Telehealth Updates to Outpatient Psychiatric and Addiction Recovery and Treatment Services (ARTS) Services
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The purpose of this bulletin is to notify providers of planned changes to the Telehealth Services Supplement – a supplement to multiple manuals, including the Addiction Recovery and Treatment Services (ARTS), Psychiatric Services, Mental Health Services and Physician-Practitioner Manuals.
DMAS intends to update the Telehealth Services Supplement to continue allowing delivery of certain outpatient psychiatric and ARTS services via audio-only telehealth that are at present allowed under the authority of the federal COVID-19 Public Health Emergency (PHE). The federal COVID-19 PHE is set to expire on May 11, 2023 and the planned changes will allow continued audio-only telehealth delivery of the following CPT codes:
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90785 |
90791 |
90792 |
90832 |
90833 |
90834 |
90836 |
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90837 |
90838 |
90839 |
90840 |
90845 |
90846 |
90847 |
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90853 |
96116 |
96121 |
96127 |
96156 |
96158 |
96159 |
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96160 |
96161 |
99406 |
99407 |
99408 |
99409 |
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For information on technical and professional components of billed CPT codes, providers should refer to the most current CPT codebook published by the American Medical Association.
Providers must continue to follow the conditions for telehealth reimbursement outlined in the Reimbursable Telehealth Services section of the Telehealth Services Supplement when providing audio-only telehealth services. Documentation for services delivered via audio-only telehealth are the same as for a comparable in-person service. Providers should continue to bill for audio-only telehealth as they normally would if the service was provided in-person until otherwise notified. Additional reimbursement and billing guidelines for audio-only telehealth services will be included in a forthcoming update to the Telehealth Services Supplement.
DMAS will continue to evaluate whether there are additional CPT/HCPCS codes that should be authorized for audio-only telehealth coverage after the end of the Federal PHE. Future audio-only telehealth policy changes will be included in updates to the Telehealth Services Supplement.
DMAS will be holding a training regarding the telehealth update on Monday, April 24th, 2023 via Webex. The training will be recorded and posted to the DMAS Behavioral Health webpage along with the PowerPoint: Training and Resources (virginia.gov)
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DMAS Telehealth Update Training |
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Date & Time |
April 24, 2023 @ 10:00-11:30am |
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Web Link: |
https://covaconf.webex.com/covaconf/j.php?MTID=m8d3bc3595c554e7d2c6a8e4bfa7aec11 |
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Call-In: |
1-866-692-4530 |
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Access code: |
2421 233 3849 |
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Password: |
q3Gy2WZMFS8 (73492996 from phones and video systems) |
Additional information on the end of COVID-19 PHE provider flexibilities is available on the DMAS website at https://www.dmas.virginia.gov/covid-19-response/. Providers may email the DMAS Behavioral Health Division at enhancedbh@dmas.virginia.gov with questions regarding this bulletin.
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PROVIDER CONTACT INFORMATION & RESOURCES |
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Virginia Medicaid Web Portal Automated Response System (ARS) Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice. |
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Medicall (Audio Response System) Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice. |
1-800-884-9730 or 1-800-772-9996 |
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KEPRO Service authorization information for fee-for-service members.
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Provider Appeals DMAS launched an appeals portal in 2021. You can use this portal to file appeals and track the status of your appeals. Visit the website listed for appeal resources and to register for the portal. |
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Managed Care Programs Medallion 4.0, Commonwealth Coordinated Care Plus (CCC Plus), and Program of All-Inclusive Care for the Elderly (PACE). In order to be reimbursed for services provided to a managed care enrolled individual, providers must follow their respective contract with the managed care plan/PACE provider. The managed care plan may utilize different guidelines than those described for Medicaid fee-for-service individuals. |
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Medallion 4.0 |
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CCC Plus |
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PACE |
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Magellan Behavioral Health Behavioral Health Services Administrator, check eligibility, claim status, service limits, and service authorizations for fee-for-service members. |
www.MagellanHealth.com/Provider For credentialing behavioral health service information, visit: www.magellanofvirginia.com, email: VAProviderQuestions@MagellanHealth.com,or Call: 1-800-424-4046 |
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Provider Enrollment |
In-State: 804-270-5105 Out of State Toll Free: 888-829-5373 Email: VAMedicaidProviderEnrollment@gainwelltechnologies.com |
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Provider HELPLINE Monday–Friday 8:00 a.m.-5:00 p.m. For provider use only, have Medicaid Provider ID Number available. |
1-804-786-6273 1-800-552-8627 |
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Aetna Better Health of Virginia |
www.aetnabetterhealth.com/Virginia 1-855-270-2365 1-866-386-7882 (CCC+) |
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Anthem HealthKeepers Plus |
1-833-207-3120 1-833-235-2027 (CCC+) |
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Molina Complete Care
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1-800-424-4524 (CCC+) 1-800-424-4518 (M4) |
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Optima Family Care |
1-800-643-2273 1-844-374-9159 (CCC+) |
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United Healthcare |
1-844-284-0149 1-855-873-3493 (CCC+) |
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Virginia Premier |
1-800-727-7536 (TTY: 711), www.virginiapremier.com |
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Dental Provider DentaQuest |
1-888-912-3456 |