Updates to the Telehealth Services Supplement
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The purpose of this memorandum is to notify providers that the Telehealth Services Supplement has been updated with the following changes:
Reimbursement and billing guidelines for audio-only telehealth have been added along with a table (Table 8) listing services authorized for delivery by audio-only telehealth.
The populations eligible for remote patient monitoring have been updated to be consistent with § 32.1-325 of the Code of Virginia.
Place of service guidance has been updated to require the use of the telehealth place of service codes. A complete list of place of service codes can be found here: https://www.cms.gov/medicare/coding-billing/place-of-service-codes/code-sets
Corrections have been made to Table 2, Medicaid-covered mental health and substance use disorder services authorized for delivery by telemedicine. The following corrections were made to reflect current practice:
The CPT codes for prolonged services were updated to the current CPT codes 99417 – 99418 for these services
The CPT codes 96202 – 96203 for multiple-family group behavior management/modification training were added
Additions were made to reflect current telemedicine allowances in Mobile Crisis Response, Residential Crisis Stabilization and Psychosocial Rehabilitation
A table (Table 3) listing Medicaid-covered Developmental Disabilities (DD) Waiver services authorized for delivery by telemedicine has been added.
Virginia Medicaid Web Portal Automated Response System (ARS) Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice. | |
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 |
Acentra Health 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. | |
Managed Care Programs Cardinal Care Managed Care 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. | |
Cardinal Care Managed Care | https://www.dmas.virginia.gov/for-providers/managed-care/cardinal-care-… |
PACE | |
Acentra Health Behavioral Health Services
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Provider Enrollment | In-State: 804-270-5105 Out of State Toll Free: 888-829-5373 Email: VAMedicaidProviderEnrollment@gainwelltechnologies.com |
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 |
Aetna Better Health of Virginia | https://www.aetnabetterhealth.com/virginia/providers/index.html 1-800-279-1878
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Anthem HealthKeepers Plus | 1-800-901-0020
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Molina Complete Care
| 1-800-424-4524 https://www.molinahealthcare.com/providers/va/medicaid/home.aspx
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Sentara Community Plan | 1-800-881-2166 https://www.sentarahealthplans.com/providers
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United Healthcare | 1-844-284-0149
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Dental Provider DentaQuest | 1-888-912-3456 |