We hope that everyone is staying safe during the COVID-19 crisis. State health departments are, of course, doing what they can to facilitate management of transmission of COVID-19 by healthcare providers. Some recent actions by the New York Department of Health (“DOH”) to allow or promote telephonic and telehealth services include:

Telephonic Evaluation – Beginning with dates of service of March 13, Medicaid will reimburse telephonic evaluation and management services for established patients where face-to-face visits may not be recommended and it is medically appropriate to evaluate and manage the patient by phone. Additionally, where a patient face-to-face visit is not possible due to the State of Emergency, telephonic visits documented as clinically appropriate by the provider will be considered medically necessary for Medicaid payment purposes.

Face to Face Requirements – DOH has authorized Home and Community Based Services provided under both the Home Health Care Management and 1915(c) Children’s Waiver to be provided telephonically or via telehealth whenever possible in lieu of face-to-face contact.   

Cost Sharing – For New York Medicaid Managed Care plans, the Medicaid program will cover services including testing for COVID–19 and for physician, clinic, and emergency visits without copays for members when the purpose of the visit is testing for COVID–19. New York State Department of Health, New York State Medicaid Update, March 2020 Special Edition – COVID-19 (Mar. 10, 2020).

Telehealth – Also for New York Medicaid Managed Care plans, under prior amendments to the New York Insurance and Public Health Laws, services that are covered under a comprehensive health insurance policy or contract must be covered when the service is delivered via telehealth. DOH is encouraging the use of telehealth modalities to provide COVID–19 related services to Medicaid recipients. More information on the current telehealth policy can be found in the February 2019 Medicaid Update here. New York State Department of Health, New York State Medicaid Update, March 2020 Special Edition – COVID-19 (Mar. 10, 2020).

Medicaid Special Editions can be found at https://www.health.ny.gov/health_care/medicaid/program/update/2020/index.htm

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