Progress on Implementing Telehealth for California’s LEA Billing Option Program

In a webinar held on September 26, 2013, the Department of Health Care Services (DHCS) reported on the steps being taken to implement Telehealth billing policy and guidance for the LEA Billing Option program. In a brief portion of the presentation devoted entirely to the LEA Billing Option program (see pg. 14-15 of the presentation PowerPoint), the Department discussed:

  • plans to add a Telehalth billing section to the LEA Medi-Cal Provider Manual which will list reimbursable Telemedicine services and Telehealth billing guidelines for Local Educational Agencies (LEAs) based on those already established in the updated Medi-Cal Provider Manual section, ‘Medicine: Telehealth’,
  • their ongoing work to assess LEA services and determine access to care issues and availability of services related to Telehealth,
  • the general policy that Telehealth-delivered services will be subject to same Medi-Cal requirements as traditionally delivered services, including: provider qualifications, service requirements, confidentiality of information, and documentation of services.

California regulatory code defines Telehealth as, “the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care while the patient is at the originating site and the health care provider is at a distant site.”

While Medi-Cal recognizes and reimburses for certain health services furnished via Telehealth, the LEA Medi-Cal Provider Manual must first be updated with Telehealth billing policy and guidance before California school districts and claiming units can begin billing for these services under the LEA Billing Option program. Over the past year, the Safety Net Financing Division (SNFD) of DHCS has worked closely with members of the LEA Ad-Hoc Workgroup to gather necessary information to shape the Department’s Telehealth billing policy for LEAs.


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View the DHCS Medi-Cal Telehealth Billing Webinar PowerPoint presentation…

Visit the DHCS Telehealth web page…

Visit the DHCS Telehealth Resources web page…