Kansas

Last updated 11/27/2024

Consent Requirements

Telemedicine services (including telephonic contact) can be made when there is verbal consent received from the patient (to be followed up by written approval) in the medical record. Tele-video communication can only be utilized if that contact is HIPAA compliant.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, (Nov 2024), pg. 2-28 (Accessed Nov. 2024).

Signed member consent for telehealth home services is required.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Home Health Agency, p. AIII-19 (Oct 2024). (Accessed Nov. 2024).

Last updated 11/27/2024

Definitions

Telemedicine is the use of communication equipment to link health care practitioners and patients in different locations. Healthcare services are thus provided while the patient is at an originating site and the healthcare provider is at a distant site. This technology is used by health care providers for many reasons, including increased cost efficiency, reduced transportation expenses, improved patient access to specialists and mental health providers, improved quality of care, and better communication among providers. Kansas Medicaid guidelines with be in accordance with the Kansas Telemedicine Act (Senate Substitute for House Bill No. 2028).

Telemedicine does not include communication between:

• A healthcare provider to another healthcare provider that consists solely of a telephone voice-only conversation, email, or facsimile transmission.
• A physician and a patient that consists solely of an email or facsimile transmission.

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, (Nov 2024), p. 2-28 & 2-29, (Accessed Nov. 2024).

“Telemedicine,” including “telehealth,” means the delivery of healthcare services or consultations while the patient is at an originating site and the healthcare provider is at a distant site. Telemedicine shall be provided by means of real-time two-way interactive audio, visual, or audio-visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support healthcare delivery, that facilitate the assessment, diagnosis, consultation, treatment, education and care management of a patient’s healthcare. “Telemedicine” does not include communication between:

‘‘Telemedicine’’ does not include communication between:

1. 1. Healthcare providers that consist solely of a telephone voice-only conversation, email or facsimile transmission; or
   2. a physician and a patient that consists solely of an email or facsimile transmission.

SOURCE:  KS Statute Ann. § 40-2,211(5), (Accessed Nov. 2024).

Telemedicine is the use of communication equipment to link health care practitioners and individuals in different locations.

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Certified Community Behavioral Health Clinic (CCBHC), p. 8-5 (May 2024). (Accessed Nov. 2024).

Home Health Agency Licensure

“Telehealth” means the use of information and communication technology while a patient is at one site and a qualified health professional is at another site so that clinical parameters and other clinical data can be sent to qualified health professionals overseeing the health care provided to the patient. This term is also known as “telemedicine,” “telemonitoring,” or “remote monitoring.”

SOURCE:  KS Administrative Regulation, Sec. 28-51-100, (Accessed Nov. 2024).

Last updated 07/03/2024

Email, Phone & Fax

Telemedicine services (including telephonic contact) can be made when there is verbal consent received from the patient (to be followed up by written approval) in the medical record. Tele-video communication can only be utilized if that contact is HIPAA compliant.

See manual for eligible codes.

Telemedicine does not include communication between:

• A healthcare provider to another healthcare provider that consists solely of a telephone voice-only conversation, email, or facsimile transmission.
• A physician and a patient that consists solely of an email or facsimile transmission.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, (Nov 2024), pg. 2-28 to 29 (Accessed Nov. 2024).

COVID allowance for telephonic coverage for Consultative Clinical and Therapeutic Services (CCTS) and Intensive Individual Support (IIS), and Select Speech Therapy codes was discontinued effective May 11, 2023.

SOURCE:  KMAP General Bulletin 23118 (May 2023), & KMAP General Bulletin 23115 (May 2023), (Accessed Nov. 2024).

Effective on and retroactive to May 1, 2022, the Telephone Evaluation and Management codes listed below must be billed with Place of Service (POS) code 02 (Telehealth Provided Other than in Patient’s Home) or 10 (Telehealth Provided in Patient’s Home) when services are provided within a Certified Community Behavioral Health Clinic (CCBHC):

• 99441
• 99442
• 99443

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, Bulletin 24170, CCBHC PPS Code Clarification for E&M Services, (Aug. 2024), (Accessed Nov. 2024).

