Association Executive Directors Community

Expand all | Collapse all

MD - telephonic services

  • 1.  MD - telephonic services

    Posted 03-20-2020 14:10
    This afternoon, Maryland's governor released an executive order authorizing telephonic contacts. We understand that more detailed guidance for behavioral health services, including paraprofessional/rehab services, is being drafted.

    Shannon Hall
    Executive Director
    Community Behavioral Health Association of Maryland
    Catonsville MD
    410-788-1865 ext 2

  • 2.  RE: MD - telephonic services

    Posted 03-20-2020 15:42
    Are your states requiring a modifier code to be used when the session is completed using telephone/telehealth for delivery of a non telemedicine code (ie, skills building)? Indiana's guidance today requires the use of a moodier code. This seems an unnecessary step and adds to the risk of denials, MCO administrative burdens, etc. A simple notation in the case note the session was completed through phone is really all that should be required. It's always there for audit if needed. Curious what your states are requiring. Thanks. 

  • 3.  RE: MD - telephonic services

    National Council Staff
    Posted 03-20-2020 16:04

    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.




    Joe Parks
    Vice President, Practice Improvement & Medical Director
    National Council for Behavioral Health
    1400 K Street NW Suite 400, Washington, DC 20005
    Direct: (202) 629-5791

  • 4.  RE: MD - telephonic services

    Posted 03-20-2020 17:21
    I do get need for future data and information usage, however, this will create more immediate barriers when we need less administrative oversight. I suspect MCO denials and administrative headaches will be increased by requiring a modifier. Also, MCOs are typically paid PMPM. I suspect health care services will be dramatically reduced for most non COVID 19 treatment. MCOs will continue to reap monies while serving less and we will be financially strained. Seems broken to me.  Any excess dollars need to flow back to us to help offset losses.