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Medi-Cal & Telehealth

The Department of Health Care Services (DHCS) considers telehealth a cost-effective alternative to health care provided in-person, particularly to underserved areas. Telehealth is not a distinct service, but a way that providers deliver health care to their patients that approximates in-person care. The standard of care is the same whether the patient is seen in-person or through telehealth.

DHCS’s coverage and reimbursement policies for telehealth align with the California Telehealth Advancement Act of 2011 and federal regulations. State law defines telehealth as “the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient's health care while the patient is at the originating site and the health care provider is at a distant site.” This definition applies to all health care providers in California, not just Medi-Cal providers.

Medi-Cal also complies with federal regulations for telehealth, which are the same for Medicaid as they are for Medicare. Medicaid regulations authorize telehealth using “interactive communications” and asynchronous store and forward technologies. Interactive telecommunications must include, at a minimum, audio and video equipment permitting real-time two-way communication, according to the Centers for Medicare and Medicaid Services.

 

Medi-Cal pays for current Medi-Cal benefits appropriately provided via telehealth:
  • Selected Evaluation and Management (E&M) services for patient visit and consultation.
  • Selected psychiatric diagnostic interview examination and selected psychiatric therapeutic services.
  • Teledermatology by store and forward.
  • Teleophthalmology by store and forward.
  • Teledentistry
  • Transmission costs (up to 90 minutes per patient, per day, per provider).
  • Originating site facility fee.
  • Interpretation and report of X-rays and electrocardiograms performed via telehealth.

 

Please see the Medi-Cal Provider Manual: Telehealth and the Teledentistry Resources page for more information.

For additional information about Medi-Cal’s coverage and reimbursement telehealth policies, as well as resources for providers, please see the Telehealth Resources page and Frequently Asked Questions.

For questions about submitting a claim for services provided by telehealth, please call the Telephone Service Center (TSC) at 1-800-541-5555 (outside of California, please call 916-636-1980).

Providers may email questions about Medi-Cal telehealth policy to Medi-Cal_Telehealth@dhcs.ca.gov.

CAUTION: THIS IS A PUBLIC MAILBOX. Please DO NOT include any personal or private information about yourself or anyone else in your email. DHCS is unable to protect such information if it is submitted through this public mailbox.

Personal and/or private information includes the name, address, Social Security number, and any other information that could be used to identify the patient, such as the geographic area where the patient lives, phone number, email address, date of birth, account numbers, medical condition or diagnosis, and information about the kind of care the patient received in the past and where and when they've received this care. Information that identifies the patient is private, even if it’s not medical information.

Last modified on: 5/20/2016 12:05 PM