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News & Press: Updates for Members

Telephone Codes Allowed for Medicaid

Thursday, April 23, 2020   (0 Comments)
Posted by: Kay Castillo
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Effective April 20, 2020, NC Medicaid in partnership with the Department of Health and Human Services Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSAS), is temporarily modifying its Behavioral Health and Intellectual and Developmental Disability Clinical Coverage Policy 8C: Outpatient Behavioral Health Services Provided by Direct-Enrolled Providers to better enable the delivery of care to NC Medicaid, NC Health Choice and State-funded individuals in response to the COVID-19 Pandemic.


In addition to previous flexibilities published in COVID-19 Special Medicaid Bulletins #9, #19, and #46, the Department is issuing guidance on allowing telephonic outpatient psychotherapy, in addition to the telehealth flexibilities previously added. As clinically appropriate, services may still be offered via HIPAA-compliant, real-time, two-way interactive audio and video telehealth appointment to proceed with the behavioral health intervention(s). (Note: please see OCR guidance relaxing technology requirements). If that option is not available, services may be offered via non-HIPAA compliant audio and video telehealth appointment with documented beneficiary or legal guardian consent. If two-way audio-visual options are not accessible to the beneficiary, the following services may be offered via telephonic modality.


These temporary changes are retroactive to March 10, 2020, and will end the earlier of the cancellation of the North Carolina state of emergency declaration or when the policy modification is rescinded. When the temporary modifications end, all prior service requirements will resume.


For more information, please see SPECIAL BULLETIN COVID-19 #59: Telehealth Clinical Policy Modifications - Outpatient Behavioral Health Services.

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