Hospital E&M

A “comprehensive exam” is considered a “hands on” specialist examination. Telephone consultation with a specialist is not the equivalent of comprehensive exam.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, FFS Provider Manual, Hospital, p. 8-4 (Sept. 2024). (Accessed Nov. 2024).

Hospice

Providers can submit claims for SIA end of life care if the following criteria are met: … The service is not covered if provided by a social worker via telephone.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, FFS Provider Manual, Hospice, (Jun. 2024), pg. 8-11. (Accessed Nov. 2024).

Certified Community Behavioral Health Clinic (CCBHC) Services

Telephone evaluation and management service provided by a qualified healthcare professional to an established patient, parent, or guardian. National coding guidelines specify the criteria for appropriately billing these three codes.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, FFS Provider Manual, Certified Community Behavioral Health Clinic (CCBHC) Services, May 2024, pg. 8-6. (Accessed Nov. 2024).

Local Education Agencies

Not all services provided by LEAs are billable. Examples include but are not limited to: …

• Telephone calls/conferences/contacts

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, FFS Provider Manual, Learning Education Agencies, (Oct. 2024), pg. 8-7. (Accessed Nov. 2024).

CBST, Mental Health Assessment, and Psychiatric Diagnostic Evaluation

Note: Codes 90791 and 90792 can only be billed once per day, and both codes cannot be billed on the same day. Services listed shall be provided face-to-face as defined in the KMAP General Benefits Fee-for-Service Provider Manual for telemedicine. These services are excluded from Telephonic provision. Visual observation of the child, and (as appropriate) the child actively participating in the meeting is required.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, Bulletin 24163, Mental Health Assessment, and Psychiatric Diagnostic Evaluation, (Aug. 2024), (Accessed Nov. 2024).

Last updated 07/03/2024

Live Video

POLICY

No individual or group health insurance policy, medical service plan, contract, hospital service corporation contract, hospital and medical service corporation contract, fraternal benefit society, health maintenance organization or the Kansas medical assistance program shall exclude an otherwise covered healthcare service from coverage solely because such service is provided through telemedicine, rather than in-person contact, or based upon the lack of a commercial office for the practice of medicine, when such service is delivered by a healthcare provider.

SOURCE: KS Statute Ann. § 40-2,213(b).  (Accessed Nov. 2024).

ELIGIBLE SERVICES/SPECIALTIES

Office visits, individual psychotherapy, and pharmacological management services are examples of services which may be reimbursed when provided via telecommunication technology. The provider at the distant side must bill an appropriate code from the lists below with place of service (02) designating a telemedicine service provided other than in the patient’s home OR place of service (10) designating a telemedicine service provided in the patient’s home. (Please note: the GT modifier is no longer used to designate a telemedicine service.) Services delivered via telemedicine will be reimbursed at the same rate as a face-to-face (in the same physical location) service. Documentation requirements are the same as an in-person service.

See manual for eligible codes.

QMB only codes are not noted in these tables. Additionally, telemedicine rules governing HCBS waiver codes may change depending on waiver submissions; therefore, the specific HCBS waiver manual needs to be consulted for current code status allowances.

KMAP does not recognize AMA CPT consultation codes 99242, 99243, 99244, 99245, 99252, 99253, 99254, and 99255 for payment.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, (Nov. 2024), pg. 2-28 to 29, (Accessed Nov. 2024).

Note: Refer to Section 2720 of the General Benefits Fee-for-Service Provider Manual for complete details regarding Telemedicine.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, p. 8-14 (May 2024); Provider Manual, Substance Use Disorder, p. A-2, (May. 2024); Local Education Agency (Oct. 2024), pg. 8-7; Provider Manual, Certified Community Behavioral Health Clinic (CCBHC), p. 8-5 (May 2024); Home Health Agency, p. 8-29 (Oct 2024), Mental Health, p. 8-3, 8-21, A-I, (Oct. 2024), Rehabilitative Therapy Services, (May 2024), pg. 8-5, (Accessed Nov. 2024).

