DOH Telehealth Medicaid Guidance in Effect

The Department of Health's telehealth billing guidance has been in effective since the end of the Federal Public Health Emergency on May 11th. According to the guidance:

  • Article 28 FQHCs not opted into APGs will bill the threshold visit PPS rate (4013) when either the patient OR provider is on site and an audio-visual telehealth OR an audio-only telephonic visit is delivered.
  • Article 28 FQHCs not opted into APGs will bill the offsite rate (4012) when neither the patient nor provider are on site and an audio-visual telehealth OR an audio-only telephonic visit is delivered.
  • Article 28 FQHCs opting into APG can bill for Professional Component only when neither the patient nor provider are on site.
  • Remote Patient Monitoring: FQHCs that have opted out of Ambulatory Patient Groups (APGs) will continue to be unable to bill for Remote Patient Monitoring (RPM) services.
  • Article 31 and 32 FQHCs can bill the full APG rate for all instances of telehealth. CHCANYS is still waiting on confirmation from DOH regarding billing instructions for Article 31 and 32 FQHCs billing PPS.

Please review the DOH Telehealth Medicaid Guidance for more information.

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