Pennsylvania Office of Medical Assistance Programs Releases Telehealth Bulletin

The Pennsylvania Department of Human Services (DHS), Office of Medical Assistance Programs (OMAP) released MA Bulletin 99-21-06, “Guidelines for the Delivery of Physical Health Services via Telemedicine.” The purpose of this bulletin is to notify providers that, effective Sept. 30, 2021, the DHS is expanding the scope of services for which telemedicine may be used, expanding the scope of providers who may render MA covered services to beneficiaries using interactive telecommunication technology to include all enrolled providers, if permitted according to their scope of practice, licensure, or certification and establishing ongoing guidelines for services rendered via telemedicine. Key points from the Bulletin:

  • The MA Program will pay for MA covered services rendered to beneficiaries via telemedicine when clinically appropriate and allowable according to the provider’s scope of practice. Services rendered via telemedicine must be provided according to the same standard of care as if delivered in-person. Providers are encouraged to establish protocols for the use of telemedicine. MA MCOs may, but are not required to, allow for the use of telemedicine.
  • Providers are to obtain consent prior to rendering a service via telemedicine from the beneficiary receiving services or their legal guardian. Providers must also allow beneficiaries to elect to return to in-person services at any time.
  • Providers should fully document the services rendered and the telecommunication technology used to render the service in the MA beneficiary’s medical record. If the service was rendered using audio-only technology, providers are to document that the services were rendered using audio-only technology and the reason audio/video technology could not be used. Providers should obtain the location of the beneficiary at the time each service is rendered via telemedicine should there be a need for emergency medical services.
  • DHS added Place of Service (POS) 02 (telemedicine) for providers to identify services that are rendered via telemedicine. Providers are no longer required to utilize the GT modifier to indicate the use of telemedicine and are instead to use POS 02. Providers are to indicate in the beneficiary’s medical record when telemedicine services are rendered via audio-only.

This bulletin obsoletes MA bulletin 09-12-31 et al., Consultations Performed Using Telemedicine, issued May 23, 2012 and, Provider Quick Tips #229 and #242, Telemedicine Guidelines Related to COVID-19.