FAQ

Q. Is guidance available regarding telehealth services for the 301-provider system?

A. Yes, SCDHHS published a memo on April 17, 2020, that clarified authorities for telehealth authorities for Act 301 local alcohol and drug abuse authorities. The memo is available here on SCDHHS’ COVID-19 website.

Q. For Quality Measures related to wellness visits, what documentation requirements can be self-reported?

A. SCDHHS continues to use the National Committee for Quality Assurance (NCQA) technical specifications as standard for requirements related to supplemental data for hybrid measures for the Healthcare Effectiveness Data and Information Set (HEDIS).

Q. Does SCDHHS require use of a certain platform to provide telehealth services?

A. Providers have the same ethical and other obligations to maintain the security and privacy of their patients’ information and the service delivery platform. The agency understands not everyone has the same capabilities and/or has adopted a Health Insurance Portability and Accountability Act (HIPAA)-compliant platform and is expecting providers to use reasonable judgement and show evidence of a good faith effort. SCDHHS does not want technical compliance with certain requirements to stand in the way of patient care during this emergency response period.

Q. What is the location code when billing telephonic and telehealth codes?

A. For COVID-19-related telehealth services submitted to the fee-for-service benefit, providers can elect to submit either ‘02’, indicating telehealth, or place of service code they would have used if the service had been provided in person (FQHCs billing through the SCDHHS webtool should select “POS 12”). Medicaid MCOs may have additional requirements related to the place of service for COVID-19 related telehealth services.

Q. Can you please advise on the proper use of this GT modifier? We use another code in the first block. Does this take that place or does it go in the second block?

A. When billing for a service with a GT modifier, the GT modifier should be listed after any other modifiers. For example, if you bill with a HO modifier and a GT modifier, HO should be included in the first block and GT should be included in the second block.

Q. Why is there a difference between covered dates of service and the claims submission acceptance date?

A. SCDHHS’ goal in preparing and responding to COVID-19 is to authorize services quickly, but the agency also needs time to update its system(s) to receive bills and reimburse for claims.

Q. Does the South Carolina Healthy Connections Medicaid program provide or reimburse for interpreters and/or translators?

A. The Medicaid provider enrollment agreement and the SCDHHS policy manual both require providers to deliver services to non-English speaking individuals without additional compensation or support from the agency.

Pages

Subscribe to RSS - FAQ
Back to Top
Report Fraud