Falling Colors has been directed to
allow codes for Behavioral Health Telephonic Visits through the duration of the public health emergency to assure the continuation of essential services to clients receiving behavioral health services.
Falling Colors will allow behavioral health providers to bill for telephonic visits using the same codes and rates that are currently established for such services.
These services will be paid as if the client received services onsite and in person.
This will remain an option for providers through the termination of the emergency declaration and applies to both initiation of care as well as treatment of established patients. Initiation of care can be for any reason, including client self-referral.
Providers are directed to bill for BH Telephonic Visits using the
modifier on claims files to indicate telephonic services. All other normal modifiers should be included on the claim if otherwise required. The originating site HCPCS code Q3014 is not billable for these services since the normal office visit payment is to be made instead.
These visits will be considered as equivalent to in-person visits through the termination of the emergency declaration. In accordance with existing policy, providers are expected to maintain all appropriate medical records. Any medical records requiring in person presence (e.g., height, weight, etc.) are to be noted in the record as “Excused per state declaration re: COVID-19”.
Telephonic BH visits must be synchronous; that is, consisting of live voice conversation with the patient. Asynchronous or “store and forward” visits are not payable under this provision.
Telephonic BH visits must take place during the provider’s normal business hours as if provider’s office were open and the member were able to attend the visit in person. Services must be provided by a practitioner within the practitioner’s normally allowed scope of practice.
Rules for determining the Fund Source should remain as they currently exist.
Providers who submit Workbooks are required to indicate what services were provided via telephonic means within their spreadsheet.
For Encounters services, Falling Colors will add a checkbox to indicate the service was provided via telephonic means. This feature is schedule to be released next week March 30-April 3.