Mobile Response Stabilization Services/Mobile Crisis Response (MRSS/MCR) H2011 U1

MRSS/MCR services are to be provided in person by teams of at least two individuals, at the preferred location of the individual or family (home, school, or other community-based setting). In circumstances where face to face service by a LMHP is not viable, the medical record should reflect the reason that a LMHP was unable to respond in person to the crisis. In those cases, utilization of telemedicine delivery by the LMHP is allowed, however, an in-person response should be made that would provide the telemedicine access to a LMHP.

SOURCE: KS Dept of Health and Environment, KS Medical Assistance Program, Provider Manual, Mental Health, p. 8-3, 8-21, A-I, (Oct. 2024), (Accessed Nov. 2024). 

Stand-alone vaccine counseling may also be covered when provided via telehealth.

The face-to-face encounter [for home health] may occur through telehealth, as implemented by the State.

Telehealth and transportation codes are covered codes for OTP services. Please refer to the Kansas Medicaid Telehealth and Non-Emergency Medical Transportation (NEMT) policies

SOURCE: KS Dept. of Health and Environment, Provider Manual, Professional, (Sept. 2024). (Accessed Jul. 2024).

Stand-alone vaccine counseling will be covered only when the vaccine counseling and the administration of the vaccine occurs on two separate visits. Vaccine counseling is content of service when the vaccine counseling and administration of the vaccine occur at the same visit. Stand-alone vaccine counseling may also be covered when provided via telehealth.

SOURCE: KS Dept. of Health and Environment, Provider Manual, KAN Be Health EPSDT, (9/24), (Accessed Nov. 2024).

Autism Services

Family Adjustment Counseling Limitations – Delivery of this service may occur via telemedicine, telehealth, or other modes of video distance monitoring methods that adhere to all required HIPAA guidelines and meet the state standards for telemedicine delivery methods. This service delivery model is subject to state program manager approval. A request submitted for this exception must include, at a minimum, three written statements from service providers in at least a 50-mile radius declining to provide services because the participant resides in a location that is so remote or far away that the provider does not have the staff to meet with the child on a continual and/or intermittent basis as needed.

Parents Support and Training – Delivery of this service may occur via telemedicine, telehealth, or other modes of video distance monitoring methods that adhere to all required HIPAA guidelines and meet the state standards for telemedicine delivery methods. This service delivery model is subject to state program manager approval. A request submitted for this exception must include, at a minimum, three written statements from service providers in at least a 50-mile radius declining to provide services because the participant resides in a location that is so remote or far away that the provider does not have the staff to meet with the child on a continual and/or intermittent basis as needed.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, HCBS Autism Services, p. 8-5 & 8-8 (Sept. 2024). (Accessed Nov. 2024).

Intellectual/Developmentally Disabled Services

All functional assessments must be conducted in-person at a location of the individual’s choosing, or, if available, through the use of real-time interactive telecommunications equipment that includes, at a minimum, audio and video equipment. Those responsible for conducting the assessment will be flexible in accommodating the individual’s preference for the meeting location and time of assessment.

SOURCE: KS Dept. of Health and Environment, Provider Manual, HCBS Intellectual/Developmentally Disabled, p. I-1 (Oct. 2024). (Accessed Nov. 2024).

Prenatal Care At Risk Enhanced Care Coordination

Effective with dates of service on and after May 1, 2023, procedure code H1002 will be covered for telemedicine for video and audio transmissions. Existing provisions for the delivery of this service will remain in effect. Place of service (POS) code 10 (telehealth services provided in patient’s home) will be covered for code H1002.

SOURCE: KS Department of Health and Environment, KMAP Bulletin 23051, Prenatal Care At Risk Enhanced Care Coordination, Mar. 2023, (Accessed Nov. 2024).

Lactation Counseling

Effective with dates of service on or after April 1, 2023, lactation counseling services (utilizing procedure code S9443) for nonphysician lactation counselors will be additionally covered via telemedicine. Both video and audio transmissions will be covered. The home setting is allowed for this service delivery. Existing provisions for the delivery of this service will remain in effect until specifically rescinded.

Telemedicine Place of Service (POS) codes include:

• 02 – Telehealth
• 10 – Telehealth in patient home

SOURCE: KS Department of Health and Environment, KMAP Bulletin 23042, Lactation Counseling Via Telemedicine, Feb. 2023, (Accessed Nov. 2024).

