Commercial Insurance
On March 18th, the Department of Managed Health Care issued an All Plan Letter requiring HMOs to immediately begin reimbursing for telehealth services, including telephonic visits, at the same rate as those provided in-person. While the Department of Insurance has not yet required the same of PPO commercial insurance, Blue Shield and United Health PPOs have updated their policies to allow for a variety of services to be conducted via telehealth. For more information about reimbursement for telehealth services in Medi-Cal and Medicare, please see CMS’ FAQ.
Family PACT
Family PACT providers may may utilize telehealth in delivering Family PACT covered services when medically appropriate, as a means to limit patients’ exposure to others who may be infected with COVID-19, and to increase provider capacity. Please refer to DHCS’ telehealth policies, which are outlined in the Medi-Cal Provider Manual: section. “Medicine: Telehealth.” The telehealth document is posted to DHCS’ website under Frequently Asked Questions.
Family PACT providers may also enroll and recertify clients through telehealth or other virtual/telephonic communication modalities. Family PACT providers may also complete the Client Eligibility Certification (CEC) form (DHCS 4461) and Retroactive Eligibility Certification (REC) form, if applicable, on behalf of the applicant/client. Client Eligibility forms may be accessed on the Family PACT website.
