COVID-19 Information and Checklist for Expanded Access
to Medical and Behavioral Health Services Using Telehealth

The Ohio Department of Medicaid (ODM) and the Ohio Department of Mental Health and Addiction Services (OhioMHAS), in partnership with the Governor’s Office, have relaxed regulations to allow Ohioans on Medicaid to access medical and behavioral healthcare providers from their homes.

This will largely be done through telehealth, which refers to healthcare services delivered through smartphones, tablets, computers, or other devices.

The changes:

• Can be accessed by both new and existing patients. This will allow patents to receive telehealth services regardless of previous face-to-face visits with their healthcare provider or their status as a new or existing patient.
• Authorize Medicaid billing regardless of patients and practitioners’ locations.
• Expand the practitioners and provider organizations that can provide telehealth.
• Allow for expanded types of interactions, including two-way, real-time audio and/or visual communication as well as one-way, delayed-response communications, including telephone calls, voice mail messaging, faxes and emails.
• Allows additional behavioral health services to be delivered via interactive videoconferencing, including peer recovery, substance use disorder (SUD) case management, crisis intervention, assertive community treatment (ACT), and intensive home-based treatment (IHBT).
• ODM and OhioMHAS are aligning with privacy flexibilities currently implemented at the federal level, and within the confines of state law. Both agencies rely on the judgment of health care professionals to determine the communications mechanism best suited to ensure patient privacy without compromising patient access or care.

Providers are encouraged to:

1. Speak with the Medicaid member prior to a service describing potential limitations or risks associated with telehealth care.
    
2. Inform Medicaid members of the clinical aspects of telehealth treatment, security considerations, and confidentiality for individual and group counseling.with the Medicaid member prior to a service describing potential limitations or risks associated with telehealth care.
3. Convey the contingency plan for providing telehealth services when technical issues arise.

Practitioners permitted to deliver services via telehealth:

• Physicians.
• Podiatrists.
• Psychologists.
• Physician assistants.
• Clinical Nurse Specialists (CNS), Certified Nurse-Midwives (CNW), and Certified Nurse Practitioners (CNP).
• Dietitians.
• Independently licensed behavioral health practitioners and supervised behavioral health practitioners and trainees as defined in Ohio Administrative Code (OAC) Chapter 5160-8-05.
• Audiologists, audiologist assistants, and audiology aides.
• Occupational therapists and occupational therapist assistants.
• Physical therapists and physical therapist assistants.
• Speech-language pathologists, speech language pathology aides, and individuals holding a conditional license as defined in section 4753.071 of the Ohio Revised Code (ORC).
• Medicaid School Program (MSP) practitioners, as defined in OAC Chapter 5160-35.
• Practitioners affiliated with community behavioral health centers.

Medicaid providers authorized to bill for telehealth services include:

• Independently practicing clinicians identified above.
• Professional medical groups.

• Federally qualified health centers (FQHCs) and rural health clinics (RHCs).
• Ambulatory health care clinics (AHCCS), as defined in OAC Chapter 5160-13, which include end-stage renal disease (ESRD) dialysis clinics, family planning clinics, outpatient rehabilitation clinics, primary care clinics, public health department clinics, and speech-language-audiology clinics.
• Outpatient hospitals.
• Hospitals delivering outpatient hospital behavioral health (OPHBH) services, including psychiatric hospitals.
• Medicaid School Program (MSP) providers.
• Community behavioral health centers that are certified by OhioMHAS.
• Providers of applied behavioral analysis (ABA) billing through the MCPs.

Services provided through telehealth, if conditions do not exceed moderate complexity, can include:

• Evaluation and management of new and existing patients.
• Inpatient or office consultations for new or established patients.
• Mental health and substance use disorder evaluations and psychotherapy.
• Remote evaluation of recorded video or images.
• Virtual check-ins by a physician or other qualified healthcare professional.
• Online digital evaluation and management services.
• Remote patient monitoring of physiologic parameters.
• Occupational therapy, physical therapy, speech language pathology, and audiology services.
• Medical nutrition services.
• Lactation counseling provided by dietitians.
• Psychological and neuropsychological testing.
• Smoking and tobacco use cessation counseling.
• Developmental test administration.
• Follow-up consultation with a patient.
• Services under the specialized recovery services (SRS) program.
   

Medicaid School Programs can bill telehealth services to Medicaid, the MCPs, and the MCOPs as can nearly all behavioral health services delivered by OhioMHAS-certified providers, as outlined at www.bh.medicaid.ohio.gov.

OhioMHAS certified entities can bill Medicaid for the following services via telehealth:

• Evaluation and management of new and existing patients.
• Psychiatric diagnostic evaluation.
• Psychotherapy (individual, group, and family).
• Psychological testing.
• Smoking cessation.
• Community psychiatric supportive treatment (CPST).
• Therapeutic Behavioral Services (TBS) and psychosocial rehabilitation (PSR). NOTE: TBS group service (hourly and per diem as defined in OAC 5160-27-06) is not included in billable Medicaid services when delivered via telehealth.
• Registered Nurse (RN) and Licensed Practical Nurse (LPN) services.
• Substance Use Disorder (SUD) assessment, counseling (individual, group, intensive outpatient group, and partial hospitalization group), and case management.
• Assertive community treatment (ACT).
• Intensive home-based therapy (IHBT).
• Peer recovery support.
• Behavioral health crisis intervention.
• SBIRT (screening, brief intervention, and referral to treatment).
• Practitioner services rendered to individuals in SUD residential treatment.
• Specialized Recovery Services (SRS).
  • Outpatient hospital behavioral health (OPHBH) services will be allowed to the same extent they are allowed for OhioMHAS-certified providers.

Reources for Parents and Families: https://coronavirus.ohio.gov/wps/portal/gov/covid-19/home/family-activities/resources-for-parents-and-families

For answers to your COVID-19 questions, call 1-833-4-ASK-ODH (1-833-427-5634).

If you or a loved one are experiencing anxiety related to the coronavirus pandemic, help is available. Call the Disaster Distress Helpline at 1-800-985-5990 (1-800-846-8517 TTY); connect with a trained counselor through the Ohio Crisis Text Line by texting the keyword “4HOPE” to 741 741; or call the Ohio Department of Mental Health and Addiction Services help line at 1-877-275-6364 to find resources in your community. 

Protect yourself and others from COVID-19 by taking these precautions.

• Stay home 
• Practice Social Distancing
• Get adequate sleep and eat well-balanced meals
• Wash hands often with water and soap (20 seconds or longer)
• Dry hands with a clean towel or air dry your hands
• Cover your mouth with a tissue or sleeve when coughing or sneezing
• Avoid touching your eyes, nose, mouth with unwashed hands or after touching surfaces
• Clean and disinfect "High-Touch" surfaces often
• Call before visiting your doctor
• Practice good hygiene habits 

If you have questions regarding Coronavirus/COVID-19 please call 1-833-4-ASK-ODH (1-833-427-5634)

CLEAN ALL "HIGH-TOUCH" SURFACES EVERY DAY

High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Also, clean any surfaces that may have blood, stool, or body fluids on them. Use a household cleaning spray or wipe according to the label instructions. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product.

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