Certain Medicaid and CHIP services may soon be delivered using telemedicine, telehealth, and audio-only methods on an ongoing basis. This includes services that have been made available through telemedicine, telehealth, and audio-only methods during the COVID-19 public health emergency (PHE) as well as other services.
With input from advisory committees and other stakeholders, HHSC staff are evaluating services to determine whether this method of delivery is cost-effective and clinically appropriate.
This work will be completed in phases and will continue throughout 2022. You can find additional information about HHSC’s evaluation framework (PDF).
Submit Feedback to HHSC
Rules and medical policy changes will be happening in 2022 with opportunities for stakeholder input and feedback, including a formal comment period. We will post about these opportunities here.
If you have general questions or comments about Medicaid and CHIP teleservices, please e-mail HHSC_MCS_House_Bill_4@hhs.texas.gov.
Expected Timeline
Phase I: Analysis - Winter 2022 - Complete
- HHSC released guidance about certain services that are approved for telemedicine, telehealth, and audio-only delivery methods on an ongoing basis.
- HHSC began releasing draft rules and other policy updates.
Phase II: Analysis - Spring 2022 - Complete
- HHSC requested stakeholders for input about additional services that were available for remote delivery during the PHE to help determine whether permanent telemedicine, telehealth, and audio-only delivery methods would be cost-effective and clinically appropriate.
- HHSC released guidance about additional services that are approved for telemedicine, telehealth, and audio-only delivery methods.
- HHSC posted draft rules required by legislation for informal comment.
Phase III: Rulemaking - Summer 2022 - Complete
- Changes to medical benefit policies were posted for public comment.
Phase IV: Finalizing Policy - Fall 2022 through Early 2023
- Rules required by legislation will be formally posted for public comment.
- HHSC expects to finalize formal rule changes after providing an opportunity for stakeholder input on posted rules.
Background Legislation
House Bill (HB) 4 (87th Legislative Session, 2021):
HHSC allowed the use of telemedicine, telehealth, and audio-only for many new Medicaid services during the COVID-19 PHE. In response, this bill requires HHSC to allow more services to be delivered using telemedicine, telehealth, and audio-only methods on a permanent basis after the PHE ends if clinically appropriate and cost-effective.
Senate Bill (SB) 670 (86th Legislative Session, 2021):
MCOs have the responsibility to determine which services could be delivered through telemedicine, telehealth, and audio-only methods.
MCOs cannot deny reimbursement to health care providers for a Medicaid service or procedure just because it was delivered via telemedicine or telehealth. MCOs also cannot deny or reduce reimbursement for a Medicaid service or procedure based on the health care provider’s choice of platform.
Additional Resources
Opportunities for Public Comment
Notices and Policy Updates Published
- TMHP bulletin title SHARS Benefits to Change for Texas Medicaid October 1, 2022 posted on August 12, 2022.
- TMHP bulletin title Changes to Case Management for Children and Pregnant Women, Including Teleservices, Effective September 1, 2022 posted on July 18, 2022
- TMHP bulletin title Telemedicine and Telehealth Benefit Information to Be Updated September 1, 2022 posted on July 15, 2022
- TMHP bulletin title HB4: Behavioral Health Services Delivered by Telemedicine or Telehealth Effective September 1, 2022 posted on July 15, 2022
- TMHP bulletin title Telemedicine and Telehealth Services for the HTW and HTW Plus Programs posted on July 15, 2022
- TMHP bulletin title Telehealth Services for the Early Childhood Intervention Program posted on July 15, 2022
- TMHP bulletin title HB4 PT, OT, ST, and Related Durable Medical Equipment Services: Telehealth and Exclusions posted on July 15, 2022
- TMHP bulletin title Synchronous Audiovisual Telemedicine Delivery for Certain Physician Evaluation and Management Procedure Codes Effective September 1, 2022 posted on July 15, 2022
- TMHP bulletin title Medical Nutrition Counseling Policy Updated to Allow Procedure Code S9470 Through Synchronous Telephone (Audio-Only) Technologies Delivery posted on July 15, 2022
- TMHP bulletin title Texas Health Steps Preventive Care Medical Checkups Through Synchronous Audiovisual or Synchronous Telephone (Audio-only) to Be Allowed During a State of Disaster posted on July 15, 2022
- TMHP bulletin title HTW and HTW Plus Telemedicine and Telehealth Services Interim Guidance posted on April 29, 2022
- HB4: ECI TCM Telehealth Delivered by Synchronous Audio-visual or Telephone (Audio-only) Technology posted on April 29, 2022
- HHSC Alert, Revised Guidance for COVID-19 Flexibility for Nursing Services by Telehealth for CLASS, DBMD, HCS and TxHmL, posted on April 29, 2022
- TMHP bulletin titled HB 4: School Health and Related Services (SHARS) Telemedicine or Telehealth Delivered by Synchronous Audio-visual or Telephone (Audio-only) Technology posted on April 28, 2022
- TMHP bulletin titled Update to HB4: Behavioral Health Services Delivered by Synchronous Audio-visual or Telephone (Audio-only) Interim Guidance posted on April 28, 2022
- HHSC Information Letter No. 2022-24, HB4: Interim Guidance for Behavioral Support, Cognitive Rehabilitation Therapy, Dietary Services, Music Therapy and Recreational Therapy Delivered by Telehealth, posted on April 26, 2022
- HHSC Information Letter No. IL22-27, Interim Guidance for Renewal of ID/RC Assessments and for Renewal, Revised, and Transfer IPCs for CLASS, HCS and TxHmL posted on April 26, 2022
- TMHP bulletin titled Telemedicine and Telehealth Services Provided by Rural Health Clinics posted on February 28, 2022
- Information Letter No. 2022-08, HHSC HB4: Physical Therapy, Occupational Therapy, Speech Therapy Services Delivered by Synchronous Audio-Visual posted on January 24, 2022
- TMHP bulletin titled HB4: Behavioral Health Services Delivered by Synchronous Audio-visual or Telephone (Audio-only) Interim Guidance posted on January 19, 2022
- TMHP bulletin titled Synchronous Audiovisual Technology Telemedicine and Telehealth Services for Healthy Texas Women (HTW) posted on January 18, 2022
- TMHP bulletin titled HB4: Interim Guidance for Physical Therapy, Occupational Therapy, Speech Therapy Services Delivered by Synchronous Audiovisual posted on January 18, 2022