Medi-Cal Special Programs
Back to Telehealth FAQs
Do the California Children's Services (CCS) Program and Genetically Handicapped Person's Program (GHPP) cover telehealth services?
Yes. CCS Program and GHPP providers should refer to the Medi-Cal Provider Manual: Telehealth section and relevant Bulletins for specific information about billing for telehealth services.
Does Medi-Cal cover telehealth services for the Newborn Hearing Screening Program (NHSP)?
No. Telehealth is not covered for NHSP at this time.
Does Medi-Cal cover telehealth services for the Child Health and Disability Prevention (CHDP) Program?
Yes, to the extent that the services provided are allowable CHDP Program services. If you have any questions about telehealth for the CHDP Program, please contact your local CHDP Program. If needed, the local CHDP Program may contact the Integrated Systems of Care Division (ISCD) .
Do the CCS Program service code groupings (SCGs) include the HCPCS codes for transmission of telehealth services at both the originating and distant sites?
Yes. The SCG 01 includes all CPT-4 and the HCPCS codes identified on the Medi-Cal and Telehealth website. The SCGs 04, 05, 06, 11 and 12 have also been updated to include the Q3014, T1014, and certain office codes.
Does the provider use GT and GQ modifiers when submitting a service authorization request (SAR) for the CCS Program of the GHPP services?
No. The SAR does not require a request for authorization of telehealth GQ or 95 modifiers. However, the provider's Medi-Cal claim form for telehealth services does require the appropriate telehealth GQ, or 95 modifiers to bill for telehealth services.
How does the provider bill for telehealth services for the CCS Program and GHPP clients?
The provider's Medi-Cal claim form must utilize the appropriate telehealth modifiers along with the HCPCS and/or CPT-4 codes to bill for telehealth services. Providers should refer to the Medi-Cal Provider Manual:Telehealth section and relevant bulletins for specific information about billing for telehealth services.
How do the state or county CCS Program or GHPP staff handle provider calls for telehealth claims information or assistance?
County and/or state staff should refer callers inquiring about submitting a claim for services provided by telehealth to the Telephone Service Center (TSC) at (800)541-5555 (outside of California, please call (916) 636-1980) or the Telehealth section of the
Medi-Cal Provider Manual:Telehealth.
Can the DHCS Partners for Children (a Pediatric Palliative Care Waiver Program) bill for telehealth services as part of regular care?
Guidelines for billing for telehealth services for the DHCS Partners for Children program are being developed.
Do the CCS Program, the GHPP and/or CHDP Program cover telehealth services for private duty nursing?
No. Not at this time.
