Medicaid and CHIP Requirements for Current Telehealth and Telemedicine

February 21, 2022

What is New?

The Texas Health and Human Services Commission (HHSC) is currently in the process of implementing House Bill (H.B.) 4 (87th-R), to ensure the option to receive services as telemedicine medical services, telehealth services, home telemonitoring services, and other telecommunication or information technology. HHSC will be proposing rules regarding the use of telecommunications or information technology to conduct managed care assessments and service coordination and the rules forthcoming in 2022.

Blue Cross and Blue Shield of Texas (BCBSTX) is responsible for continuing to provide access to teleservices through implementation of key provisions of S.B. 670 (86th-R) including:

  • We cannot deny reimbursement to network providers for a covered health care service or procedure solely because it was delivered remotely via telemedicine or telehealth.
  • We cannot deny or reduce reimbursement for a covered health care service or procedure based upon the network provider’s choice of platform.
  • We must ensure that telemedicine and telehealth services promote and support patient-centered medical homes.

For CHIP members through implementation of key provisions of H.B.4 in accordance with Section 62.1571, Health and Safety Code, which includes the duty to ensure the following requirements are met:

  1. Preventative health and wellness services
  2. Case management services
  3. Behavioral health services, including audio-only services
  4. Occupational, physical, and speech therapy services
  5. Nutritional counselling services

For more information, call the TMHP Contact Center at 1-800-925-9126.


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