Telehealth Delivery of Substance Use Disorder Services
Overview
Telehealth is the delivery of health care services or consultations through the use of real time, two-way interactive audio and visual communications. Telehealth provides or supports health care delivery and facilitates the assessment, diagnosis, consultation, treatment education and care management of a patient’s health care while the patient is at originating site and the licensed health care provider is at a distant site
MHCP allows payment for telehealth services in substance use disorder treatment for services that are otherwise covered as direct face-to-face services. Payment is allowed for interactive audio and video telecommunications which permit real-time communication between the distant site provider’s counselor or practitioner and the member. The services must be of sufficient audio and visual fidelity and clarity as to be functionally equivalent to a face-to-face encounter. The information provided in this manual section explains the specific requirements related to SUD. Review the Telehealth Services section of the MHCP Provider Manual for an overview and requirements that apply to all telehealth services.
Eligible Providers
Providers currently authorized to provide services may conduct the same services via telehealth. Providers must self-attest that they meet all of the conditions of the MHCP telehealth policy by completing and submitting the Telehealth Provider Assurance Statement (DHS-6806) (PDF) to be eligible to provide and be reimbursed for services via telehealth.
Eligible Members
Telehealth coverage applies to all MHCP members.
Covered Services
The following medically necessary substance use disorder (SUD) services provided by eligible SUD providers via telehealth are covered:
Noncovered Services
See the Telehealth Services section of the MHCP Provider Manual for noncovered telehealth services.
Billing
Providers who have an approved Telehealth Provider Assurance Statement (DHS-6806) (PDF) on file with MHCP who submit professional claims for services via telehealth should use claim format 837P (professional).
Use the appropriate place of services that identifies the location of the recipient when the service is provided.
Place of service 02 (newly defined): Telehealth provided other than the patient’s home. The location where health services and health-related services are provided or received through telecommunication technology. The patient is not located in their home when receiving health services or health-related services through telecommunication technology.
Place of service 10 (new place of service): Telehealth provided in patient’s home. The location where health services and health-related services are provided or received through telecommunication technology. The patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health-related services through telecommunication technology.
Modifier 93, Audio only: Synchronous telehealth service rendered via telephone or other real-time interactive audio-only telecommunications system. MHCP requires modifier 93 when audio-only telehealth is used.
Individual and group treatment services (H2035 and H2035 HQ) are billable on the 837I with type of bill 89X and modifier GT.
Legal References
Minnesota Rules 2960.0430-0490
Minnesota Rules, parts 9530.6405 to 9530.6505 (Rule 31)Minnesota Rules, parts 9530.6510 to 9530.6590 (Rule 32)
Minnesota Statutes 245F
Minnesota Statutes 245G
Minnesota Statutes 256B.0625, subdivision 3b(b)
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