Update on Occupational Therapy Telehealth Flexibilities
On April 29, 2022, the South Carolina Department of Health and Human Services (SCDHHS) announced future updates to the telehealth flexibilities that were created during the federal coronavirus disease 2019 (COVID-19) public health emergency (PHE) through Medicaid bulletin 22-005. While an end date for the federal PHE remains unknown, the agency is updating its guidance on occupational therapy to extend the flexibility for one year after the expiration of the current federal PHE for further evaluation.
The policy change announced in this bulletin applies to occupational therapy for all Healthy Connections Medicaid members and serves as an update to the occupational therapy changes outlined in Medicaid bulletin 22-005. This change means that occupational therapy services described in Medicaid bulletins 20-008 and 20-016 will continue to be eligible for reimbursement when delivered via telehealth that includes both audio and visual components for one year beyond the end date of the current federal PHE. Initial evaluations still must be performed in a face-to-face encounter to be eligible for reimbursement. Occupational therapy provided as audio-only telephone services will no longer be reimbursable upon expiration of the current federal PHE.
Medicaid bulletin 22-005 will also be updated with a disclaimer to reflect these changes. The updates to the table included in that bulletin are also included below.
|Code||Description||Billable for New Patient?|
*Eligible for reimbursement when performed via telehealth for new patients once an initial evaluation has been performed. Initial evaluations must be performed in a face-to-face encounter to be eligible for reimbursement.
View a comprehensive list of the COVID-19-specific policy guidance SCDHHS issued during the PHE. Providers with questions about the policy changes announced in this bulletin should submit their questions to COVID@scdhhs.gov.
Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.