Consent Requirements

A parent or legal guardian must provide written or verbal consent to the distant site provider to allow any other individual, other than the health professional as required by Texas Government Code §531.0217(c-4)(4) for school-based telemedicine, to be physically present in the distant or patient site environment during a telehealth or telemedicine service with a child.

An adult client must also provide written or verbal consent to the distant site provider to allow any other individual to be physically present in the distant or patient site environment during a telehealth or telemedicine service.

Documentation of the written or verbal consent must be maintained in the client’s medical record. (In CSHCN Manual only).

SOURCE:  TX Medicaid Telecommunication Services Handbook, p. 4-5 (Apr. 2025) & SOURCE: TX Medicaid CSHCN Telecommunication Services Handbook, p. 4 (Mar. 2025) [language varies].  (Accessed Apr. 2025).

Provider must obtain informed consent from the client, client’s parent, or the client’s legally authorized representative prior to rendering a behavioral health service through a synchronous audio-only technology platform; except when doing so is not feasible or could result in death or injury to the client. Verbal consent is permissible and must be documented in the client’s medical record.

The distant site provider must obtain informed consent to treatment from the patient, patient’s parent, or the patient’s guardian prior to rendering a telemedicine medical service.

The distant site provider must obtain informed consent to treatment from the patient, patient’s parent or the patient’s legal guardian prior to rendering a telehealth service.

If a patient has a primary care provider who is not the distant site provider and the patient or their parent or legal guardian provides consent to a release of information, a distant site provider must provide the patient’s primary care provider with the following information:

• A medical record or report with an explanation of the treatment provided by the distant site provider
• The distant site provider’s evaluation, analysis, or diagnosis of the patient

SOURCE: TX Medicaid Telecommunication Services Handbook, p. 6, 8, 11 & 12 (Apr. 2025). (Accessed Apr. 2025).

School-Based Setting

The parent or legal guardian of the client provides consent before the service is provided.

SOURCE: TX Medicaid Telecommunication Services Handbook, p. 10 (Apr. 2025). (Accessed Apr. 2025).

Conditions for telemedicine medical services provided in a primary or secondary school-based setting.

For a child receiving telemedicine medical services in a primary or secondary school-based setting, advance parent or legal guardian consent for a telemedicine medical service must be obtained.

The patient’s primary care physician or provider must be notified of a telemedicine medical service, unless the patient does not have a primary care physician or provider.

• The patient receiving the telemedicine medical service, or the patient’s parent or legal guardian, must consent to the notification.
• For a telemedicine medical service provided to a child in a primary or secondary school-based setting, the notification must include a summary of the service, including:
  • exam findings;
  • prescribed or administered medications; and
  • patient instructions.

If a child receiving a telemedicine medical service in a primary or secondary school-based setting does not have a primary care physician or provider, the child’s parent or legal guardian must be offered:

• the information in subparagraph (B)(ii) of this paragraph; and
• a list of primary care physicians or providers from which to select the child’s primary care physician or provider.

Telemedicine medical services provided in a school-based setting by a physician, even if the physician is not the patient’s primary care physician or provider, are reimbursed if:

• the physician is enrolled as a Medicaid provider;
• the patient is a child who receives the service in a primary or secondary school-based setting; and
• the parent or legal guardian of the patient provides consent before the service is provided.

SOURCE: TX Admin Code Title 1, Sec. 354.1432, (Accessed Apr. 2025).

Physical Therapy, Occupational Therapy, and Speech Therapy

The provider should obtain informed consent for treatment from the patient, patient’s parent, or the patient’s legal guardian prior to rendering a telehealth service. Verbal consent is permissible and should be documented in the client’s medical record.

SOURCE: TX Medicaid Physical Therapy, Occupational Therapy, and Speech Therapy Services Handbook pg. 9 (Apr. 2025). (Accessed Apr. 2025).

Managed Care (also applies to START Kids and STAR Health)

When an MCO conducts a change in condition assessment using audio-visual communication, verbal consent must be obtained and documented, and a HIPAA-compliant audio-visual communication product must be used.

If verbal consent for audio-visual communication is not received, the MCO must use in-person communication.

The MCO must inform members who utilize audio-visual communication for change in condition assessments that the member’s services will be subject to the following:

• The MCO must monitor services for fraud, waste, and abuse.
• The MCO must determine whether additional social services or supports are needed.
• The MCO must ensure that verbal consent to use telecommunications is documented in writing.

See rules Sec. 1604-1506 for additional requirements for each program.

SOURCE: TX Admin Code, Title 1, Part 15, Sec. 353.1503, (Accessed Apr. 2025).

Teledentistry

The client or parent/guardian must agree to receiving the teledentistry service.