Fee-for-Services (FFS) Telephone (Audio-Only) Telemedicine Services for Non-Behavioral Health Conditions

Date: December 7, 2023

Attention: All Providers

Effective for dates of service on or after November 1, 2023

Call to action: The purpose of this communication is to offer information about the implementation of a new telemedicine services delivery method for certain non-behavioral health conditions.

How this impacts providers: The following office and other outpatient telemedicine services may be provided by synchronous telephone (audio-only) technology for the diagnosis, evaluation, and treatment of non-behavioral health conditions if clinically appropriate and safe, as determined by the provider and agreed to by the client receiving services:

• Established patient services (procedure codes 99212, 99213, 99214, and 99215)
• Established patient service (procedure code 99211) – only during certain public health emergencies

Established patient services for non-behavioral health conditions provided by synchronous telephone (audio-only) technology must be billed using modifier 93.

Next step for Providers: Providers should share this communication with their staff.

Previously posted communication from Texas Children’s Health Plan on Telemedicine services:

http://www.thecheckup.org/2023/05/09/provider-alert-hsc-to-end-telephone-audio-only-medical-services-covid-19-guidance-and-issue-temporary-guidance-for-certain-audio-only-services/

http://www.thecheckup.org/2023/02/14/provider-alert-covid-19-update-alert-4-telemedicine-services-physicians-bh-fqhc-and-rhc-providers-9/

http://www.thecheckup.org/2023/02/13/provider-alert-telemedicine-telehealth-claims-guidance-provider-alert/

http://www.thecheckup.org/2022/12/06/provider-alert-telemedicine-telehealth-claims-guidance/

If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.

For access to all provider alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers