Cov lus nug nquag nug Telehealth
General Telehealth Subjects:
General Telehealth
Telehealth yog dab tsi?
California law defines telehealth as the “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. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.” See Business and Professions Code 2290.5
Kev Qhia Qhia
Leej twg txiav txim siab seb puas yuav muab kev pabcuam los ntawm telehealth?
Feem ntau, tus kws saib xyuas kev noj qab haus huv txiav txim siab seb qhov txiaj ntsig lossis kev pabcuam puas tsim nyog tau txais kev pabcuam los ntawm kev hloov kho telehealth, raws li kev pom zoo los ntawm tus neeg mob.
Leej twg tuaj yeem siv telehealth los muab kev pabcuam kev noj qab haus huv?
Tus kws kho mob muab Medi-Cal them cov txiaj ntsig lossis cov kev pabcuam uas tau muab los ntawm kev kho mob hauv xov tooj yuav tsum ua raws li Txoj Cai Kev Lag Luam thiab Kev Ua Haujlwm (B&P Code), Tshooj 2290.5(a)(3) lossis yog ib hom kws kho mob uas raug xaiv los ntawm DHCS los muab kev kho mob hauv xov tooj, raws li Kev Noj Qab Haus Huv thiab Lub Tsev Haujlwm Code 14132.725 (2A) Cov kws kho mob sau nqi rau cov kev pabcuam xa los ntawm telehealth yuav tsum tau tso npe ua Medi-Cal cov kws kho mob.
For policy and billing information specific to FQHCs, RHCs or IHS-MOA clinics, providers may refer to the Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) and Indian Health Services (IHS), Memorandum of Agreement (MOA) 638, Clinics sections in the appropriate Part 2 manual, as well as any relevant guidance issued during the COVID-19 PHE.
Puas yog cov kws kho mob tuaj yeem siv telehealth los tsim kev sib raug zoo ntawm tus neeg mob tshiab?
Video synchronous sib cuam tshuam: Cov kws kho mob (xws li FQHCs/RHCs) tuaj yeem tsim kev sib raug zoo nrog cov neeg mob tshiab los ntawm kev mus ntsib video telehealth.
Nco tseg: Hauv cov kev pabcuam tshwj xeeb rau kev puas siab puas ntsws, kev tsim kho rau tus neeg mob tshiab yog hais txog kev ntsuas kev puas siab puas ntsws ua los ntawm tus kws kho mob uas muaj ntawv tso cai. Rau lub hom phiaj ntawm kev siv tshuaj kho mob hauv Drug Medi-Cal thiab Tshuaj Kho Mob Medi-Cal Organized Delivery System, kev tsim kho tus neeg mob tshiab yog hais txog American Society of Addiction Medicine Assessment.
Audio-only synchronous interaction: Providers may not establish a relationship with new patients via audio-only synchronous telehealth (i.e., over the phone), except for in the following instances: (1) When the visit is related to sensitive services as defined in subsection (n) of Section 56.06 of the Civil Code*; (2) When the patient requests an audio-only modality or attests they do not have access to video, and when established in accordance with department specific requirements and consistent with federal and state laws, regulations, and guidance.
Asynchronous store and forward: Only FQHC and RHC providers may establish a new patient via asynchronous store and forward, subject to certain conditions: (1) the patient is physically present at an FQHC or RHC, or at an intermittent site of the FQHC or RHC, at the time the service is provided; (2) the individual who creates the patient records at the originating site is an employee or contractor of the FQHC or RHC, or other person lawfully authorized by the FQHC or RHC to create a patient record; (3) the FQHC or RHC determines that the billing provider is able to meet the applicable standard of care; (4) an FQHC patient who receives telehealth services shall otherwise be eligible to receive in-person services from that FQHC pursuant to Health Resources and Services Administration (HRSA) requirements.
* “Sensitive services” means all health care services related to mental or behavioral health, sexual and reproductive health, sexually transmitted infections, substance use disorder, gender-affirming care, and intimate partner violence, and includes services described in Sections 6924, 6925, 6926, 6927, 6928, 6929, and 6930 of the Family Code, and Sections 121020 and 124260 of the Health and Safety Code, obtained by a patient at or above the minimum age specified for consenting to the service specified in the section.
Puas yog cov kws kho mob uas muab ib qho qauv ntawm telehealth (xws li suab-tsuas yog synchronous telehealth) yuav tsum muaj lwm yam kev kho mob hauv xov tooj (xws li video synchronous telehealth)?
Sijhawm dhau mus, tab sis tsis ntev tshaj Lub Ib Hlis 1, 2024, Medi-Cal yuav xav kom cov kws kho mob mus rau theem-hauv txoj hauv kev uas muab cov neeg mob xaiv qhov kev hloov kho video telehealth thaum muaj kev saib xyuas los ntawm telehealth. Tshwj xeeb, yog tias tus kws kho mob muab cov kev pabcuam audio nkaus xwb, tus kws kho mob kuj yuav tsum tau muab kev xaiv rau kev pabcuam video. Lub Tsev Haujlwm yuav tshaj tawm cov lus qhia txog qhov yuav tsum tau muaj nyob rau xyoo 2023, uas yuav txiav txim siab txog qhov muaj kev nkag tau dav dav thiab Medi-Cal cov kws kho mob nkag mus rau cov thev naus laus zis uas yuav tsum tau ua.
Puas yog tus kws kho mob uas muaj ntawv tso cai yuav tsum tau nrog tus neeg mob yog lub tsev yog qhov chaw pib?
No, unless the distant site provider determines it is medically necessary for a health care provider to be with the patient. Please see the Medi-Cal Provider Manuals for Rural Health Clinics/Federally Qualified Health Centers and Indian Health Services MOA 638 clinics for requirements specific to the originating site.
Yog tias kuv muaj cai thiab ntawv pov thawj hauv kuv lub tsev kho mob, kuv puas xav tau cov cai thiab cov ntaub ntawv pov thawj ntawm lub tsev kho mob keeb kwm los saib xyuas tus neeg mob hauv lub tsev kho mob ntawd?
Issues of privileges and credentialing for distant physicians to care for patients via telehealth are determined by the policies of the originating hospital. However, state law – see Business and Professions Code section 2290.5 (h) – and federal regulations –Title 42 of the Code of Federal Regulations, Part 482.12, 482.22 and 485.616 – allow hospitals to accept the privileges and credentials for providers at distant hospitals.
Puas yog Medi-Cal tso cai rau cov kws kho mob sab nraud los muab kev pabcuam hauv xov tooj?
Tus kws kho mob uas muaj ntawv tso cai muab Medi-Cal them cov txiaj ntsig lossis cov kev pab cuam los ntawm kev hloov kho xov tooj yuav tsum muaj ntawv tso cai hauv California, tso npe ua Medi-Cal tus kws kho mob lossis tus kws kho mob tsis yog kws kho mob (NMP), thiab koom nrog pawg kws kho mob Medi-Cal rau npe. Pawg neeg muab kev pab Medi-Cal rau npe uas tus kws kho mob muab kev pab cuam hauv xov tooj yuav tsum ua tau raws li tag nrho Medi-Cal cov kev cai rau npe kawm thiab yuav tsum nyob hauv California lossis ib lub zej zog ciam teb.
For policy and billing information specific to FQHCs, RHCs or IHS-MOA clinics, providers may refer to the Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) and Indian Health Services (IHS), Memorandum of Agreement (MOA) 638, Clinics sections in the appropriate Part 2 manual , as well as any relevant guidance issued during the COVID-19 PHE.
Tus neeg uas tau ntawv tso cai ua tus kws kho mob hauv lwm lub xeev thiab ua haujlwm los ntawm pawg neeg saib xyuas kev noj qab haus huv tsis tas yuav muaj ntawv tso cai hauv California los ua kev pabcuam rau pab pawg neeg saib xyuas kev noj qab haus huv hauv California lossis ib cheeb tsam ciam teb (Kev Lag Luam thiab Kev Ua Haujlwm Txoj Cai Tshooj 719).
Cov peev txheej twg muaj rau cov neeg muab kev pabcuam?
Please see the DHCS Telehealth Resources webpage for helpful information for providers.
The California Telehealth Resource Center (CTRC) is a federally designated resource center dedicated to helping providers implement and sustain telehealth programs. Services include: program needs assessment for implementation or expansion, equipment selection, telehealth presenter training; operational workflow; contracting with specialists; billing; and credentialing and staff roles. In addition, CTRC also produces a Telehealth Program Developer Kit that can be downloaded from the CTRC website. It provides a step-by-step guide to help providers develop a telehealth program.
The Center for Connected Health Policy (CCHP) is a federally designated national telehealth resource center on policy. The CCHP works closely with all telehealth resource centers in the United States and provides technical assistance to state agencies and lawmakers on telehealth policy. For recent information on telehealth legislation and policy, visit the CCHP website.
Kev Pabcuam & Kev Them Rov Qab
Hom kev pab cuam twg muab los ntawm telehealth puas Medi-Cal them?
Medi-Cal suav nrog synchronous telehealth (piv txwv li, video synchronous sib cuam tshuam thiab suab-tsuas yog synchronous interaction) thiab asynchronous telehealth (piv txwv li, khw muag khoom thiab xa mus thiab e-consults) thoob plaws ntau cov kev pabcuam thiab kev xa khoom, suav nrog kev noj qab haus huv ntawm lub cev, kho hniav, tshwj xeeb thiab tsis yog tshwj xeeb ntawm kev puas siab puas ntsws, thiab SUD cov kev pabcuam (MediC PlanalCry thiab Drug System) DMC-ODS). Medi-Cal suav nrog cov kev pabcuam sib txuas lus thiab asynchronous telehealth uas xa los ntawm telehealth hauv 1915(c) waiver programs, Targeted Case Management (TCM) Program thiab Local Education Agency Medi-Cal Billing Option Program (LEA-BOP). Cov kev pabcuam xa los ntawm telehealth yuav tsum ua raws li cov txheej txheem txhais thiab cov khoom ntawm CPT lossis HCPCS code. Medi-Cal tseem suav nrog kev saib xyuas tus neeg mob nyob deb (RPM); saib cov lus nug hauv qab no kom paub meej ntxiv.
Thov mus saib Cov Lus Nug Nquag Rau Cov Kev Pabcuam Tshwj Xeeb Medi-Cal kom paub meej txog cov kev pabcuam ntawd.
Puas yog Medi-Cal them tus nqi tib yam rau cov kev pabcuam uas tau muab los ntawm telehealth raws li nws them rau tib qhov kev pabcuam uas tau muab rau tus kheej (piv txwv li, kev them nyiaj sib npaug)?
Yog lawm. Medi-Cal them tus nqi tib yam rau cov kev pabcuam kho mob uas muab los ntawm telehealth raws li nws them rau cov kev pabcuam uas muab rau tus kheej. Thov mus saib Tshooj Kev Them Nyiaj thiab Kev Thov ntawm nplooj ntawv no.
Kuv yuav tau them li cas rau cov kev pab cuam telehealth?
Medi-Cal tsuas yog them cov neeg muab kev pabcuam yog tias lawv ua qhov kev pabcuam khomob uas tsim nyog rau tus neeg mob uas ua tau raws li lub ntsiab lus ntawm tus lej sau nqi, yog qhov tsim nyog rau kev kho mob raws li pov thawj cov tshuaj thiab/lossis cov kev coj ua zoo tshaj plaws uas yuav tsum tau xa los ntawm telehealth, thiab ua tau raws li tus neeg mob pom zoo thiab kev kho mob tsis pub lwm tus paub. Saib daim Medi-Cal Telehealth Phau Ntawv Qhia lossis lwm yam kev qhia uas tsim nyog DHCS tus kws kho mob rau cov kev txwv thiab kev taw qhia txog kev them nqi xov tooj.
E-Consults: Tus kws kho mob ntawm qhov chaw nyob deb tuaj yeem sau npe rau e-consults nrog CPT Codes teev nyob rau hauv Medi-Cal Telehealth Phau Ntawv Qhia thaum cov txiaj ntsig lossis cov kev pabcuam xa tuaj raws li cov txheej txheem txhais thiab cov ntsiab lus ntawm CPT code rau e-consults raws li tau teev tseg los ntawm AMA nrog rau txhua yam yuav tsum tau piav qhia hauv Medi-Cal phau ntawv. Txoj cai e-consult tsis muaj feem xyuam rau FQHCs, RHCs lossis IHS-MOA cov chaw kho mob. Rau txoj cai thiab cov ntaub ntawv them nqi tshwj xeeb rau FQHCs, RHCs lossis IHS-MOA cov chaw kho mob, cov kws kho mob tuaj yeem xa mus rau Cov Chaw Kho Mob Hauv Nroog (RHC) thiab Tsoom Fwv Teb Chaws Muaj Peev Xwm Saib Xyuas Kev Noj Qab Haus Huv (FQHCs) thiab Indian Health Services (IHS), Memorandum of Agreement (MOA) 638, Cov chaw kho mob hauv phau ntawv tsim nyog Tshooj 2.
Nco tseg: Medi-Cal cov kev pab cuam lossis cov kev pab cuam uas muab rau tus neeg mob tsis siv cov kev hloov kho hauv xov tooj thiab raug nqi raws li Medi-Cal cov cai.
Puas yog Medi-Cal them rau qhov chaw pib thiab cov nqi xa mus?
Medi-Cal them tus nqi pib ntawm qhov chaw xa mus rau tus kws kho mob ntawm qhov chaw pib rau kev sib koom tes ntawm kev pabcuam hauv xov tooj, ntawm synchronous thiab / lossis asynchronous, mus rau qhov chaw nyob deb. Qhov siab tshaj plaws yog ib hnub rau ib tus neeg mob siv HCPCS code Q3014. Tus nqi pib ntawm qhov chaw tsis muaj rau lub suab nkaus xwb synchronous.
Medi-Cal them ob qho tib si hauv qhov chaw pib thiab qhov chaw nyob deb tus nqi xa mus txog 90 feeb rau ib tus neeg tau txais txiaj ntsig hauv ib hnub rau cov kev pabcuam uas siv ob txoj hauv kev, lub sijhawm sib tham sib tham sib tham hauv xov tooj (synchronous). HCPCS code yog T1014. Cov nqi sib kis tsis muaj rau kev sib txuas suab nkaus xwb.
Tus nqi pib ntawm qhov chaw thiab cov nqi xa mus tsis muaj rau FQHCs, RHCs lossis IHS-MOA cov chaw kho mob.
Cov lus nug txog kev thov thiab kev them nqi yuav raug xa mus rau Lub Chaw Pabcuam Xov Tooj (TSC) ntawm (800) 541-5555 (sab nraum California, thov hu rau (916) 636-1980.
Puas muaj kev txwv rau hom kev teeb tsa rau qhov chaw pib lossis nyob deb?
No. Medi-Cal does not limit the type of setting where telehealth services may be provided to a patient by a health care provider. For example, the type of setting where a patient may be seen (i.e., “originating site”) includes, but is not limited to a medical office, community clinic, or the patient’s home. Medi-Cal does not place limits on the type of distant sites, but requires providers to ensure and maintain patient privacy in any location from where they are delivering services.
Please see the Medi-Cal Provider Manuals for Rural Health Clinics/Federally Qualified Health Centers and Indian Health Services MOA 638 clinics for requirements specific to the originating site in those settings.
Puas yog Medi-Cal them rov qab rau cov nuj nqis hauv chav kuaj mob thiab/lossis them cov khoom siv los teeb tsa kev ua haujlwm hauv xov tooj?
Medi-Cal tsis them rau kev yuav khoom siv telehealth. Thov saib cov lus nug dhau los hais txog tus nqi pib ntawm qhov chaw.
Puas yog Medi-Cal them rau kev saib xyuas tus neeg mob nyob deb (telemonitoring)?
Yes, effective July 1, 2021, remote physiologic monitoring (RPM), also known as remote patient monitoring, was implemented for fee-for-service and managed care beneficiaries. RPM services are provided for established patients ages 21 and older and are reimbursable when ordered by and billed by physicians or other qualified health professionals (QHP).
Puas yog Medi-Cal Managed Care Plans (MCPs) them cov kev pab cuam xov tooj?
Yog lawm, Medi-Cal cov kev pab them nqi kho mob muaj tib yam kev pab them nqi kho mob hauv xov tooj thiab cov cai them rov qab raws li Medi-Cal FFS. Cov phiaj xwm yuav xaiv los muab kev pab them nqi ntxiv thiab cov txiaj ntsig tshaj qhov yuav tsum tau ua los ntawm FFS qhov kev pab cuam.
Puas yog Medi-Cal them rau cov kev pabcuam hauv xovtooj uas muab rau hauv Tsoom Fwv Saib Xyuas Kev Noj Qab Haus Huv (FQHCs), Cov Chaw Kho Mob Hauv Nroog (RHCs), thiab Indian Health Services (IHS) cov chaw kho mob?
Yes, allowable costs associated with telehealth services may be included in the clinic’s Prospective Payment System (PPS) rate; however, FQHCs, RHCs, and IHS clinic PPS sites may not bill for originating site or transmission fees. Please see the Provider Manuals for RHCs/FQHCs and IHS MOA 638 clinics for scenarios about billing for services provided by telehealth.
Kuv tuaj yeem hu rau leej twg yog tias kuv muaj lus nug txog kev xa cov ntawv thov?
Cov lus nug txog kev them nqi-rau-Service thiab kev them nqi tuaj yeem xa mus rau Lub Chaw Pabcuam Xov Tooj (TSC) ntawm (800) 541-5555 lossis xa email rau Medi-CalOutreach@Xerox.com. Rau cov lus nug txog kev them nqi kho mob, hu rau Medi-Cal qhov kev pab them nqi kho mob.
Patient Rights & Tso Cai
Tus neeg mob puas xav tau kev tso cai ua ntej tau txais kev pabcuam los ntawm telehealth?
Yes. State law requires the health care provider initiating the use of telehealth to obtain written or verbal consent once before the initial delivery of telehealth services. Medi-Cal has developed Telehealth Patient Consent Language, which includes language outlining a beneficiary’s right to in-person services, the voluntary nature of consent, the availability of transport to access in-person services if needed, and potential limitations/risks of receiving services via telehealth. Patient consent can be completed verbally or in writing. Patients who consent to synchronous video must separately consent to synchronous audio-only services.
Cov kws kho mob yuav tsum ua ntaub ntawv tso cai li cas?
Cov kws kho mob tuaj yeem sau ntawv pom zoo los ntawm tus neeg txais txiaj ntsig kos npe rau daim ntawv lossis daim ntawv hluav taws xob uas tuaj yeem suav nrog hauv tus neeg mob cov ntaub ntawv kho mob lossis los ntawm tus kws kho mob daim ntawv tso cai hauv tus neeg mob cov ntaub ntawv kho mob.
Puas yog cov chaw muab kev pabcuam yuav tsum siv cov qauv lus uas tau tshaj tawm los ntawm DHCS?
Tsis yog - qhov no yog los txhawb kev ua raws li txoj cai. Thov xa mus rau AB-32 Telehealth (2021-2022)Sec.2-Section 14132.725 ntawm Txoj Cai Kev Noj Qab Haus Huv thiab Tsev Kawm Ntawv.
