Telehealth is a method of delivering health services using interactive telecommunications when the member and the behavioral health provider are not in the same physical location.
What are the benefits of telehealth? Expand
Telehealth offers a range of benefits for both clinicians and your clients.
- Flexible schedule
- Improves access of care to vulnerable populations
- Allows individuals that may have been discouraged due to social stigma to seek care in the privacy of their homes.
- Increased Income
– Additional hours at non-traditional times
– Opens access to more clients
– Removes barriers for clients
– Fewer no shows
How does ICANotes provide telehealth? Expand
ICANotes offers a proprietary Telehealth feature that works in conjunction with the EHR. The clinician can launch a telehealth session from the appointment, the chart, or the chart room. The client receives either an email or a text message with a link that they simply click to join the session.
Start Telehealth Session from multiple points in ICANotes: Chart Room, Chart Face, Event Details
What services can I provide via telehealth? Expand
CMS will now allow for more than 80 additional services to be furnished via telehealth. These include therapy services, telepsych, and medication management. For more information: State Telehealth and Licensure Expansion COVID-19
ICANotes Telehealth is a secure, fully-featured and comprehensive behavioral health telemedicine application. An email is sent to the client from the clinician within ICANotes. The client then clicks the secured, encrypted link. Once the link is pressed, the telehealth session starts within the web browser. No download is needed on the client’s side.
“Facebook Live, Twitch, TikTok, and similar video communication applications are public facing, and should not be used in the provision of telehealth by covered health care providers.” (Health and Human Services)
Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency
Is telehealth different from telemedicine? Expand
Telehealth is different from telemedicine in that it refers to a broader scope of remote healthcare services than telemedicine. While telemedicine refers specifically to remote clinical services, telehealth can refer to remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services. [Source: HealthIT.gov]
What equipment do I need? Expand
- A broadband internet connection
- Computer (desktop or laptop)
What should I consider with my digital office space? Expand ● Privacy ● Noise Level ● Visual Distractions ● Clothing ● Lighting ● Eye Contact How do I prepare for a session? Expand Prepare Yourself Test out your telehealth platform before your first appointment. Send a practice link to a friend and ask them to hop on quickly so you know what the process looks like. This also allows you to make sure all of your equipment is working properly and lets you catch any problems before your real appointment. Prepare Your Client Inform your client about what they should expect during their telehealth session. Let them know in advance how you’ll be conducting your sessions. Consent Documents Whether you need to provide your clients with consent documentation or not depends on your state regulations. Some states do not require any consent documentation, while others require verbal or written consent. Does my patient need to consent to telehealth services? Expand
Telehealth consent varies by each state and payer source. Below are two sample Telehealth Consent forms.
Can I prescribe medicine using telehealth? Expand
Yes, utilizing Dr. First you can send prescriptions electronically in conjunction with the Telehealth application.
How do I schedule my telehealth appointments? Expand
The ICANotes calendar has a direct link to our telehealth solution. You can schedule clients on the ICANotes calendar and then initiate a session from the calendar.
How much does telehealth cost? Expand
$10 per clinician per month.
Do I need to attest to an insurance company before providing telehealth service? Expand
At this time, ICANotes encourages clinicians to attest to an insurance company prior to providing telehealth service. However, some insurance companies have waived attestation at this time. Check with your payers to see if attestation has been waived.
For more detailed guidance for behavioral health providers on telehealth expansion and reimbursement, please see the following resources:
Aetna Telehealth Guidance for Behavioral Health Providers
Cigna Telehealth Guidance for Behavioral Health Providers
Optum Telehealth Guidance for Behavioral Health Providers [PDF]
How do I document a telehealth service in preparation for billing? Expand
There are some key factors in behavioral health that are recommended for telehealth documentation. All clinicians will perform their normal assessment of individuals. However, key factors to note in the documentation are where the client is located. We encourage you to inquire and document this at the start of your telehealth session. This information is valuable in case a client has a crisis and you need to contact someone for assistance, such as a mobile crisis unit or the police.
CMS reports providers should, “Submit telehealth services claims, using Place of Service (POS) 02 – Telehealth, to indicate you furnished the billed service as a professional telehealth service from a distant site.” [Source: CMS]
It is recommended to bill the same codes for telehealth services, with the addition of specific modifiers – GT, 95, and GQ. Some payers may not require this. Check with your clearinghouse and insurance payers for more details. The ICANotes Knowledge Base provides additional resources for setting up telehealth billing:
How to Setup a Telehealth Site
Setting up Telehealth Modifier Rules
In addition, we’ve introduced a new “telehealth session” checkbox next to the service code work area of most note types in ICANotes. When a note is compiled and the telehealth session box is checked, a sentence will be added near the end of the finished note text which reads, “This encounter was conducted via a telehealth session.”
