(March 15) – We want to thank you for your ongoing commitment to the health and well-being of our members, particularly during the current public health crisis. We are sensitive to the challenges that you will face balancing your obligations to maintain services to those in your care, providing access to new individuals in need, and guarding the health and safety of your staff.
Alliance is working closely with the State on options to increase flexibility in the manner that services can be delivered, primarily the ability to utilize telephonic support and other forms of virtual care and treatment. Our goal is to provide the greatest amount of support possible to enable you to continue to provide essential treatment and support to our members.
The State is working to provide final guidance on several new procedure codes that will allow non-physician, licensed clinicians to bill for telephonic support to existing clients. Once we receive this guidance, we will be adding these procedure codes to provider contracts. These are not psychotherapy codes, but can be used to assess member progress and needs, and help manage their behavioral health conditions. Again, these codes are only to be used to support existing clients. Here is information regarding the codes:
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.
Additionally, to increase the use of telepsychiatry, Alliance has requested that certain requirements within the State’s telemedicine/telepsychiatry clinical coverage policy be waved to support the greater use of virtual treatment, and we are drafting an alternative policy for DHB approval. We will notify eligible providers as waivers are granted.
Alliance has also requested several waivers related to enhanced services related to face-to-face contacts and certain documentation standards. Again, as we receive additional guidance and approvals from the State we will immediately communicate these changes.
The State has also submitted a request to CMS to waive numerous requirements within the Innovations waiver that should allow greater flexibility and stability for service providers.
In the event that COVID-19 seriously impacts your ability to provide services to our members, please notify Alliance immediately by submitting the Temporary Disruption of Service Delivery form found on our website.
Alliance greatly values the partnership of our provider network in working to enrich the lives of the individuals and families that we collaboratively serve. Again, we appreciate the challenges that the current situation presents, and look forward to supporting you in every way possible. We commit to staying in communication with you, and together to endure this national health crisis.
