11/19/2024
Important Information
Effective Dec. 1, 2024, the Texas Medicaid Provider Procedures Manual will be updated related to telemedicine and telehealth services for certain medical nutrition therapy services, medical nutrition counseling services, and end-stage renal disease conditions.
Impact
The following telemedicine and telehealth services may continue to be provided by synchronous audiovisual technology for medical nutrition therapy and medical nutrition counseling, and the diagnosis, evaluation, and treatment of end-stage kidney dialysis conditions if clinically appropriate and safe, as determined by the provider and agreed to by the client receiving services:
- Medical nutrition therapy services (procedure codes 97802, 97803, and 97804).
- Medical nutritional counseling service (procedure code S9470).
- End-stage renal disease services (procedure codes, 90951, 90952, 90954, 90955, 90957, 90958, 90960, and 90961).
- Services delivered by synchronous audiovisual technology must be billed using modifier 95.
New language will indicate that during certain public health emergencies or natural disasters, and if clinically appropriate and safe, as determined by the provider and agreed to by the client receiving services, the following procedure codes may be provided by synchronous telephone (audio-only) technology:
- Medical nutrition therapy services (procedure codes 97802, 97803, and 97804).
- Medical nutritional counseling service (procedure code S9470).
- Services delivered by synchronous telephone (audio-only) technology must be billed using modifier 93.
Note: As a reminder, Senate Bill 670, 86th Legislature, Regular Session, 2019 prohibits Medicaid and CHIP health plans from:
- Denying reimbursement to health care providers for a Medicaid service or procedure solely because it was delivered by telemedicine or telehealth, and
- Denying or reducing reimbursement to health care providers for a Medicaid service or procedure based on the health care provider’s choice of platform.
Resources:
TMHP provider notice published on October 11, 2024: Medical Nutritional Counseling a Benefit of HTW Effective December 1, 2024
Questions
Providers, for questions or additional information, please:
- Contact your BCBSTX Medicaid Provider Network team at 1-855-212-1615
- Submit via email Texas Medicaid Network Department