1. Are telemedicine and telehealth services billable and payable?
Yes, for services provided on or after September 1, 2018.
- 28 Texas Administrative Code (TAC) §134.203 sets the reimbursement rates for telemedicine and telehealth services.
- 28 TAC §133.30 sets the billing requirements and allows injured employees to receive telemedicine and telehealth services from a distant site provider.
2. Can any medical service be delivered through telemedicine and telehealth?
No. The Texas Department of Insurance, Division of Workers' Compensation (DWC) adopts by reference the CMS list of telemedicine and telehealth services.
3. Can maximum medical improvement/impairment rating services be delivered through telehealth and telemedicine?
No. Codes 99455 and 99456 are not among the list of codes permitted to be delivered through telemedicine and telehealth.
4. Can injured employees receive physical medicine and rehab services from physical therapists (PTs), occupational therapists (OTs), and speech language pathologists (SLPs) through telehealth services?
As a result of the federal public health emergency, physical medicine and rehab CPT codes are included on the CMS list of telemedicine and telehealth services and may be provided by PTs, OTs, and SLPs.
Telemedicine and telehealth services must be consistent with the following:
- health care provider's scope of practice and licensing requirements;
- rules of the health care provider's licensing board;
- standard of care requirements; and
- DWC rules related to telemedicine and telehealth.
5. What is the standard of care for telehealth and telemedicine services?
A health practitioner providing a service through telemedicine or telehealth must give the same standard of care that would be given in person. Any questions about standard of care should be directed to the appropriate licensing board. Occupations Code §111.007.