HCBS Appendix K

The service delivery options that will continue after November 11 include the following: …

A Remote Option for Receiving Services:

• Members will be able to receive some in-home services through tele-video. The State is currently working to receive approval from the federal government for this. Managed Care Organization (MCO) Care Coordinators will provide members more information when this option is approved.

SOURCE: KMAP General Bulletin 23302 HCBS Appendix K – COVID Measure Rescinding (PHE Changes Ending), Nov. 2023, (Accessed Nov. 2024).

Non-Waiver Mental Health Attendant Care Service

Telehealth services are excluded from the EVV process for Non-Waiver Mental Health Attendant Care. Centers will continue to submit claims for Non-Waiver Mental Health Attendant Care until otherwise instructed.

SOURCE: KMAP General Bulletin 23326 Non-Waiver Mental Health Attendant Care Service Code – EVV Implementation Resuming, Dec. 2023, (Accessed Nov. 2024).

Advance Directives

The face-to-face encounter may occur through telehealth, as implemented by the State.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Home Health, (Oct 2024), pg. 8-7. (Accessed Nov. 2024).

Serious Emotional Disturbances 

Wraparound Facilitation:  Meetings can be telehealth or by conference call by member’s choice when the meeting is not the initial or 6-month review.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, HCBS Serious Emotional Disturbances (SED), (Oct. 2023), pg. 7-3. (Accessed Nov. 2024).

Medication Assisted Treatment

Telehealth and transportation codes are covered codes for OTP services. Please refer to the Kansas Medicaid Telehealth and Non-Emergency Medical Transportation (NEMT) policies.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Mental Health, (Nov. 2024), pg. 8-15; & Substance Use Disorder Provider Manual, (May 2024), pg. 7-6. (Accessed Nov. 2024).

Mobile Crisis Intervention Services

MCR services are to be provided in person by teams of at least two individuals at the preferred location of the individual or family (home, school, or other community-based setting). In circumstances where face-to-face service by a LMHP is not available, the medical record should reflect the reason that an LMHP was unable to respond in person to the crisis. In those cases, utilization of telemedicine delivery by the LMHP is allowed; however, an in-person response should be made to provide telemedicine access to an LMHP.

SOURCE: Dept. of Health and Environment, Kansas Medical Assistance Program, Bulletin, Mobile Crisis Intervention Services, Bulletin 24162, Aug. 2024, (Accessed Nov. 2024).

ELIGIBLE PROVIDERS

Provisions in the Kansas Telemedicine Act will allow speech-language pathologists and audiologists licensed by KDADS to provide services via telemedicine. Services must be provided via real-time, interactive (synchronous) audio-video telecommunication equipment that is compliant with HIPAA.

Note: See specific Telemedicine code allowances and guidelines under Section 2720 of this manual.

The provider at the distant side must bill an appropriate code from the lists below with place of service (02) designating a telemedicine service provided other than in the patient’s home OR place of service (10) designating a telemedicine service provided in the patient’s home. (Please note: the GT modifier is no longer used to designate a telemedicine service.) Services delivered via telemedicine will be reimbursed at the same rate as a face-to-face (in the same physical location) service. Documentation requirements are the same as an in-person service.

“Distant site” means a site at which a healthcare provider is located while providing healthcare services by means of telemedicine.

“Healthcare provider” means an individual appropriately licensed, registered, certified, or otherwise authorized to provide a specifically designated telemedicine service.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, (Nov 2024), pg. 2-27 to 29, (Accessed Nov. 2024).

ELIGIBLE SITES

The provider at the distant side must bill an appropriate code from the lists below with place of service (02) designating a telemedicine service provided other than in the patient’s home OR place of service (10) designating a telemedicine service provided in the patient’s home. (Please note: the GT modifier is no longer used to designate a telemedicine service.) Services delivered via telemedicine will be reimbursed at the same rate as a face-to-face (in the same physical location) service. Documentation requirements are the same as an in-person service.

The originating site provider, with the patient present, may bill Q3014 with the appropriate place of service code denoted.

