a natural or man-made disaster for which the Governor of the State of Alabama has declared or proclaimed a state of emergency or where the President of the United States has declared a disaster in accordance with the Disaster Relief and Emergency Assistance Act of 1988 as amended. SOURCE: AL Medicaid, All Provider Alert, BMI Recording for Telemedicine Visits, 6/7/23, (Accessed Jun. Disclose to the patient the identity and credentials of the physician and any other applicable personnel. Medicaid:Temporary Telemedicine Extension for Optometrists, Medicaid:Telemedicine Coverage Extension, Medicaid:Authorization of Telemedicine for Prenatal Visits During COVID-19 Emergency, Medicaid: Tip Sheet Guidance to Rehab Option Service Providers. Certain Medicare and Medicaid waivers and broad flexibilities for health care providers are no longer necessary and will end. 2023, C-1, (Accessed Jun. 111, Pg. Apr. SOURCE:AL Admin Code 630-X-13-.02. 28, p.17) Apr. 2023). (Accessed Jun. 2023). During the COVID-19 PHE, CMS used a combination of emergency authority waivers, regulations, and sub-regulatory guidance to ensure and expand access to care and to give health care providers the flexibilities needed to . 2023). AL Medicaid Management Information System Provider Manual, Physician Services (ch. AL Code Sec. Jun 30, 2023 - Beginning April 1, 2023, Alabama Medicaid no longer requires PA for the dental procedure codes listed below when provided in an inpatient or outpatient hospital setting (place of service 19, 21, or 22) to recipients ages 5 and older. 2023). Apr. Member of the Physical Therapy Licensure Compact. The site provider shall implement protocols that ensure the same confidentiality of the telemedicine visit as for in-person visits. SOURCE: Audiology and Speech-Language Pathology Interstate Compact. Code 560-X-1-.18, (Accessed Jun. the following Telemedicine allowances will be discontinued effective May 31, 2023. AL Medicaid Management Information System Provider Manual, Home Health (17-p. 2) Apr. The most current information in the online tool may be exported for each state into a PDF document. 2023). SOURCE:Psychology Interjurisdictional Compact. A prescriber may prescribe a legend drug, medical supplies, or a controlled substance to a patient as a result of a telehealth medical service if the prescriber is authorized to prescribe the drug, supplies, or substance under applicable state and federal laws. 2023. PDF Alabama - mTelehealth See: AL Medicaid Store-and-Forward. During telemedicine visits, providers should use subjective data to calculate the BMI which can include providers asking the recipient for his or her height and weight during thevisit. A provider may delegate tasks and activities at an established treatment site to an assistant who is properly trained and supervised or directed. The Telehealth office manages several grants that provide for the deployment of the carts and specialty equipment, and funding for county health department staff, primarily nurses and social workers who are trained as "telepresenters," to operate the equipment during the telehealth appointments. See: AL Medicaid Live Video. 2023). (Accessed Jun. (Accessed Jun. All services (including those rendered via teleconference with a direct service or consultation recipient) must be rendered by an approved Medicaid treatment provider (operating within their scope of practice) as outlined in Section 110.1.1. 2023. Certified Registered Nurse Practitioners (CRNPs), Licensed Marriage and Family Therapist and Associates, Licensed Independent Clinical Social Workers, Physicians must be enrolled with Alabama Medicaid with a specialty type of 931 (Telemedicine Service), Physician must submit the telemedicine Service Agreement/Certification form. To be valid, a prescription must be issued for a legitimate medical purpose by a prescriber acting in the usual course of his or her professional practice. Code r. The services are provided in consultation, as further provided by Section 34-24-74, with a physician licensed to practice medicine or osteopathy in this state. SOURCE:AL Admin Code 610-X-6-.16, (Accessed Jun. (Accessed Jun. SOURCE:AL Medicaid Management Information System Provider Manual, Therapy Services, Apr. AL Medicaid Management Information System Provider Manual, Physician Services (ch. Read More Eligible Sites Click for a list of eligible sites. 2023. With Alabama governor signing the Interstate Medical Licensing Compact in 2015, the state officially allowed for telemedicine expansion, as the aim of the compact is to make the process of getting a license much easier for physicians across several states. CCHP encourages you to check with the appropriate state agency for further information and direction. You can search the entire Medicaid provider list by clicking the link below. 2023, (Accessed Jun. Identification of the provider including credentials. 2023). Transmissions must employ acceptable authentication and identification procedures by both the sender and the receiver. There is no explicit definition of telemedicine given in state Medicaid policy. Psychology Interjurisdictional Compact. Specific covered services list provided in manual by provider type. Telemedicine health care providers shall ensure that the telecommunication technology and equipment used at the recipient site and at the provider site, is sufficient to allow the provider to appropriately evaluate, diagnose, and/or treat the recipient for services billed to Medicaid. SOURCE:AL Medicaid Management Information System Provider Manual, Physician Services (ch. 2023, pg. COVID-19 Update from Alabama Medicaid. 2023. 2023). 15 Alabama FQHC Manual, Apr. The Center for Connected Health Policy's (CCHP) Spring 2023 Summary Report of the state telehealth laws and Medicaid program policies is now available as well as updated information on our online Policy Finder tool. Services are performed in cooperation with a speech-language pathologist or audiologist licensed by the Board. If you are not an ADPH employee or telehealth collaborating partner, you will not have access to this Calendar. 