Webhome care, pharmaceutical or personal care services in the residence of a client or individual in Virginia. HHAs help patients function in a home setting (as opposed to having to stay in a more restrictive place like a skilled nursing facility). A licensed psychiatrist or nurse practitioner (who is acting within the scope of their professional license and applicable State law) must be available to the program 24/7 either in person or via telemedicine to provide assessment, treatment recommendations and consultation. Service providers must include the modifier GT on claims for services delivered via telemedicine. WebHealth Care Policy Board, the regulations necessary to implement the provisions and purpose of Chapter 8 of the Act (35 P.S. Our site does not feature every educational option available on the market. SOURCE: VA Department of Medical Assistance Services. Medicaid Memo. The establishment of a new practitioner-patient relationship requires a Virginia license and must comport with the requirements for telemedicine found in 54.1-3303 of the Code of Virginia. This information should not be construed as legal counsel. In cases in which a dentist is providing teledentistry, the examination required by clause (ii) shall not be required if the patient has been examined in person by a dentist licensed by the Board within the six months prior to the initiation of teledentistry and the patients dental records of such examination have been reviewed by the dentist providing teledentistry. Outstanding communication skills accompanied by excellent organizational and interpersonal skills. A pharmacist may initiate treatment with, dispense, or administer drugs, devices, controlled paraphernalia, and other supplies and equipment pursuant to this section through telemedicine services, as defined in 38.2-3418.16, in compliance with all requirements of 54.1-3303 and consistent with the applicable standard of care. SOURCE: VA Dept. A. VA provides several types of home health care including: Skilled home health care. 600 East Broad StreetRichmondVirginia. Billing Instructions, (Oct. 2021), (Accessed Nov. 2022). and 34 ( 54.1-3400 et seq.) Does not explicitly specify that an FQHC is eligible. DMAS and all managed care organizations (MCOs) will cover remote patient monitoring (RPM) services for full benefit Medicaid and FAMIS populations in accordance with the 2021 Special Session I Budget, Item 313.VVVVV. SOURCE: VA Code 54.1-2901. VA Statute 54.1-2711. of Medical Assistance Svcs. Initiated additional diagnostic tests or referrals as needed. Certain audio-only codes are eligible for reimbursement in VA Medicaid. Clarification of Existing Medicaid Coverage of Continuous Glucose Monitoring for Members in Medicaid/FAMIS/FAMIS MOMS Fee-for-Service Programs. VA Board of Medicine. Occupational Therapy Compact Map (Accessed Nov. 2022). Prescribing controlled substances, in-person or via telemedicine services, is at the professional discretion of the prescribing practitioner. (Accessed Nov. 2022). Includes the delivery of patient care through real-time interactive audio-visual technology; Conforms to the standard of care expected for in-person care; and. Public Participation Guidelines - revised December 15, 2016. I have chosen Virginia's Nursing Home Staffing and Care Standard bill. of Medical Assistant Svcs. SOURCE: VA Medicaid Telehealth Questions and Answers (Aug. 2021). Training requirements may be met in any of several ways. The Board, subject to the approval of the Governor, is authorized to prepare, amend from time to time, and submit to the U.S. Secretary of Health and Human Services a state plan for medical assistance services. Medicaid Provider Manual, Mental Health Services, Ch. This direct contact information ensures ease of access by pharmacists to clarify prescription orders, and further facilitates the prescriber-patient-pharmacist relationship. VA Code Annotated 54.1-3303, (Accessed Nov. 2022). All home health services that exceed 60 visits in a calendar year require prior authorization. Telemedicine does not include an audio-only telephone. Providers working in the Mobile OBAT setting shall provide services in-person as well as be permitted to utilize technology to provide telemedicine sessions with providers located at the Preferred OBATs primary location. 54.1-3408.3. The FQHC section of CCHPs Policy Finder Tool is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $1,656,250 with zero percentage financed with non-governmental sources. Code Ann. The Medicaid member is located at a provider office or other location where services are delivered on an in-person basis (this does not include the members residence); The member and distant site Provider are not located in the same location; and. Remote patient monitoring services includes monitoring of clinical patient data such as weight, blood pressure, pulse, pulse oximetry, blood glucose, and other patient physiological data, treatment adherence monitoring, and interactive videoconferencing with or without digital image upload. See Telehealth Supplement for Documentation and Equipment/Technology Requirements. P. 3 (Aug. 19, 2021). The practitioner-patient relationship is fundamental to the provision of acceptable medical care. Adds to the conditions aprescriber must meet for a bona fide practitioner-patient relationshipfor the purpose of prescribing Schedule II through VI controlled substances by an examination through