Telehealth Delivery of Substance Use Disorder Services
Overview
Telehealth is the delivery of health care services or consultations using real time, two-way interactive audio and visual communications. Telehealth provides or supports health care delivery and facilitates the assessment, diagnosis, consultation, treatment education and care management of a patient’s health care while the patient is at originating site and the licensed health care provider is at a distant site.
Minnesota Health Care Programs (MHCP) allows payment for telehealth services in substance use disorder treatment for services that are otherwise covered as direct face-to-face services. Payment is allowed for interactive audio and video telecommunications which permit real-time communication between the distant site provider’s counselor or practitioner and the member. The services must be of sufficient audio and visual fidelity and clarity as to be functionally equivalent to a face-to-face encounter. The information provided in this manual section explains the specific requirements related to SUD. Review the Telehealth Services section of the MHCP Provider Manual for an overview and requirements that apply to all telehealth services.
Eligible Providers
Providers currently authorized to provide services may conduct the same services via telehealth. Providers must self-attest that they meet all of the conditions of the MHCP telehealth policy by completing and submitting the Telehealth Provider Assurance Statement (DHS-6806) (PDF) to be eligible to provide and be reimbursed for services via telehealth.
Eligible Members
Telehealth coverage applies to all MHCP members.
Covered Services
The following medically necessary substance use disorder (SUD) services provided by eligible SUD providers via telehealth are covered:
Noncovered Services
Refer to the Telehealth Services section of the MHCP Provider Manual for noncovered telehealth services.
Billing
Use the appropriate place of service listed for covered services that are submitted on claim format 837P:
Place of service 02: Telehealth provided other than the patient’s home. The patient is not located in their home when receiving health services or health-related services through telecommunication technology.
Place of service 10: Telehealth provided in patient’s home. The patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health-related services through telecommunication technology.
Use the appropriate modifier listed for covered services that are submitted on claim format 837P or 837I with type of bill 89X:
Modifier 93, Audio only: Synchronous telehealth service rendered via telephone or other real-time interactive audio-only telecommunications system. MHCP requires modifier 93 when audio-only telehealth is used.
Modifier 95, Audio and video: Synchronous telehealth service rendered via a real-time interactive audio and video telecommunications system.
Legal References
Minnesota Rules, 2960.0430-0490
Minnesota Statutes, 245F
Minnesota Statutes, 245G
Minnesota Statutes, 256B.0625, subdivision 3b(b)
Minnesota Statutes, 254B.0505, subdivision 2
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