Telehealth and Medicaid ABA Information

by | Apr 24, 2023 | Medicaid

Due to COVID-19, a Public Health Emergency (PHE) was declared and several flexibilities were initiated.  Click here for specifics.  The PHE will end on May 11, 2023.

You can find the Medicaid Telehealth Supplement in the Mental Health Services Manual (which you can get to by clicking here and going through some links).

A training was provided on April 24, 2023 and can be found here (when posted).

Here are some key points:

  • Important to note a key difference between telehealth and telemedicine is that telemedicine does not include audio only (telephone).
  • Face-to-face is included in telemedicine (audio and video) but some services have an in-person component.
  • When the PHE expires on 5/11, two ABA provisions will expire: 97156 can no longer be audio only; 97151 must have an in-person assessment component
  • Providers must maintain a practice in VA or be able to refer to someone local; all providers must be licensed in VA; there must be informed telehealth patient consent (see manual)
  • Remember the place of service is where the member would have been if the services were provided in person.  Do not use “02” telehealth, but rather use the GT modifier
  • As always, telemedicine should be used if it’s the right solution for the client and not just as a convenience for the provider
  • There are limited CPT codes available for telemedicine, so make sure to be familiar with the manual
  • None of the ABA codes for Medicaid services will be allowed by Audio Only telehealth.  However, there are some provisions for audio only with respect to Therapeutic Consultation.

Any questions? Email or (and please copy