face-to-face interactive, two-way, real-time communications services or store-and-forward technologies. The assessment includes documented recent history of the severity, intensity, and duration of symptoms and surrounding psychosocial stressors. Remote Patient Monitoring (RPM) involves the collection and transmission of personal health information from a beneficiary in one location to a provider in a different location for the purposes of monitoring and management. Home Health Agencies The Interpretive Guidelines serve to interpret and clarify the Conditions of Participation for home health agencies (HHAs). WebThe Virginia Administrative Code contains the regulations adopted by state agencies in the Commonwealth of Virginia. Virginia Medicaid reimburses for live video, store-and-forward, remote patient monitoring and certain audio-only codes under certain circumstances. (Accessed Nov. 2022). Telemedicine Guidance. of Medical Assistance Svcs. 2022). Does not explicitly state a FQHC is eligible to bill Q3014. SOURCE: VA Code Annotated Sec. All fee-for-service claims for audio only codes should be billed directly to DMAS, including those delivered in the context of mental health and substance use disorder services. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100% and 400% of the federal poverty level (FPL). A nurse practitioner or physician assistant working under the licensed psychiatrist may provide this coverage for the psychiatrist. Billing Instructions, (July 2022) (Accessed Nov. 2022). VA Board of Medicine. Prescriptions must comply with the requirements set out in Virginia Code 54.1-3408.01 and 54.1-3303(A). MCO contracted providers should consult with the contracted MCOs for their specific policies and requirements for telehealth. P. 4 (Aug. 19, 2021). (Accessed Nov. 2022). SOURCE: VA Dept. Oct. 23, 2019. Home care agencies must follow hiring and training requirements set down in state code. See Code for required provisions for statewide telehealth plan. Providers shall contact DMAS Provider Enrollment (888-829-5373) or the Medicaid MCOs for more information. of Medical Assistant Svcs., Medicaid Provider Manual Supplement-Telehealth Services (Available in multiple manuals, including physician/practitioner, see overview for full list), (Oct. 2022) (Accessed Nov. 2022). VA Board of Medicine. Web ABQ VA: Veteran Services: 7 week outpatient clinical/ home health PT maintaining +75% of the caseload. (Aug. 19, 2021). Medicaid Bulletin: Clarification of DMAS Requirements Related to the Use of Telemedicine in Providing MAT for OUD. VA Code Annotated Sec. 54.1-3408.3. Services delivered via telehealth will be eligible for reimbursement when all of the following conditions are met: In order to be reimbursed for services using telehealth that are provided to MCO-enrolled individuals, Providers must follow their respective contract with the MCO. Nursing homes are also subject to co-extensive federal government regulation. It is rare to have a complementary, yet overlapping system of regulation for an industry, but each level of regulation serves its own purpose. For the federal government, it is the Department of Health and Human Services that is the applicable regulator. Attachment A in the Telehealth Supplement lists covered services that may be reimbursed when provided via telehealth. They must receive orientation. Telemedicine is available for selected services. Credentialed Addiction Treatment Professional means: An individual licensed or registered with the appropriate board in the following roles: Preferred OBAT services must be provided by a buprenorphine-waivered practitioner and a co-located Credentialed Addiction Treatment Professional and may be provided in a variety of practice settings including primary care clinics, outpatient health system clinics, psychiatry clinics, Federally-Qualified Health Centers (FQHCs), Community Service Boards (CSBs), local health department clinics, and physicians/physician extenders offices. VA Dept. 32.1-325, (Accessed Nov. 2022). Doc. SOURCE: VA Dept. Facility fee is only available for synchronous telehealth services. See our Privacy Policy. A supervisee in social work who is under the supervision of a licensed clinical social worker and is registered with the Virginia Board of Social Work (18VAC140-20-10). Expand the Medicaid program to cover all adults with income below 138% of the FPL. DMAS will reimburse an originating site fee to emergency ambulance transport providers for facilitating a telemedicine consultation between a Medicaid member and a Medicaid- enrolled provider for the purposes of identifying whether the Medicaid member is in need of emergency ambulance transportation. WebVirginia Department of Health Office of Licensure and Certification Administers state licensing programs for hospitals, outpatient surgical hospitals, nursing facilities, home care organizations, and hospice programs. They go through a competency evaluation process through Pearson VUE. (Accessed Nov. 2022). Prescribing controlled substances for the treatment of addiction delivered via telemedicine must include a qualified provider and a telepresenter located at the originating site, as well as a qualified prescribing provider located at the remote site. SOURCE: VA Dept. The Consolidated Appropriations Act of 2023 extended many of the telehealth flexibilities authorized during the COVID-19 public health emergency through December 31, 2024.