Medi-Cal & Telehealth
Background
California 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". (Business and Professions Code section 2290.5(a)(6))
Medi-Cal's telehealth coverage began in 1996 with the passage of the California Telemedicine Advancement Act (SB 1665), which established telemedicine payment and provision of care requirements, and additional legislation continued to expand access to services through the 2000s. The passage of the Telehealth Advancement Act (AB 415) in 2011 laid the foundation for Medi-Cal to drastically expand coverage of telehealth in Medi-Cal, eliminating the ban on email and telephone-delivered services, permitting patients to verbally consent to telehealth, and enabling all California-licensed and Medi-Cal enrolled providers to practice via telehealth.
In response to the COVID-19 pandemic, the Department of Health Care Services (DHCS) implemented telehealth flexibilities via waivers and Disaster Relief state plan amendments (SPAs). This enabled Medi-Cal's health care delivery systems to meet the health care needs of our enrollees in an environment where in-person encounters were not recommended and, at times, not available. Additionally, pursuant to Section 380 of
Assembly Bill (AB) 133 (Committee on Budget, Chapter 143, Statutes of 2021), DHCS convened a
Telehealth Advisory Workgroup for the purposes of informing the 2022 – 2023 Governor's Budget and the development of post-public health emergency (PHE) telehealth policies.
Medi-Cal Telehealth Utilization Dashboard
Utilization Report
Policy Highlights
For additional information about Medi-Cal coverage and reimbursement telehealth policies, as well as resources for providers, please see the Telehealth Resources page and Frequently Asked Questions.
DHCS' Telehealth Provider Manual outlines provider requirements and reimbursement for delivering medically necessary services via telehealth. Program specific details on DHCS's telehealth policy are available in the Provider Manuals for the following:
DHCS also published All Plan Letter 23-007 regarding telehealth services in managed care health plans.
To stay informed about updates for telehealth and other DHCS topics, sign up for DHCS Stakeholder Announcements. Providers can also sign up to receive notices when Provider Manuals are updated. Providers are also encouraged to check this webpage for updates.
