37-16, (Accessed Jun. AL Code Sec. 2023). EPSDT, Family Planning, or Prenatal Encounter Face-to-face contact to receive services within the parameters of the program guidelines. A provider may delegate tasks and activities at an established treatment site to an assistant who is properly trained and supervised or directed. Specific covered services list provided in manual by provider type. S/he has a right to see an appropriately trained staff or employee in-person immediately after the telemedicine consultation/telehealth treatment service if an urgent need arises, or to be informed ahead of time that this is not available. Note: If a Medicaid-enrolled provider performs another medically necessary service(s), the provider may bill for the covered service(s) in addition to providing his/her facility as an origination site and be eligible for reimbursement for the origination site facility fee and the other medically necessary service(s). 2023, 110-18, (Accessed Jun. The origination fee will be limited to one per date of service per recipient and may be billed by all of the providers listed above under Origination Sites. 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. 2023). 2023). Hospital providers are eligible to bill for telehealth services provided by licensed psychologists and independent practitioners not . 37, p. 16). The provider must retain documentation in the medical record to show the services were rendered. In order for providers to qualify for Medicaid reimbursement for telehealth services, the origination site must be located in the state of Alabama. Physical location of the patient, including the city and state. 2023). 2023. Code r. AL Medicaid Management Information System Provider Manual, Remote Patient Monitoring (Ch. Member of the Psychology Interjurisdictional Compact. Set up my account Necesitas ayuda? Code r. 560-X-6-3, p. 8 (Accessed Jun. Medicaid:Telemedicine Coverage Extension, Medicaid: Telemedicine Origination Site Facility Fee for Outpatient Clinic Services, Medicaid:Speech Language and Occupational Therapy Providers, Medicaid:Temporarily Allowing Physical Therapy Services Through Telemedicine, Medicaid:Temporary Changes to allow Delivering Healthcare Professionals Reimbursement for Telephonic Postpartum Visits, Medicaid:Extension of Procedure Code Coverage For Physicians, CRNPs, PAs, FQHCs, RHCs, Optometrists, ADPH, and CRS, Medicaid:Origination Site Facility Fee for Outpatient Clinic Services, Medicaid:Telemedicine for Prenatal Visits, Medicaid:Temporary Physical Therapy Services, Medicaid:Extension of Telemedicine Procedure Codes. See code for requirements. Physician must obtain prior consent from the recipient before services are rendered. 2023). Written comments regarding the proposed . 2023). 2023). Based on their ability to collect the origination site fee, FQHCs are eligible originating site. (Accessed Jun. New Jersey New Jersey Medicaid Guidance on Telehealth-All Providers . 2023 28, p. 17). For ABA therapy or PBS services listed above provided via telemedicine, enrolled providers are eligible to participate in the Telemedicine Program to provide medically necessary telemedicine services to Alabama Medicaid eligible recipients. SOURCE:AL Admin. 2023). Benefit Coordination/Third Party Liability, Provider Electronic Solutions (PES) Software, Help for Medicaid Applicants and Recipients, Use of the modifier CR (catastrophe/disaster related) and place of A prescription for a controlled substance may only be issued via telehealth if: Telehealth medical services may only be provided following the patients initiation of a physician-patient relationship, or pursuant to a referral made by a patients licensed physician with whom the patient has an established physician-patient relationship, in the usual course of treatment of the patients existing health condition. Compressed digital interactive video, audio, or data transmission; Clinical data transmission using computer imaging by way of still image capture and store and forward; Other technology that facilitates access to health care services or optometric specialty services. The Alabama Medicaid Agency (Agency) will begin paying an origination site facility fee of $20.00. Non-billable encounters can not be forwarded to the Fiscal Agent for payment. 105, p. 1 & 60). 34-22-85, (Accessed Jun. Rehabilitative Services (ASD) DMH, Apr. 2023). Additionally, The BMI should be calculated, based on the information provided by the recipient, and appended to the claim for reimbursement. 2023). Apr. AL Admin. (Accessed Jun. Prior to providing any telehealth medical service, the physician, to the extent possible, shall do all of the following: If a physician or practice group provides telehealth medical services more than four times in a 12-month period to the same patient for the same medical condition without resolution, the physician shall do either of the following: The provision of telehealth medical services that includes video communication to a patient at an originating site with the in-person assistance of a person licensed by the Board of Medical Examiners or by the Board of Nursing pursuant to Chapter 21 of Title 34 of the Code of Alabama 1975, shall constitute an in-person visit for the purposes of this subsection. Telehealth is a statewide program with sixty-five county health departments equipped with telehealth carts. 