The following are social determinants codes which may be applicable to documentation and billing for telehealth services:
|Z55.1||Schooling unavailable and unattainable||Z60.8||Other problems related to social environment|
|Z55.8||Other problems related to education and literacy||Z62.29||Other upbringing away from parents|
|Z56.0||Unemployment, unspecified||Z62.820||Parent-biological child conflict|
|Z56.6||Other physical and mental strain related to work||Z62.891||Sibling rivalry|
|Z56.89||Other problems related to employment||Z63.0||Problems in relationship|
|Z57.8||Occupational exposure to other risk factors||Z63.4||Death and disappearance of family member|
|Z59.0||Homelessness||Z63.6||Dependent relative needing care at home|
|Z59.1||Inadequate housing||Z63.79||Other stressful life events affecting family and household|
|Z59.5||Extreme poverty||Z65.4||Victim of crime and terrorism|
|Z59.6||Low income||Z65.8||Other specified problems related to psychosocial circumstances|
|Z59.8||Other problems related to housing and economic circumstances||Z73.0||Burn-out|
|Z60.0||Problems of adjustment to life-cycle transitions||Z73.2||Lack of relaxation and leisure|
|Z60.2||Problems related to living alone||Z73.3||Stress, not elsewhere classified|
|Z60.3||Acculturation difficulty||Z73.89||Other problems related to life management difficulty|
|Z60.4||Social exclusion and rejection||Z75.4||Unavailability and inaccessibility of health-care facilities|
|Z60.5||Target of (perceived) adverse discrimination and persecution||Z75.8||Other problems related to medical facilities and other health care|
Will I be reimbursed for telehealth? Expand
Yes, you may continue utilizing the current workflow for electronic or paper claims submission in order to bill for your telehealth services. See our documentation on how to set your Site and Place of Service Code accordingly.
Medicaid Telehealth Guidance to States [PDF]
Are there licensing waivers for telehealth? Expand
Each state is dealing with the COVID-19 pandemic in different ways regarding telehealth. Below is a comprehensive list that is regularly updated with each state’s specifications.
State Telehealth and Licensure Expansion COVID-19 [external link]
What are the requirements for Title Telehealth Grants? Expand
The FCC approved a $200 million telehealth grant program for eligible health care providers.
Consistent with the 1996 Act and the CARES Act, we limit the program to nonprofit and public eligible health care providers that fall within the categories of health care providers in section 254(h)(7)(B) of the 1996 Act: (1) post-secondary educational institutions offering health care instruction, teaching hospitals, and medical schools; (2) community health centers or health centers providing health care to migrants; (3) local health departments or agencies; (4) community mental health centers; (5) not-for-profit hospitals; (6) rural health clinics; (7) skilled nursing facilities; or (8) consortia of health care providers consisting of one or more entities falling into the first seven categories. The Commission has more than two decades of experience administering its RHC Program for these types of healthcare providers, and limiting the COVID-19 Telehealth Program to public and nonprofit health care providers that fall within these statutory categories is in the public interest because it will facilitate the administration of this program and ensure that funding is targeted to health care providers that are likely to be most in need of funding to respond to this pandemic while helping us ensure that funding is used for its intended purposes.
[Source: FCC – view downloadable PDF]
Instructions for Filing Applications: COVID-19 Telehealth Program applications must reference WC Docket No. 20-89, and must be filed electronically using the Internet by accessing ECFS, https://www.fcc.gov/ecfs, see Electronic Filing of Documents in Rulemaking Proceedings, 63 FR 24121 (1998). All filings must be addressed to the Commission’s Secretary, Office of the Secretary, Federal Communications Commission. Applicants must also send a courtesy copy of their application via email to EmergencyTelehealthSupport@fcc.gov.
For questions, please contact (1) Rashann Duvall at (202) 418-1438, Rashann.Duvall@fcc.gov or (2) Hayley Steffen at (202) 418-1586, Hayley.Steffen@fcc.gov.
Where can I learn more about telehealth? Expand
American Telemedicine Association
Center for Connected Health Policy: The National Telehealth Policy Resource Center
Great Plains Telehealth Resources and Assistance Center: Checklist for Initiating Telehealth Services
Mid-Atlantic Telehealth Resource Center: MATRC Remote Patient Monitoring Toolkit
Telehealth Services-MLN Booklet [PDF]
University of Arizona Telemedicine Checklist
Washington State Guidebook, including checklist for implementing a new telehealth system [PDF]