The purpose of this bulletin is to clarify the Department of Medical Assistance Services’ (DMAS) policy regarding telemedicine coverage, specifically as it relates to Federally Qualified Health Centers (FQHCs). The clarification is that FQHCs may bill DMAS for services delivered via telemedicine, both as an originating site or as a remote site.

Please refer to the May 13, 2014 Medicaid memo entitled, “Updates to Telemedicine Coverage,” for additional guidance. The memo includes key telemedicine definitions and requirements related to enrollment, billing, allowed services and providers, as well as guidance regarding individual contracts between FQHCs and Managed Care Organizations (MCOs) under contract to DMAS.  

If the individual is enrolled in managed care, providers should direct coverage questions to the specific MCO in question.

Medicaid Expansion

New adult coverage begins January 1, 2019.  Providers will use the same web portal and enrollment verification processes in place today to verify Medicaid expansion coverage.  In ARS, individuals eligible in the Medicaid expansion covered group will be shown as “MEDICAID EXP.”  If the individual is enrolled in managed care, the “MEDICAID EXP” segment will be shown as well as the managed care segment, “MED4” (Medallion 4.0), or “CCCP” (CCC Plus).  Additional Medicaid expansion resources for providers can be found on the DMAS Medicaid Expansion webpage at:  http://www.dmas.virginia.gov/#/medex.  

Medicaid Bulletin: Federally Qualified Health Centers Telemedicine Coverage  

March 4, 2019 Page 2