Txhua yam hauv qab no yuav tsum tau hais los ntawm tus kws kho mob mus rau Medi-Cal tus neeg tau txais txiaj ntsig, sau ntawv lossis hais lus, tsawg kawg yog ib lub sijhawm ua ntej, lossis ua ke nrog, pib xa ib lossis ntau qhov kev pabcuam kev noj qab haus huv los ntawm xov tooj mus rau Medi-Cal tau txais txiaj ntsig:
- ib qho kev piav qhia tias cov neeg tau txais txiaj ntsig muaj txoj cai nkag mus rau cov kev pab cuam uas yuav raug xa los ntawm telehealth los ntawm kev mus ntsib tus neeg, ntsib ntsej muag;
- kev piav qhia tias kev siv xov tooj yog kev yeem thiab qhov kev pom zoo rau kev siv xov tooj tuaj yeem raug tshem tawm txhua lub sijhawm los ntawm Medi-Cal tus neeg tau txais txiaj ntsig yam tsis muaj kev cuam tshuam lawv lub peev xwm nkag mus rau cov kev pab cuam Medi-Cal yav tom ntej;
- kev piav qhia txog qhov muaj Medi-Cal kev pab them nqi tsheb thauj mus los rau kev mus ntsib tus kheej thaum lwm cov peev txheej uas muaj tau ua tiav lawm;
- cov kev txwv lossis kev pheej hmoo cuam tshuam txog kev tau txais kev pabcuam los ntawm telehealth piv rau kev mus ntsib tus kheej, txog qhov kev txwv lossis kev pheej hmoo raug txheeb xyuas los ntawm tus kws kho mob.
Visit the Model Patient Consent language webpage published by DHCS.
Puas yog pab pawg kev coj ua thiab cov txheej txheem tuaj yeem tau txais kev tso cai rau cov kev pabcuam yav tom ntej nrog cov chaw muab kev pabcuam sib txawv uas tau muab los ntawm telehealth thaum tus neeg tau txais txiaj ntsig thawj zaug mus ntsib hauv kev coj ua / system (vs. ua ntej tau txais kev pabcuam telehealth los ntawm txhua tus neeg muab kev pabcuam)?
A health care provider must communicate to a Medi-Cal beneficiary, in writing or verbally, on at least one occasion prior to, or concurrent with, initiating the delivery of one or more health care services via telehealth. Group practices need to obtain and document a patient’s initial consent for purposes of telehealth services prior to the initiation of health care services via telehealth. If consent is documented by the group practice, it is not necessary for each provider rendering health care services via telehealth to document consent.
Dab tsi yog cov txiaj ntsig zoo, thiab kev pheej hmoo lossis kev txwv, cuam tshuam txog kev txais kev pabcuam los ntawm telehealth?
Cov txiaj ntsig:
- Nws yooj yim dua, yooj yim dua, thiab ua kom tau txais kev kho mob thiab kev kho mob zoo dua
- Cov neeg mob tuaj yeem sib txuas lus nrog cov kws kho mob yam tsis tas yuav tsum tau teem sijhawm hauv chaw ua haujlwm.
Kev txwv lossis kev pheej hmoo:
- Kev ncua sij hawm ntawm kev soj ntsuam kev kho mob / kev kho mob lossis kev tsis tuaj yeem tau txais kev kho mob uas xav tau tuaj yeem tshwm sim yog tias yuav tsum tau mus ntsib tus neeg tom qab.
- Cov khoom siv hluav taws xob tuaj yeem ua tsis tau thaum mus ntsib kws kho mob.
Kuv tsis xav tau kev pabcuam los ntawm telehealth. Kuv tuaj yeem nrhiav tau cov ntaub ntawv ntau ntxiv txog kev pabcuam kev thauj mus los rau kev mus ntsib tus kheej li cas?
Medi-Cal offers transportation to and from appointments for services covered by Medi-Cal. This includes transportation to medical, dental, mental health, or substance use disorder appointments, and to pick up prescriptions and medical supplies, if they attest that all other available resources have been reasonably exhausted.
Cov menyuam yaus puas tuaj yeem tso cai (sau, hais lus) yam tsis muaj niam txiv lossis tus saib xyuas?
Minors who receive confidential care, including sexual health, reproductive health, mental health under the Minor Consent Program, may consent to receive the same services via telehealth that are appropriate for telehealth. More information is available on the Minor Consent Program.