To help slow the spread of the coronavirus, several new temporary telehealth policies allow injured workers to receive treatment from their medical providers by video or phone in some instances.
The detailed temporary policies are scheduled to end July 3 and may be updated as needed. You can find these policies on L&I's Medical Aid Rules and Fee Schedules (MARFS) Updates and Corrections page:
- Temporary Telehealth Payment Policy
- Temporary Telerehab Payment Policy: Physical therapists, occupational therapists, and speech language pathologist may use telehealth to deliver services for established patients in outpatient settings. This policy allows telerehab for certain services, including but not limited to:
- Supervised therapeutic exercise
- Self-care/home management
- Cognitive therapy for speech pathology
- Temporary TeleSIMP Payment Policy: This temporary policy allows some Structured Intensive Multidisciplinary Program (SIMP) services to be delivered by telehealth to workers enrolled in this program. This policy isn't intended to replace Chapter 34: Chronic Pain Management.
- Temporary Work Hardening Payment Policy: This temporary policy allows work hardening (billing codes 97545 and 97546) to be delivered by telehealth to workers. This policy isn't intended to replace Chapter 25: Physical Medicine Services.
Common Questions About Telehealth
This information is meant to answer many of the questions L&I is receiving regarding telehealth (also known as telemedicine).
Is a worker's home considered an originating site for telehealth?
Yes, the worker's home is considered an originating site under L&I's temporary telehealth policy in effect during the pandemic.
What services are currently covered using telehealth?
A full list of the covered services can be found on the MARFS Updates and Corrections page. We've temporarily added group psychotherapy, outpatient physical, occupational, work hardening and speech therapy, and SIMP as services covered with telehealth.
What are the requirements for billing a telehealth visit?
Will L&I pay for telehealth visits for new patients referred from an emergency room if the patient has no prior provider and does not require an in-person visit?
Is L&I considering using telehealth to deliver other services?
What are the confidentiality and release of information requirements when using video applications for appointments?
The provider is required to ensure the privacy and confidentiality of the worker at all times.
Will L&I pay for Activity Prescription Forms (APF) if they are generated during a telehealth or telephone appointment?
Under the new temporary policy, L&I will pay for APFs generated during a telehealth session. L&I doesn't intend to pay for APFs generated during an appointment over the phone. L&I will publish the policy on the MARFS Updates and Corrections page when it is complete.
Does the Temporary Interpreter Telehealth Policy allow face-to-face interpreters to provide services through telehealth if the interpreter is face-to-face with either the provider or the patient?
If interpreter services are needed, providers may access a telephonic interpreter using the identified vendor in Chapter 14: Interpretive Services. You can also schedule a face-to-face interpreter under the Temporary Interpretive Services via Video or Telephone Policy; however, face-to-face interpretation is not covered when the worker's home is the originating site. More details are available on the MARFS Updates and Corrections page.
Are patient signatures required on L&I forms for COVID-19 telehealth appointments? How should COVID-19 patients submit a claim that needs their signature?
The worker may file a Report of Accident (ROA) with an electronic signature.
Center for Medicaid and Medicare Services (CMS) recently posted an update to pay for telephone calls at the same reimbursement rate as an office visit. Will L&I follow this CMS message?
We are continuing to use our established telephone fees. We will publish our updated fee schedule Sept. 1.
Questions about temporary telehealth payment policies? Contact L&I's Healthcare Policy & Payment Methods team.