December 11, 2019
Area(s) of Interest: Advocacy Licensing & Regulatory Issues
In August 2019, the Department of Health Care Services (DHCS) issued its final telehealth policy, which allows for broad reimbursement of telehealth services in Medi-Cal, as long as the treating physician at the distant site believes that the benefits or services being provided are clinically appropriate to be delivered via telehealth based upon evidence-based medicine and/or best practices.
All Medi-Cal covered services or benefits may be provided via telehealth subject to existing Medi-Cal coverage and reimbursement policies, including any preauthorization requirements. According to DHCS’s Telehealth FAQ, Medi-Cal pays the same rate for professional medical services provided by telehealth as it pays for in-person services.
The new policy allows physicians flexibility to determine if a particular service or benefit is clinically appropriate for telehealth and places no limitations on originating or distant sites. There is also no requirement for a health care provider to be present at the originating site.
Full details regarding the updated telehealth guidelines, including the specific requirements have been published in the Medi-Cal provider manuals.