2023). AL Medicaid Management Information System Provider Manual, Physician Services (ch. 1-2), Apr. Providers must bill the procedure code Q3014, telemedicine origination site facility fee, on a CMS-1500 or UB-04 claim. AL Medicaid, Telemedicine Policy, 5/26/23, Effective June 1, 2023, (Accessed Jun 2023). A distant site provider who provides telemedicine services to a patient that is not present at an established treatment site shall ensure that a proper provider-patient relationship is established, which shall include at least the following: Evaluation, treatment, and consultation recommendations made via telemedicine, including, but not limited to the issuance of prescriptions, shall be held to the same standards of practice as those in traditional in-person clinical settings. 111, Pg. 2023). PDF Medicaid Telemedicine Consent Form - mobilepeds.com ), which directs the medical society to create a telehealth registration / license process for providers who are fully licensed and in good standing in . See the patient in person within a reasonable amount of time, which shall not exceed 12 months. Why Should You Use Anthem Telehealth Services? Apr. Until further notice continue to bill the currently approved codes (as posted on the Alabama Medicaid Agency website with the 02 and CR modifiersyour State Agency provider will notify you when to begin utilizing the codes, modifier and processes). ALERTs. 2023). 2023). The provider shall implement confidentiality protocols that include, but are not limited to: These protocols and guidelines must be available to inspection at the telemedicine site and to the Medicaid Agency upon request. Non-billable encounters cannot be forwarded to Medicaids fiscal agent for payment. (Accessed Jun. Physician manual outlines reimbursement for live video telemedicine. A physician shall be exempt from the requirements of subsection (b) and may issue a prescription for a controlled substance to a patient if the prescription is for the treatment of a patients medical emergency, as further defined by rule by the Board of Medical Examiners and the Medical Licensure Commission. The Alabama Medicaid Agency (Agency) will begin paying an origination site facility fee of $20.00. (Accessed Jun. AL Medicaid Management Information System Provider Manual, Rehabilitative Services (105-9). 2023 Design by Neurogic SOURCE: AL Medicaid, Telemedicine Policy, 5/26/23, Effective June 1, 2023, (Accessed Jun. It is the position of the Board that, when prescribing medications to an individual, the prescriber, when possible, should personally examined the patient. 2023). Telemedicine services provided to minors under the age of medical consent must have a parent or legal guardian attend the telemedicine visit. Referrals for RPM may be accepted from any source, including physicians, ACHN Care Coordinators, patient or caregiver, the Health Department, hospitals, home health agencies, or community-based organizations. See: AL Medicaid Remote Patient Monitoring, Audio-only is reimbursed in AL Medicaid, per the AL Telemedicine policy with modifier FQ, however no explicit mention is made to whether or not FQHCs specifically can be reimbursed for the modality. 37-16, (Accessed Jun. (Accessed Jun. 2023). 2023). Telehealth is the use of telecommunications and information technology to provide access to health assessment, diagnosis, intervention, consultation, supervision and information across distance. On October 1, 34-22-81, (Accessed Jun. AL Admin Code 630-X-13-.01(7). Apr. Services incident to an encounter are inclusive. 40-p. 33). A covered telemedicine service will count as part of each recipients benefit limit of 14 annual physician office visits currently allowed, if applicable. 2023). Additionally, Billable services must be designated by procedure codes from the Physicians Current Procedure Terminology (CPT) or by special procedure codes designated by Medicaid for its own use. Code r. 560-X-6-.14(f)(5), p. 31. A recipients home should not be considered an origination site entitled to receive an origination site fee. Code. 2023. ADPH Telehealth Calendar. AL Admin Code 850-x-2-.04. 3/24/2020 . Physicians who engage in the provision of telehealth medical services to any individual in this state must possess a full and active license to practice medicine or osteopathy issued by the Medical Licensure Commission. 2023). 2023). Provider Types NOT Eligible for Telemedicine Reimbursement. 2023). Providers will receive a notification when it is time to re-validate. Alabama Alabama Medicaid Emergency Rules for COVID-19 . 2023). SOURCE: AL Admin. 560-X-6-.14., p. 27 & 31. 2023. Transmissions must employ acceptable authentication and identification procedures by both the sender and the receiver. AL Medicaid Management Information system Provider Manual, Appendix C Family Planning, Apr. The Agency will not reimburse providers for origination site or transmission fees. In order for providers to qualify for Medicaid reimbursement for telehealth services, the origination site must be located in the state of Alabama. SOURCE:AL Admin. At one time, telehealth in Medicaid had been referred to as telemedicine. 2023). 2023. Medical necessity and appropriateness of services billed. Covered services does not include a telephone conversation, electronic mail message, or facsimile transmission between the physician, recipient, or a consultation between two physicians. This requirement does not apply to the provision of mental health services as defined in state law (Ala. Code 22-50-1). 2023). The Telehealth equipment is also utilized by ADPH staff for meetings and training events. 37, p. 16). (Accessed Jun. 111, Pg. Apr. Alabama Medicaid reimburses for live video for certain services and under certain circumstances. The distant site is the location of the treatment provider providing the telehealth professional services. Services must be administered via an interactive audio or audio and video telecommunications system which permits two-way communication between the distant site provider and the site where the recipient is located (this does not include electronic mail message or facsimile transmission between the provider and recipient). (Accessed Jun. AL Medicaid Management Information System Provider Manual, Therapy Services, Apr. PLEASE NOTE: CCHP is providing the following for informational purposes only. 2023, C-1, (Accessed Jun. 34-22-82 & 83, (Accessed Jun. This process must be documented appropriately. chapters, will be included in the July 2023 publication of the Provider Billing (CDT) codes descriptors, and other data are copyright 20.
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