California

Last updated 01/08/2026

Consent Requirements

Health care providers must inform the member prior to the initial delivery of telehealth services about the use of telehealth and obtain verbal or written consent from the member for the use of telehealth as an acceptable mode of delivering Medi-Cal covered benefits or services.

If a health care provider, whether at the originating site or distant site, maintains a general consent agreement that specifically mentions use of telehealth (either synchronous or asynchronous interactions) as an acceptable modality for delivery of Medi-Cal covered benefits or services and includes the required information, as explained below, then this is sufficient for documentation of member consent and should be kept in the member’s medical file. Health care providers also need to document when a member consents to receive services via audio-only synchronous interactions prior to initial delivery of Medi-Cal covered benefits or services.

The consent shall be documented in the member’s medical file and be available to DHCS upon request. Health care providers are required to share additional information with members regarding the following topics:

• Right to face-to-face/in-person services
• Voluntary nature of consent
• Availability of transportation to access face-to-face/in-person services when other available resources have been reasonably exhausted
• Limitations/risks of receiving services via telehealth, if applicable
• Availability of translation services

Consent requirements may be found in B&P Code, Section 2290.5 [b] and WIC, Section 14132.725 [d]. Model member consent language may be found on the DHCS’ Patient Consent website.

FQHCs and RHCs are directed to refer to the above on consent requirements.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth. (Nov. 2025), Pg. 7, CA Department of Health Care Services (DHCS). Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHC) Outpatient Services Manual. Nov. 2025. Pg. 14. (Accessed Jan. 2026).

Applies to Healthcare Providers including FQHCs/RHCs

In addition to any existing law requiring beneficiary consent to telehealth, including, but not limited to, subdivision (b) of Section 2290.5 of the Business and Professions Code, all of the following shall be communicated by a health care provider, FQHC, and RHC to a Medi-Cal beneficiary, in writing or verbally, on at least one occasion prior to, or concurrent with, initiating the delivery of one or more health care services via telehealth to a Medi-Cal beneficiary:

• An explanation that beneficiaries have the right to access covered services that may be delivered via telehealth through an in-person, face-to-face visit;
• An explanation that use of telehealth is voluntary and that consent for the use of telehealth can be withdrawn at any time by the Medi-Cal beneficiary without affecting their ability to access covered Medi-Cal services in the future;
• An explanation of the availability of Medi-Cal coverage for transportation services to in-person visits when other available resources have been reasonably exhausted; and
• The potential limitations or risks related to receiving services through telehealth as compared to an in-person visit, to the extent any limitations or risks are identified by the provider, FQHC, or RHC.

The provider, FQHC, or RHC shall document in the patient record the provision of this information and the patient’s verbal or written acknowledgment that the information was received.

The department shall develop, in consultation with affected stakeholders, model language for purposes of the communication described in this subdivision.

This subdivision does not apply to Medi-Cal covered services delivered by providers via any telehealth modality to eligible inmates in state prisons, county jails, or youth correctional facilities.

SOURCE: Welfare and Institutions Code 14132.725 & Welfare and Institutions Code 14132.100 slight updates to this section scheduled to take effect July 1, 2026 pursuant to AB 116 (2025 Session). (Accessed Jan. 2026).

State law requires the  health care provider initiating the use of telehealth to obtain written or verbal consent once before the initial delivery of telehealth services. Medi-Cal has developed Telehealth Patient Consent Language,​ which includes language outlining a beneficiary’s right to in-person services, the voluntary nature of consent, the availability of transport to access in-person services if needed, and potential limitations/risks of receiving services via telehealth. Providers are not required to use DHCS model language but rather can be utilized as a resource. Patient consent can be completed verbally or in writing. Patients who consent to synchronous video must separately consent to synchronous audio-only services.

Health care providers may document consent either by having the beneficiary sign a paper or electronic form that can be included in the patient’s medical record or by having the provider note consent in the patient’s medical record. Group practices need to obtain and document a patient’s initial consent for purposes of telehealth services prior to the initiation of health care services via telehealth.  If consent is documented by the group practice, it is not necessary for each provider rendering health care services via telehealth to document consent.

Minors who receive confidential care, including sexual health, reproductive health, mental health under the Minor Consent Program, may consent to receive the same services via telehealth that are appropriate for telehealth. More information is available ​on the Minor Consent Program​​.

SOURCE: CA Department of Health Care Services. Telehealth FAQs. (Accessed Jan. 2026).

Indian Health Services, Memorandum of Understanding Agreement (IHS-MOA)

Refer to fee-for-service policy. All consent for homeless patients must be documented.

SOURCE: CA Department of Health Care Services (DHCS). Indian Health Services, Memorandum of Agreement (MOA) 638, Clinics Manual. Nov. 2025. Pg. 8. (Accessed Jan. 2026).

Vision Care

Providers must include a record of the written or verbal request for the consultation by the referring provider or other source in the medical record.  Verbal and written informed consent from the patient or the patient’s legal representative is required if the consulting provider has ultimate authority over the care or primary diagnosis of the patient.

SOURCE: CA Department of Health Care Services, Vision Care: Professional Services Manual. (Nov. 2025), Pg. 5. (Accessed Jan. 2026).

Teledentistry

Medi-Cal providers must also inform the patient about the use of teledentistry and obtain verbal or written consent from the patient for the use of teledentistry as an acceptable mode of delivering dental services. The consent shall be documented in the patient’s dental record (Business and Professionals Code Section 2290.5(b)) and be available to the Department upon request.

