Medi-Cal Payment for Telehealth and Virtual/Telephonic Communications Relative to the 2019-Novel Coronavirus (COVID-19)
June 23, 2020 (Supersedes April 30, 2020 and March 24, 2020 Guidance)
Overview: In light of both the federal Health and Human Services Secretary’s January 31, 2020, public health emergency declaration, as well as the President’s March 13, 2020, national emergency declaration relative to COVID-19, the Department of Health Care Services (DHCS) is issuing additional guidance to enrolled Medi-Cal providers, including, but not limited to physicians, nurses, mental health practitioners, substances use disorder practitioners, dentists – as well as Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Tribal 638 Clinics. This guidance is relative to all of the following:
•Section I: Current Medi-Cal Policy for Enrolled Medi-Cal Providers: Asoutlined in the Medi-Cal Provider Manual (Medicine: Telehealth) and/or posted tothe Medi-Cal Rates Information Page:
Traditional telehealth modalities, i.e., synchronous two-way interactive,audio-visual communication and asynchronous store and forward,inclusive of e-consults
Other virtual/telephonic communication modalities
•Section II: Current Medi-Cal Policy for FQHCs, RHCs, Tribal 638 Clinics: As outlined in various sections of the Medi-Cal Provider Manual (Federally Qualified Health Centers/Rural Health Clinics, and Indian Health Services Memorandum of Agreement 638 Clinics), and/or posted to the Medi-Cal Rates Information Page:
Traditional telehealth modalities, i.e., synchronous two-way interactive,audio-visual communication and asynchronous store and forward.
•Section III: Waiver and State Plan Amendment (SPA) 20-0024 Related to the Novel Coronavirus Disease (COVID-19), approved on May 8, 2020 and May 13, 2020 respectively
Additional flexibilities and options relative to traditional telehealth modalities, i.e., synchronous two-way, audio-visual communication and asynchronous store and forward, inclusive of e-consults Medi-Cal Payment for Virtual/Telephonic Communications Relative to COVID-19
Additional flexibilities and options relative to other virtual/telephonic communication modalities
Frequently Asked Questions (FAQ)
DHCS compiled a list of “Frequently Asked Questions” (FAQ) with responses below to provide additional guidance and clarification to Medi-Cal providers regarding both the current telehealth and virtual/telephonic communications outlined in Sections I and II as well as the Section 1135 Waiver temporary flexibilities relative to telehealth and virtual/telephonic communications outlined in Section III. As DHCS receives additional questions, the FAQ section will continue to be updated.
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