2023). 2023. Providers must hold a license in the State of Alabama unless there is a qualifying exemption as noted in Code of Alabama 1975, Section 34-28A-3; 870-X-2-.01 and shall be in compliance with the statutory and regulatory requirements of the patient site. 2023). 2023). 37-15 to 16, (Accessed Jun. 2023). (Accessed Jun. A patient may have one physical health encounter and one behavioral health (psychologist or clinical social worker) encounter on the same day. 28, p. 17). and CDT). Manual. Member of the Physical Therapy Licensure Compact. 2023). 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. SOURCE:AL Medicaid Management Information System Provider Manual, Alabama Coordinated Health Network (ACHN) Primary Care Physician (PCP) and Delivering Healthcare Professional (DHCP) Billing, (Manual Ch. Apr. AL Admin. At least one field must be entered. 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. Telemedicine: As used in these regulations, a health service that is delivered by a licensed optometrist acting within the scope of his or her license and that requires the use of telecommunications technology other than telephone or facsimile. SOURCE:AL Medicaid Management Information System Provider Manual, Rehabilitative Services DMH, DHR, DYS, DCA (105, p. 11). Alabama Alabama Medicaid Emergency Rules for COVID-19 . AL Admin Code 610-X-6-.16, (Accessed Jun. Obtain the patients consent for the use of telehealth and document it in the patients medical record. The Current Procedural Terminology (CPT) and Current Dental Terminology A patient can have one dental encounter in addition to one physical health and/or behavioral health encounter on the same day. Encounters are classified as either billable or non-billable. There is no explicit definition of telemedicine given in state Medicaid policy. 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. SOURCE: AL Medicaid Alert, Origination Site Facility Fee, Mar. (Accessed Jun. 2023. 2023, pg. 2023). The licensed nurse shall adhere to the existing Alabama Nurse Practice Act and Alabama Administrative Code. A provider that is licensed, certified, registered, or authorized with the appropriate state agency or board and exclusively offers telehealth services (as defined in IC 12-15-5-11(a)) to maintain a physical address or site in Indiana to be eligible for enrollment as a Medicaid provider. Apr. For rehabilitative services, the distant site may be located outside of Alabama as long as the physician has an Alabama license and is enrolled as an Alabama Medicaid provider. 28, p.17). See our Privacy Policy. 2023). The provision of telehealth medical services is deemed to occur at the patient's physical location within Alabama at the time telehealth medical services are provided. 2023). Digital health, telehealth, telemedicine, and the applicable technologies and devices used in the delivery of telehealth. Apr. The physician-patient relationship may be formed without a prior in-person examination. 110, p. 18). Providers must submit the Telemedicine Service Agreement/Certification to Medicaids fiscal agent. Apr. You can also call either of our office locations and one of our care coordinators can help you find a doctor and get an appointment. (Accessed Jun. AL Medicaid Management Information System Provider Manual, Remote Patient Monitoring (Ch. Federally Qualified Health Centers (FQHCs), Hospital-based or CAH-based Renal Dialysis Centers (including satellites). r. 540-X-9-.11, p. 23 (Accessed Jun. 2023). Jun 30, 2023 - On June 1, 2023, Alabama Medicaid resumed the EPSDT referral requirement . (CDT) codes descriptors, and other data are copyright 20. SOURCE:AL Medicaid Management Information System Provider Manual, Rehabilitative Services DMH, DHR, DYS, DCA(105, p. 12). The Telehealth equipment is also utilized by ADPH staff for meetings and training events.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. 2023). 2023). 34-24-703 & 706, (Accessed Jun. The Alabama Medicaid Agency (Medicaid) made important changes during the COVID-19 public health emergency to better serve recipients and to assist providers in our state. Telemedicine. SOURCE: AL Medicaid Agency, Alert Telemedicine Origination Site Facility Fee, Mar. 2023). Transmissions must employ acceptable authentication and identification procedures by both the sender and the receiver. 2023. CCHP does not share or sell personal data. Telemedicine: Telemedicine services are covered for limited specialties and under special circumstances. The provider shall implement confidentiality protocols that include, but are not limited to: These protocols and guidelines must be available for inspection at the telemedicine site and to Medicaid upon request. Only the provider rendering the services via telemedicine may submit for reimbursement for services.
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