Codes S9453 and T2011 are allowed but not in the home.

“Originating site” means a site at which a patient is located at the time healthcare services are provided by means of telemedicine.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, (Nov 2024), pg. 2-27 to 29, (Accessed Nov. 2024).

Effective with dates of service on and after July 24, 2024, one of the following Place of Service (POS) codes should be utilized for all visits in AuthentiCare: …

• 02: Telehealth Provided Other than in Patient’s Home …
• 10: Telehealth Provided in Patient’s Home

SOURCE: KS KMAP General Medicaid Bulletin 24100, Jul. 2024, (Accessed Nov. 2024).

Adding Place of Service Code 10 to Home Telehealth Nursing Services

Effective with dates of processing on and after January 1, 2022, licensed practical nurses (LPNs) or registered nurses (RNs) that provide home telehealth services must use Place of Service (POS) code 10 for codes T1030 and T1031 on all claims.

SOURCE: KS Department of Health and Environment, KMAP Bulletin 23033, Adding Place of Service Code 10 to Home Telehealth Nursing Services, Feb. 2023, (Accessed Nov. 2024).

See remote patient monitoring section for more information on home telehealth services from the Home Health Agency Manual.

Intensive Individual Support (IIS) Providers

Intensive Individual Support (IIS) providers may now bill under the following POS codes:…

• 02 – Telehealth Provided Other Than in Patients Home
• 10 – Telehealth Provided in Patients Home

See bulletin for other POS codes.

SOURCE: KS KMAP General Medicaid Bulletin 23211, Aug. 2023, (Accessed Nov. 2024).

CCBHC

The allowable Place of Service (POS) codes for HCPCS code H0040 are defined to provide clarity on coverage:

• 02 – Telehealth Provided Other Than in Patients Home
• 10 – Telehealth Provided in Patients Home

SOURCE: KS KMAP General Medicaid Bulletin 24005, Jan. 2024, (Accessed Nov. 2024).

GEOGRAPHIC LIMITS

No Reference Found

FACILITY/TRANSMISSION FEE

Certified Community Behavioral Health Clinic (CCBHC) Services

The originating site, with the member present, may bill code Q3014 with the appropriate POS code. No payment will be made for Q3014 if the originating telemedicine site is place of service “home” (POS code 12) without the physical presence of a provider.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, FFS Provider Manual, Certified Community Behavioral Health Clinic (CCBHC) Services, (May 2024). (Accessed Nov. 2024).

Last updated 11/27/2024

Miscellaneous

Patient privacy and confidentiality:

• The same requirements for patient privacy and confidentiality under HIPAA of 1996 and 42 C.F.R. § 2.13, as applicable, that apply to healthcare services delivered through in-person contact also apply to healthcare services delivered through telemedicine. Nothing in this section supersedes the provisions of any state law relating to the confidentiality, privacy, and security or privileged status of protected health information (PHI).

Requirements regarding the provision telemedicine services:

• Telemedicine may be used to establish a valid provider-patient relationship.
• The same standards of practice and conduct that apply to healthcare services delivered through personal contact also apply to healthcare services delivered through telemedicine.
• A person who is authorized by law to provide and provides telemedicine services to a patient must provide the patient with guidance on appropriate follow-up care.
• Except when otherwise prohibited by any other provision of law, when the patient consents and has a primary care or other treating physician, the person providing telemedicine services will send within three business days a report to such primary care or other treating physician of the treatment and services rendered to the patient in the telemedicine encounter.
• A person licensed, registered, certified, or otherwise authorized to practice by the Behavioral Sciences Regulatory Board will not be required to comply with the provisions of requirement #4 (above).
• The provisions of this section shall also apply to the Kansas Medical Assistance Program (KMAP).
• KMAP will not exclude an otherwise covered healthcare service from coverage solely because such service is provided through telemedicine, rather than through personal contact, or based upon the lack of a commercial office for the practice of medicine.
• The insured’s medical record will serve to satisfy all documentation for the reimbursement of all telemedicine healthcare services, and no additional documentation outside of the medical record will be required.
• Payment or reimbursement of covered healthcare services delivered through telemedicine is the payment or reimbursement for covered services that are delivered through personal contact.
• Services provided through telemedicine must be medically necessary and are subject to the terms and conditions of the individual’s health benefits plan.
• KMAP cannot require a covered individual to use telemedicine in lieu of receiving an in-person healthcare service or consultation from an in-network provider.
• Nothing in the Kansas telemedicine act shall be construed to authorize the delivery of any abortion procedure via telemedicine.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, (Nov. 2024), pg. 2-29 to 30 (Accessed Nov. 2024).

