State behavioral health guidelines and updates due to COVID-19

State-specific guidelines

Effective 3/26/2020

MO HealthNet Division allows any licensed health care provider, enrolled as a MO HealthNet provider, to provide telehealth services if the services are within the scope of practice for which the health care provider is licensed. The services must be provided with the same standard of care as services provided in person. They will also be waiving some requirements such as telehealth co-payments, physicians and patient relationship prior to telehealth services and will be waiving the requirement that, in order to treat patients in the state with telemedicine or telehealth, health care providers shall be fully licensed to practice in MO state. MHD will allow providers to bill for telehealth services as long as they are licensed in the state in which they practice. However, providers must still be enrolled as MHD providers through Missouri Medicaid Audit and Compliance (MMAC). They will be allowing the use of telephone for telehealth services as well as quarantined providers and/or providers working from alternate sites or facilities to provide and bill for telehealth services.

Understanding new Commercial Payer guidelines

Many commercial payers have also issued important updates explaining their expansion of telehealth services. While expanded coverage includes more services, looser restrictions put the responsibility on the provider to determine appropriate services. This shift can significantly increase the risk of payer denials later on. An informed interpretation of these new guidelines is essential to avoid issues with your revenue cycle in the coming weeks. We are available to further discuss our findings and analysis with you. To learn more about recent updates regarding commercial payer guidelines, please contact us directly.