ILI Training Update

Alliance’s Independent Living Initiative (ILI) Training will occur remotely, as needed upon request. Preference will be given to groups but our housing coordinators will accommodate individuals. Methods of delivery may vary depending on needs and available resources. Please contact Manuel Hyman, ILI Housing Coordinator (Johnston & Durham), Zuriah Harris, ILI Housing Coordinator (Cumberland) or Renate Bender, ILI Housing Coordinator (Wake) to schedule training or for details.

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National Council Stimulus Package Q&A

Join the National Council for Behavioral Health today at 11:30am EST, as Chuck Ingoglia and National Council staff hold a special CEO tele-townhall meeting to review specifics of the COVID-19 stimulus package and answer questions from members and providers nationwide. To join the conversation, register here.

Alliance Board Meeting Going Virtual

Beginning on April 2, 2020, all Alliance Board meetings as well as Board Committee meetings will be held electronically only. You can join the meeting using Zoom or get more information on participating and/or making public comment.

Telepsychiatry Billing and Enhanced Services Billing Update

Alliance has begun adding telepsychiatry codes (CPT codes with GT modifier) to provider contracts for each of the sites where your organization is contracted to provide outpatient services. The effective date is retroactive to March 10, 2020. These codes are being added to providers that currently have outpatient, E&M and research-based behavioral treatment in their current contracts. See the code tables and get much more information here.

Provider Financial Stabilization Program

Alliance continues to take steps to help ensure that our network of providers is able to continue to provide access to services for individuals with behavioral health needs and to support members already in care during this COVID-19 crisis. Our continued focus is on implementing flexibility and other supports to ensure services are still delivered in a safe and effective manner during this time.

Alliance recognizes the operational and financial impact the COVID-19 crisis has on our network and is taking action to provide support around this issue. Our initial focus has been on developing a short-term financial stability payment for providers of enhanced and outpatient services.Get more details here.

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Telehealth Update

Alliance is working on a detailed guide pertaining to billing for services via telephone and video. We had hoped to share this information this afternoon, but DHHS announced today the addition of other behavioral health services that can be provided virtually. We are updating our guidance documents accordingly and tomorrow (March 27) we will be releasing a comprehensive guide covering the services allowed to be billed virtually, billing codes and eligible provider types. We also anticipate releasing details on our provider financial stabilization plan tomorrow.

Please direct any questions or concerns to [email protected].

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Temporary Telepsychiatry Policy Expansion Approved

Alliance is pleased to announce that the State has approved our temporary plan to expand the telepsychiatry policy. The Alliance procedure will allow associate level licensed clinicians to bill outpatient psychotherapy codes virtually. The approved policy also allows group therapy and family therapy to be provided via telehealth.

In addition to these procedures, Research Based Behavioral Health Treatment for autism spectrum disorders will also be covered. Within the next day we will be releasing additional guidance which will include a list of all covered procedure codes and billing instructions as well as effective dates. We hope these changes help provide the additional flexibility needed to maintain a high level of service and continuity of care during this crisis. Our expanded telepsychiatry procedure will remain in place throughout the COVID-19 crisis.

Alliance has developed a range of additional options to support the delivery of services to our members. We will be submitting in-lieu of service definitions to the State for Day Treatment, Psychosocial Rehabilitation and Substance Abuse Intensive Outpatient Treatment. Due to the nature of these services, we believe in lieu-of definitions that can be used by all providers of these services will allow for the greatest amount of flexibility and financial stability. We are working in conjunction with providers of these services and other LME/MCOs to ensure the services offer the maximum impact and create greater consistency across the different regions.

Although we have developed several additional avenues to immediately support greater service delivery flexibility, we are postponing the announcement of these measures based on information that we have learned today during a call with the State. As soon as possible the State will be releasing additional guidance and flexibilities for the delivery of enhanced behavioral health services. In hopes of creating greater consistency across the system, we would like the opportunity to receive and evaluate this information before deciding if Alliance needs to implement additional measures. We will update the network as we receive this new information. If you have any questions on the information contained with this announcement please send to [email protected].

FDA COVID-19 Guidance For Prescribers And Dispensers For REMs Medications

The US Food and Drug Administration issued a new guidance to sponsors and healthcare providers regarding certain Risk Evaluation and Mitigation Strategy (REMS)-required testing during this time.

“The FDA recognizes that during the COVID-19 public health emergency, the completion of some REMS-required laboratory testing or imaging studies may be difficult because patients suspected of having COVID-19 may be self-isolating and/or subject to quarantine,” said FDA Principal Deputy Commissioner Amy Abernethy, M.D., Ph.D. “Under these circumstances, undergoing testing or imaging studies in order to obtain a drug that is subject to a REMS can put patients and others at risk for transmission of the coronavirus. We will continue to work with sponsors to ensure that patients have appropriate access to the medications they need.”

Read the full FDA news release.

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Update to Telephone/Telephonic Services originally posted on March 17

The Telephonic codes have been updated to provider contract details for Medicaid in Alpha for providers that currently have Outpatient and/or E&M codes in their contract. The codes are currently effective March 13, 2020-April 30, 2020. Due to the short term nature of the codes the codes were placed in ONLY the providers main site location, please submit all billing for these codes under your main site as identified in your Alpha contract details. We are currently working on adding these codes to applicable State contracts(those that have OPT & E&M) and will send out a notification when to submit any State billing for these codes in order to reduce any billing denials.

Licensed clinicians and prescribers within the Alliance network should begin using the following telephonic codes, appropriate to licensure type, to support current consumers. There is no authorization required for these services. We encourage providers to reference the 2020 CPT Manual for any specific questions regarding the use of these codes. A rate for these services has not been finalized but as soon as possible we will add established rates to the codes and make them effective retroactive to services delivered on March 13, 2020. These codes will be added to contracts that currently have Outpatient and/or E&M codes. Providers do not need to request that these codes be added. Please note that for Medicaid members there will be a limit of one non-physician code and a limit of one physician code per day. State-funded individuals may receive up to 12 non-physician services and up to 16 physician codes. These codes will initially be active through April 30, 2020. We ask that you hold off submitting billing until you see this notification to reduce claim denials

98966
Telephone assessment and management service provided by a qualified non-physician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous seven days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion.

98967
Telephone assessment and management service provided by a qualified non-physician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous seven days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion.

98968
Telephone assessment and management service provided by a qualified non-physician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous seven days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion.

99441
Telephone evaluation and management service provided by a physician to an established patient, parent, or guardian not originating from a related E/M service provided within the previous seven days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion.

99442
Telephone evaluation and management service provided by a physician to an established patient, parent, or guardian not originating from a related E/M service provided within the previous seven days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion.

99443
Telephone evaluation and management service provided by a physician to an established patient, parent, or guardian not originating from a related E/M service provided within the previous seven days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion.

Click here for a PDF version of this update.

 

Special Bulletin: Telehealth Provisions – Clinical Policy Modification

Effective March 23, 2020, NC Medicaid is temporarily modifying its Telemedicine and Telepsychiatry Clinical Coverage Policy to better enable the delivery of remote care to Medicaid members.

Read the entire NCDHHS bulletin.