Hospice

Service Intensity Add-on (SIA) Payment for hospice care is not covered if provided by a social worker via telephone.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, FFS Provider Manual, Hospice, p. 8-11 (Jun. 2024). (Accessed Nov. 2024).

Last updated 11/27/2024

Out of State Providers

No reference found. See Cross-State Licensing Section under Professional Requirements.

Last updated 11/27/2024

Overview

Kansas Medicaid covers live video telemedicine for certain services.  Additionally, they also cover remote patient monitoring that is in real-time through home health agencies and with prior authorization.

Kansas Medicaid recently updated their provider manual to allow reimbursement for specific codes for both live video and audio-only delivery.

Last updated 11/27/2024

Remote Patient Monitoring

POLICY

Telehealth visits must use face-to-face, real-time, interactive video contact to monitor members in the home setting as opposed to a nurse visiting the home. This technology can be used to monitor a member’s health status and to provide timely assessment of chronic conditions and other skilled nursing services.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Home Health, p. AIII-8 (Oct. 2024) (Accessed Nov. 2024).

Home and Community Based Services for the Frail Elderly

Home Telehealth is a remote monitoring system that enables the member to effectively manage one or more diseases and catch early signs of trouble so intervention can occur before the member’s health declines. The provision of Home Telehealth involves member education specific to one or more diseases (e.g. COPD, CHF, hypertension, and diabetes), counseling, and nursing supervision.

SOURCE:  Kansas Medical Assistance Program, Provider Manual, HCBS Frail Elderly, p. 8-25. (Sept. 2024). (Accessed Nov. 2024).

CONDITIONS

Codes T1030 and T1031 are per visit for home telehealth visits. Bill T1030 and T1031 with place of service 02 and modifier GY for telehealth skilled nursing visits for Medicare-eligible members with a Medicaid-covered benefit plan.

Providers use codes T1030 and T1031 for the provision of telehealth visits under the Long-Term Care Home Health Service Plan. See specific provider requirements for the provision of telehealth services.

Providers may use codes T1030 and T1031 for the provision of telehealth visits to assist members in managing their diabetes. See specific provider requirements for the provision of telehealth services.

PRN visits can be requested at the time they occur or within five working days after a visit has been made. Calls made to the PA department during nonworking hours are considered to be notification of the request. Agencies have 15 working days from the time of the call to submit a physician’s order and completed, appropriate home health services PA request form to the PA department. If the required documentation is not submitted within the timeframe, the request will be denied. PRN telehealth visits are noncovered

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Home Health, (Oct. 2024). (Accessed Nov. 2024).

Home and Community Based Services for the Frail Elderly

Telehealth services are provided on an individualized basis for members who have an identified need in their ISPOC. Member options and information are provided and discussed during the development of the ISPOC.

A participant can qualify if either of the following apply:

• The participant is in need of disease management consultation and education AND has had two or more hospitalizations, including emergency room (ER) visits, within the previous year related to one or more diseases.
• The participant is using MFP to move from a nursing facility back into the community.

SOURCE:  Kansas Medical Assistance Program, Provider Manual, HCBS Frail Elderly, p. 8-25, 8-26. (Sept. 2024). (Accessed Nov. 2024).

Effective with dates of service on and after August 1, 2024, the Home and Community Based Services (HCBS)/Frail Elderly (FE) Telemonitoring installation claims must be submitted with code S0315 with a U1 modifier appended. The current HCBS/FE Telemonitoring installation coverage criteria, limitations, and prior authorization requirements will remain the same. The HCBS/FE Telemonitoring installation is not subject to Electronic Visit Verification (EVV) requirements.

