Rule 23-225-1.3 - Covered ServicesA. The Division of Medicaid covers medically necessary telehealth services as a substitution for an in-person visit for consultations, office visits, and/or outpatient visits when all the required medically appropriate criteria is met which aligns with the description of the Current Procedural Terminology (CPT) evaluation and management (E&M) and Healthcare Common Procedure Coding System (HCPCS) guidelines.B. The Division of Medicaid covers telehealth services at the following locations: 1. At the following originating sites: a) Office of a physician or practitioner,b) Outpatient Hospital (including a Critical Access Hospital (CAH)),c) Rural Health Clinic (RHC),d) Federally Qualified Health Center (FQHC),e) Community Mental Health/Private Mental Health Centers,f) Therapeutic Group Homes,g) Indian Health Service Clinic,i) School which employs a school nurse, j) Inpatient hospital setting, or2. At the distant site the following provider types are allowed to render telehealth services: e) Licensed Clinical Social Workers (LCSWs),f) Licensed Professional Counselors (LPCs),g) Licensed Marriage and Family Therapists (LMFTs),h) Board Certified Behavior Analysts (BCBAs) or Board Certified Behavior Analyst-Doctorals (BCBA-Ds),i) Community Mental Health Centers (CMHCs),j) Private Mental Health Centers,k) Federally Qualified Health Centers (FQHCs),l) Rural Health Centers (RHCs),m) Physical, occupational or speech therapy, orn) Mississippi State Department of Health (MSDH) clinics.C. The Division of Medicaid requires a telepresenter who meets the requirements of Miss. Admin Code Part 225, Rule 1.1.D. at the originating site unless the originating site is the beneficiary's home or as determined by the Division.23 Miss. Code. R. 225-1.3
42 C.F.R. § 410.78; Miss. Code Ann. §§ 43-13-117, 43-13-121; SPA 15-003.New to correspond with SPA 15-003 (eff. 01/01/2015); Adopted 7/1/2015