March 18, 2020
To: Contra Costa Health Plan (CCHP) Providers
RE: Updated information Telehealth Services
Contra Costa Health Plan (CCHP) follows all applicable Federal and State laws in the use of Telemedicine services to provide consultation, access and quality of care to our Medi-Cal and Commercial members. Due to the COVID-19 outbreak, CCHP is providing the following guidance on providing essential services by Telehealth:
- Telehealth services may be provided at a physician office, clinic setting, hospital, skilled nursing facility, residential care setting or patient home or other setting.
- The treating health care provider at the distant site believes the services being provided are clinically appropriate to be delivered via telehealth based upon evidence-based medicine and/or best clinical judgment.
- The member has provided verbal or written consent and it is documented in the medical record.
- The medical record documentation substantiates the services delivered via telehealth meet the procedural definition and components of the CPT-4 or HCPCS code(s) associated with the covered service
- The services provided via telehealth meet all laws regarding confidentiality of health care information and a patient’s right to the patient’s own medical information.
- The patient is not precluded from receiving in-person health care services after agreeing to receive telehealth services.
CCHP providers must use the appropriate modifiers and CPT-4 or HCPCS codes when billing for services delivered via telehealth and document the Place of Service code “02” on the claim.
More information about Telehealth services is available on our website at cchealth.org/healthplan/providers or at the Department of Health Care Services website. In addition, the latest COVID-19 information is available at the county website at cchealth.org/coronavirus. If you have any questions, please contact CCHP by e-mail at Providerrelations@cchealth.org or by phone 925-313-9500.
- DHCS Telehealth FAQs
- CCHP letter - 3/18/2020
- DHCS Medi-Cal Payment for Telehealth letter – 3/18/2020
- CCHP letter - 3/16/2020
- Medi-Cal Telehealth E&M billing codes
- Medi-Cal Payment for Telehealth and Virtual/Telephonic Communications Related to the 2019-Novel Coronavirus (COVID-19)