News
23-975m Updates to Medi-Cal Covered Services Offered Through Telehealth
Date: 09/05/23
Stay up to date with changes for telehealth services, effective January 1, 2024
On April 10, 2023, the Department of Healthcare Services (DHCS) issued All Plan Letter (APL) 23-007 (PDF) to provide clarification on the DHCS policy for covered services offered through telehealth and the expectations related to documentation for telehealth.
Updates for telehealth services
- Reimbursable Services: Effective January 1, 2024, all physicians and other providers offering covered services via audio-only synchronous interactions must also offer the same services via video synchronous interactions to preserve patient choice. Also, to preserve a patient’s right to access covered services in-person, physicians and other providers must do one of the following:
- Offer the same services via in-person, face-to-face contact.
- Arrange for a referral to, and a facilitation of, in-person care that does not require a patient to independently contact a different physician or other provider to arrange for that care.
- Patient Consent: Prior to the initial delivery of services via telehealth, physicians and other providers must inform patients about the use of telehealth and obtain verbal or written consent from the patient for the use of telehealth as an acceptable mode of delivering services. Patient consent must be documented in the patient’s medical record and made available upon request.
- Payment: California Health & Wellness Plan and its delegated capitated independent practice associations must reimburse participating physicians and other providers at the same rate, whether a covered service is provided in-person or through telehealth, if the service is the same regardless of the modality of delivery, as determined by the physician or other provider’s description of the service and procedure codes on the claim. Delivering covered services via telehealth does not change the at-risk payor in delegated capitated arrangements.
Learn more
Additional information on APL 23-007 (PDF) can be found on the telehealth web page of the DHCS website.
Additional information
Providers are encouraged to access California Health & Wellness Plan’s (CHWP) provider portal for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.
If you have questions regarding the information contained in this update, contact CHWP at 877-658-0305.
This Information applies to Physicians and Independent Practice Associations (IPAs).