Medicaid and CHIP Teleservices

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 here.

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

  • 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

  • Rules required by legislation will be posted for public comment.

Phase IV: Finalizing Policy -Fall 2022

  • Additional rules required by legislation will be posted for public comment.
  • HHSC expects to finalize formal policy changes after providing an opportunity for stakeholder input on posted rules and policies. Guidance will be posted on this website when available.

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

The policies listed below will be available for public comment soon. Please check the Medicaid Medical and Dental Policies website here for specific timelines and policies open for comment.

  • Behavioral Health and Case Management Services Handbook
    • Screening, Brief Intervention and Referral to Treatment (SBIRT) Services policy
    • Outpatient Mental Health Services policy
    • Peer Specialist Services policy
    • Substance Use Disorder Services policy
    • Mental Health Targeted Case Management Services policy
    • Mental Health Rehabilitation Services policy
    • Case Management for Children and Pregnant Women (CPW) Policy
  • Children’s Services Handbook
    • Early Childhood Intervention (ECI) Services policy
    • Health and Behavior Assessment and Intervention (HBAI) Services policy
    • Medical Nutrition Counseling Services (CCP) policy
    • THSteps Medical policy
  • Gynecological, Obstetrics, and Family Planning Title XIX Services Handbook
    • Obstetric Services policy
    • Gynecological Health Services policy
  • Healthy Texas Women Program Handbook
    • Healthy Texas Women policy
  • Medical and Nursing Specialist, Physicians and Physician Assistants Handbook
    • Physician Evaluation and Management (E/M) Services policy
  • Physical Therapy, Occupational Therapy, and Speech Therapy Services Handbook
    • Physical, Occupational, and Speech Therapy-Children (Acute and Chronic) policy
    • Physical, Occupational, and Speech Therapy-Adult/Clients Age 21 and Over policy
  • School Health and Related Services (SHARS) Handbook
    • School Health and Related Services (SHARS) policy
  • Telecommunication Services Handbook
    • Telemedical (physician-delivered) Services policy
    • Telehealth (non-physician delivered) Services policy

Notices and Policy Updates Published