During the COVID-19 pandemic, the Health Care Authority (HCA) has taken several steps to expand the use of telehealth, including:
- Providing services through telephone interaction;
- Online digital interaction through a patient portal; and
- Video-based evaluation and management services.
For Medicaid enrollees in both fee-for-service and managed care (see HCA guidance for billing codes), changes include:
- The fee paid to matched audio (phone) only visits and online digital services through a patient portal are increased to in-person rates;
- Telehealth clinical services (evaluation and management procedure codes) where face-to-face visits may not be feasible, and when it is medically appropriate to be evaluated by telehealth will continue to be paid.
For Public Employee Benefits Board (PEBB) and School Employee Benefits Board (SEBB) enrollees, changes include:
- Telehealth services will be paid at the same rate as in-person services; and
- Counseling visits during the pandemic provided by telephone-only will be paid.
For public employees enrolled in the Uniform Medical Plan (UMP) administered by Regence, please see Regence’s COVID-19 webpage. Public and school employees enrolled in Premera, Kaiser Permanente NW and WA, note that the HCA is working with Premera, Kaiser Permanente NW, and Kaiser Permanente WA to ensure they also implement telehealth services and pay appropriately for PEBB and SEBB enrollees.
HCA has purchased a limited number of Zoom telehealth technology licenses to support certain providers who may not already have access to HIPAA-compliant tools. Also, providers should visit HCA’s COVID-19 response page for the latest information about billing and clinical policy. (Shirley Prasad, ShirleyP@wsha.org).