# 85-12. If the Member receives emergency ambulance transportation subsequent to and based on the facilitated telemedicine consultation, submit two claims: one claim for Q3014 on a CMS-1500 and a separate claim for emergency transportation services. SOURCE: VA Dept. of Medical Assistant Svcs., Medicaid Provider Manual Supplement-Telehealth Services (Available in multiple manuals, including physician/practitioner, see overview for full list), (Oct. 2022) (Accessed Nov. 2022). VA Board of Medicine. Additional requirements apply. 104-4 Doc. The member receiving the RPM service must fall into one of the following five populations, with duration of initial service authorization in parentheses as per below: All service authorization criteria outlined in the DMAS Form DMAS-P268 are met prior to billing the following CPT/HCPCS codes: Providers must meet the criteria outlined in the DMAS Form DMAS-P268 and submit their requests to the DMAS service authorization contractor by direct data entry (DDE) via their provider portal. VA Dept. P. 4 (Aug. 19, 2021). # 85-12. Face-to-face encounters may occur through telemedicine, which is defined as the two-way, real time interactive electronic communication between the member and the Provider located at a site distant from the member. SEIU Virginia 512 is an organization that is working to improve Virginias direct care workforce, in part by supporting policies that increase wages and help those at the frontlines get the benefits that foster their health and security. The Member is located at an approved originating site with the Medicaid enrolled telepresenter. Teledentistry means the delivery of dentistry between a patient and a dentist who holds a license to practice dentistry issued by the board through the use of telehealth systems and electronic technologies or media, including interactive, two-way audio or video. (Accessed Nov. 2022). SOURCE: VA Code Annotated Sec. Before providing a telehealth service to a member, the Provider shall inform the patient about the use of telehealth and document verbal, electronic or written consent from the patient or legally-authorized representative, for the use of telehealth as an acceptable mode of delivering health care services. SOURCE:VA Dept. A pharmacist may initiate treatment with, dispense, or administer drugs, devices, controlled paraphernalia, and other supplies and equipment pursuant to this section through telemedicine services, as defined in 38.2-3418.16, in compliance with all requirements of 54.1-3303 and consistent with the applicable standard of care. Reauthorizations will be permitted for select services, as appropriate and as per criteria in the DMAS Form DMAS-P268. 4.2.c. Payment will be set at a rate per mile as established by the General Services Administration in the Federal Travel Regulations. (Mar. A bona fide dentist-patient relationship shall exist if the dentist has: SOURCE: VA Statute 54.1-2711. Treatment and consultation recommendations made in an online setting, including issuing a prescription via electronic means, will be held to the same standards of appropriate practice as those in traditional, in-person encounters. View our latest report, The Year in Child Care: 2021 Data, Analysis and Recommendations, Fee Assistance and Respite Care for Military/DoD Families. Nurse Licensure Compact (Accessed Nov. 2022). P. 2-4 (Aug. 19, 2021). (Federal Travel Regulations are published in the Federal Register.) See Code for required provisions for statewide telehealth plan. WebThe mission of the Virginia Department of Medical Assistance Services (DMAS) is improving the health and well-being of Virginians through access to high-quality health care coverage. Requirements on the coverage of telemedicine services include medically necessary remote patient monitoring services to the full extent that these services are available. 2022), (Accessed Nov. 2022). More information about coronavirus waivers and flexibilities is VA Dept. Telehealth means the use of telecommunications and information technology to provide access to medical and behavioral health assessment, diagnosis, intervention, consultation, supervision, and information across distance. MCOs will adopt equivalent service authorization criteria and quantity limits as FFS. The Administrations plan is to end the COVID-19 public health emergency (PHE) on May 11, 2023. WebThe Division of Licensing Programs protects children and vulnerable adults in day and residential care settings. Addiction and Recovery Treatment Services (ARTS). of Medical Assistant Svcs., Medicaid Provider Manual Local Education Agency, (Oct. 7, 2021). Many listings are from partners who compensate us, which may influence which programs Personnel practices Latest version. (Accessed Nov. 2022). Telemedicine Guidance. WebPrincess Anne Health & Rehabilitation Center has an exciting opportunity for a Unit Manager, RN in our 120bed skilled rehab center in Virginia Beach.. Compact Map. SOURCE: Telemedicine Guidance. Providers delivering services using telemedicine shall follow the requirements set forth in the DMAS Telehealth Services Supplemental Manual. While each circumstance is unique, such practitioner-patient relationships may be established using telemedicine services provided the standard of care is met. Some patients receive multiple health-related therapies and services in their homes. A provision for the payment of medical assistance for medically necessary health care services provided through telemedicine services, as defined in. 38.2-3418.16 (Accessed Nov. 2022). A license to operate a home care organization is issued to a person. Telehealth services includes the use of such technologies as telephones, facsimile machines, electronic mail systems, store-and-forward technologies, and remote patient monitoring devices that are used to collect and transmit patient data for monitoring and interpretation. from the expertise of practitioners known for specializing in certain conditions. However, no license shall be issued to a person who has been sanctioned pursuant to 42 Fairfax County has provided an overview of in-home care with some discussion of the role of the aide within home care (http://www.fairfaxcounty.gov/dfs/olderadultservices/in-home-care-guide.htm). (Accessed Nov. 2022). VA Department of Medical Assistance Services, Coverage of Virtual Check-In and Audio Only Services/Updates to Telehealth Services Supplement, April 1, 2022. They apply to the Board of Nursing (https://www.dhp.virginia.gov/nursing/nursing_forms.htm). SOURCE: Nurse Licensure Compact (Accessed Nov. 2022). VA Dept. VA Board of Medicine. Aides who have only personal care duties may be trained in accordance with the state personal care curriculum. No billing modifier is required on claims for services delivered via RPM. The originating site provider cannot bill an originating site fee unless the Member is assisted by a Medicaid enrolled telepresenter at the originating site. of Medical Assistant Svcs., Medicaid Provider Manual Supplement-Telehealth Services, (Oct. 2022) (Accessed Nov. 2022). Consult with an attorney if you are seeking a legal opinion. An informal or relative family child care home shall be located in the residence of the caregiver. (Providers should not use POS 02 on telehealth claims, even though this POS is referred to as telehealth for other payers. VA Dept. Additions to the Telehealth Supplement include defining virtual check-in services, identifying covered codes, specifying reimbursement requirements, and outlining fee-for-service (FFS) billing details. There must be regular communication between the consultant and the Virginia practitioner while the consultation/care is being provided. Coverage Continuous Glucose Monitoring is limited to members with: Service authorization is required. Oct. 23, 2019, (Accessed Nov. 2022). Medicare Compare, an official federal website, includes survey-based and outcome-based ratings for certified home health agencies. Attachment A in the Telehealth Supplement lists covered services that may be reimbursed when provided via telehealth. CCHP does not share or sell personal data. State regulations related to behavioral health services can be found in the Virginia AdministrativeCode. Medicaid Provider Manual, Addiction and Recovery Treatment Services, Covered Svcs and Limitations, (Mar. Telehealth encompasses telemedicine as well as a broader umbrella of services that includes the use of such technologies as telephones, interactive and secure medical tablets, remote patient monitoring devices, and store-and-forward devices. (Accessed Nov. 2022). The originating site provider cannot bill an originating site fee unless the Member is assisted by a Medicaid enrolled telepresenter at the originating site. Telemedicine Guidance. Facility fee is only available for synchronous telehealth services. (Accessed Nov. 2022). All fee-for-service claims for audio only codes should be billed directly to DMAS, including those delivered in the context of mental health and substance use disorder services. The activities and services of each applicant for issuance or renewal of a home care organization license shall be subject to an inspection or examination by VA Department of Medical Assistant Services. of Medical Assistant Svcs., Medicaid Provider Manual Supplement-Telehealth Services (Available in multiple manuals, including physician/practitioner, see overview for full list), (Oct. 2022) (Accessed Nov. 2022). Subsection (A)(15) reads as follows: Any legally qualified out-of-state or foreign practitioner from meeting in consultation with legally licensed practitioners in this Commonwealth. This statute is intended to have a Virginia practitioner involved in the care of the patient when a practitioner in another state/country consults with the Virginia practitioner or the patient. The individual may be trained as a nurse, as a nursing assistant, or as a home health aide (in accordance with federal standards for Medicare-certified agencies). Examples of originating sites include: medical care facility; Providers outpatient office; the members residence or school; or other community location (e.g., place of employment). The primary means of services delivery shall in-person for the Preferred OBAT model with the exception of telemedicine for specific member circumstances. The first is the consultant exemption found in 54.1-2901 which lists Exceptions and Exemptions Generally to licensure. Providers must maintain a practice at a physical location in the Commonwealth or be able to make appropriate referral of patients to a Provider located in the Commonwealth in order to ensure an in-person examination of the patient when required by the standard of care. Webalso covered by Medicare may be recovered by the home health agency if the member resides outside of a 15-mile radius of the home health agency. 32.1-325 (Accessed Nov. 2022). SOURCE: VA Code 54.1-2901. Home Health Agencies The Interpretive Guidelines serve to interpret and clarify the Conditions of Participation for home health agencies (HHAs).