SOURCE: KMAP General Bulletin 24113. Jul. 2024. (Accessed Nov. 2024).

PROVIDER LIMITATIONS

Telehealth visits must be provided by a RN or LPN.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Home Health, (Oct. 2024). (Accessed Nov. 2024).

Home and Community Based Services for the Frail Elderly

A registered nurse (RN) or licensed practical nurse (LPN) with RN supervision must set up, supervise, and provide participant counseling.

Providers can include home health agencies or county health departments with system equipment capable of monitoring participant vital signs daily.  This includes (at a minimum) heart rate, blood pressure, mean arterial pressure, weight, oxygen saturation, and temperature. Also, the provider must have the capability to ask the participant questions which are tailored to his or her diagnosis.

The provider and equipment must have needed language options such as English, Spanish, Russian, and Vietnamese.

SOURCE:  Kansas Medical Assistance Program, Provider Manual, HCBS Frail Elderly, p. 8-26, 8-27. (Sept. 2024). (Accessed Nov. 2024).

OTHER RESTRICTIONS

Home Telehealth Limitations

• Providers must bill T1030 and T1031 with place of service 02 for home telehealth skilled nursing visits. These codes are per visit.
• PAs are entered for no more than 60 days. Home telehealth services cannot be approved for durations of more than 60 days. Additional documentation may be required to support continuation of home telehealth service requests that exceed 60 days.
• Telehealth visits must be provided by a RN or LPN.
• Telehealth visits must use face-to-face, real-time, interactive video contact to monitor members in the home setting as opposed to a nurse visiting the home. This technology can be used to monitor a member’s health status and to provide timely assessment of chronic conditions and other skilled nursing services.
• HCBS members eligible for face-to-face skilled nursing visits provided by a home health agency (05-050) may also receive home telehealth visits with documentation of medical necessity and PA. The PA request must include units to cover the duration and frequency of home telehealth visits.
• Oral medication administration or monitoring is not considered skilled care.

Providers must be able to demonstrate that the equipment used to render home telehealth services meets program specifications (real-time, interactive, audio and video telecommunication) and is HIPAA compliant.

Providers must be able to obtain and maintain telecommunication devices to render home telehealth visits.

When the provider has satisfied all the enrollment/demonstration requirements and a site visit is performed by the state program manager, KMAP will approve enrollment of PT/PS 05-051.

Providers are eligible for reimbursement of home telehealth services that meet the following criteria:

• Prescribed by a physician or allowed nonphysician practitioner
• Considered medically necessary
• Signed member consent for telehealth services
• Skilled nursing service
• Does not exceed program limitations (limited to two visits per week for non-HCBS members)

Upon completion of the enrollment process and approval of the telehealth demonstration, home health agencies should refer to home telehealth prior authorization criteria as noted in this appendix for further guidance.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Home Health, (Oct. 2024). (Accessed Nov. 2024).

Home and Community Based Services for the Frail Elderly

See HCBS Frail Elderly provider manual for documentation requirements.

SOURCE:  Kansas Medical Assistance Program, Provider Manual, HCBS Frail Elderly, p. 8-28. (Sept. 2024). (Accessed Nov. 2024).

Last updated 11/27/2024

Store and Forward

POLICY

“Telemedicine,” including “telehealth,” means the delivery of healthcare services or consultations while the patient is at an originating site and the healthcare provider is at a distant site. Telemedicine shall be provided by means of real-time two-way interactive audio, visual, or audio-visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support healthcare delivery, that facilitate the assessment, diagnosis, consultation, treatment, education and care management of a patient’s healthcare. “Telemedicine” does not include communication between:

‘‘Telemedicine’’ does not include communication between:

1. 1. Healthcare providers that consist solely of a telephone voice-only conversation, email or facsimile transmission; or
   2. a physician and a patient that consists solely of an email or facsimile transmission.

SOURCE:  KS Statute Ann. § 40-2,211(5), (Accessed Nov. 2024).

ELIGIBLE SERVICES/SPECIALTIES

No Reference Found

GEOGRAPHIC LIMITS

No Reference Found

TRANSMISSION FEE

No Reference Found