Texas Labor Code and Division of Workers' Compensation (DWC) rules allow for billing and reimbursement of certain telemedicine and telehealth services in workers' compensation. Injured employees may get services regardless of their geographic location. Telemedicine services are provided by a physician licensed in Texas, while telehealth services are provided by health care professionals other than physicians.
Here are requirements and conditions for payment for these services:
- 28 Texas Administrative Code 133.30, Telehealth and Telemedicine Services
- CMS list of telemedicine and telehealth services (zipped Excel files)
- Billing – A health care provider must bill for telemedicine/telehealth services according to applicable Medicare payment policies, as defined in §134.203 of this title; and provisions of Chapter 133 of this title.
- Reimbursement (non-network)
- Reimbursement (networks) – Check with your contracted certified networks before you start a telemedicine or telehealth program for covered injured employees.
FAQ (updated October 2020)
Related CMS policy resources
DWC adopts Medicare coding, billing, and documentation policies by reference. Medicare policies that conflict with DWC’s adopted rules do not apply.
- CMS telehealth web page
- 100-04 Medicare Claims Processing Manual – Go to Chapter 12, Section 190 Telehealth Service
- CMS Fact Sheet: Medicare Telemedicine Health Care Provider Fact Sheet 03/17/20
Coronavirus (COVID-19) resources and timeline
Telemedicine and Telehealth timeline
- DWC coronavirus web page
- DWC memo: 28 TAC §167.1, 60-Day Extension 8/10/20
- DWC memo: Subchapter A. COVID-19 Emergency Rules 28 TAC §167.1 4/13/20
- DWC FAQ: Telemedicine Emergency Rule FAQs 4/13/20
- DWC memo: COVID-19: Centers for Medicare and Medicaid Services (CMS) issues guidance on telemedicine and telehealth 4/02/20
- CMS fact sheet: Sweeping Regulatory Changes to Help U.S. Healthcare System Address COVID-19 Patient Surge 3/30/20
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