I would be surprised if most Medicaid directors wouldn't want separate coding if nothing else because they are anticipating that their legislators will insist on some kind of reporting of how much telephonic service occurred. Second they will anticipate that they will get some requests to continue to pay for telephonic service which means they would need to do budget modeling to predict long-term impact. Third they would anticipate that there may be some special federal funding where were being able to report this separately would be advantageous. In OPTUM's announcement that they would cover telephonic services they are asking that a modifier be used also. I look forward to hearing which payers decide otherwise.