SOURCE: CA Department of Health Care Services (DHCS). Medi-Cal Dental Provider Handbook. 2025. Pg. 4-30. (Accessed Jan. 2026).

Local Education Agency Services

All of the following shall be communicated by a health care provider to a Medi-Cal beneficiary, in writing or verbally, on at least one occasion prior to, or concurrent with, initiating the delivery of one or more health care services via telehealth to a Medi-Cal beneficiary:

• An explanation that beneficiaries have the right to access covered services that may be delivered via telehealth through an in-person, face-to-face visit;
• An explanation that the use of telehealth is voluntary and that consent for the use of telehealth can be withdrawn at any time by the Medi-Cal beneficiary without affecting their ability to access covered Medi-Cal services in the future;
• An explanation of the availability of Medi-Cal coverage for transportation services to inperson visits when other available resources have been reasonably exhausted; and
• The potential limitations or risks related to receiving services through telehealth as compared to an in-person visit, to the extent any limitations or risks are identified by the provider.

Documentation of written or verbal consent to receive services via telehealth must be maintained in the student’s file. Consent requirements outlined in the Local Educational Agency provider manual section related to accessing public benefits or insurance or releasing medical information in personally identifiable form from the student’s education record must also be followed.

SOURCE: CA Department of Health Care Services (DHCS). Local Education Agency (LEA) Telehealth. Jun. 2023. Pg. 7. (Accessed Jan. 2026).

Last updated 01/04/2026

Definitions

“Telehealth” means the mode of delivering Medi-Cal covered health care benefits and services via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management and self-management of a Medi-Cal member’s (referred to as member throughout this policy) health care. Telehealth modalities can help facilitate member self-management and caregiver support and include synchronous and asynchronous interactions.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025). Pg. 1. (Accessed Jan. 2026).

California defines telehealth as “the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care while the patient is at the originating site and the health care provider is at a distant site”.

SOURCE: CA Dept. Health Care Services, Medi-Cal & Telehealth. (Accessed Jan 2026).

“Telehealth” means the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.

SOURCE: CA Department of Health Care Services. Family Planning, Access, Care and Treatment Program. Benefits Manual. May. 2024, Pg. 7. (Accessed Jan. 2026).

“Telehealth” means the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous, real-time interactions between a patient and a health care provider located at a distant site.

SOURCE: CA Department of Health Care Services. Medi-Cal LEA Telehealth Manual. Nov. 2025. Pg. 1. (Accessed Jan. 2026).

Last updated 01/08/2026

Email, Phone & Fax

For services or benefits provided via synchronous telephone or other real-time interactive audio-only telecommunications systems, the health care provider bills with modifier 93.

Modifier 93 must be used for Medi-Cal covered benefits or services delivered via synchronous, telephone or other interactive audio-only telecommunications systems. Only the portion(s) of the telehealth service rendered at the distant site are billed with modifier 93. The use of modifier 93 does not alter reimbursement for the CPT or HCPCS code.

Health care providers must use an interactive audio-only telecommunications system that permits real-time communication between the provider at the distant site and the patient at the originating site. The audio telehealth system used must, at a minimum, have the capability of meeting the procedural definition of the code provided through telehealth. The telecommunications equipment must be of a quality or resolution to adequately complete all necessary components to document the level of service for the CPT code or HCPCS code billed.

The totality of the communication of information exchanged between the provider and the patient during the audio-only service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction.

Providers must document in the patient’s medical file that the patient has given a written or verbal consent to the audio-only telehealth encounter.

See Telehealth Modifier Reference Sheet- Organized by Delivery System​​ ​for more information on modifiers.

Medi-Cal asynchronous policy does not include consultations via asynchronous electronic transmission through mobile telephone applications, emails, online questionnaires or fillable forms, chats and text messages.

Brief Virtual Communications and Check-ins – Virtual or telephonic communication includes a brief communication initiated by the member between a health care provider and a member when the member is not physically present (in-person). The member must already have an established patient relationship with the health care provider. This code cannot be used to establish a new patient relationship. Health care providers may be reimbursed using HCPCS code G2010 or CPT code 98016 for brief virtual communications.

• HCPCS code G2010: Remote evaluation of recorded video and/or images submitted by an established patient (for example, store and forward), including interpretation with follow-up with the patient within 24 hours, not originating from a related E&M service provided within the previous seven days nor leading to an E&M service or procedure within the next 24 hours or soonest available appointment.
•  CPT code 98016: Brief communication technology-based service by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related E&M service provided within the previous seven days nor leading to an E&M service or procedure within the next 24 hours or soonest available appointment; five to 10 minutes of medical discussion. Code 98016 can be billed when the virtual communication is via a telephone call.

The brief virtual communication policy is not applicable for FQHCs, RHCs, or IHS-MOA , or Tribal FQHC Clinics, and they may not separately bill for it.

Establishing a Relationship – In limited circumstances, health care providers may also establish new patient relationships with members via audio-only synchronous interactions only if one or more of the following applies:

• The visit is related to sensitive services as defined in subsection (s) of Section 56.05 of the Civil Code. Section 56.05 (s) of the Civil Code defines “sensitive services” as all health care services related to mental or behavioral health, sexual and reproductive health, sexually transmitted infections, substance use disorder, gender-affirming care, and intimate partner violence, and includes services described in Sections 6924 through 6930 of the Family Code, and Sections 121020 and 124260 of the Health and Safety Code, obtained by a member at or above the minimum age specified for consenting to the service specified in the section.
• The member requests an audio-only modality.
• The member attests that they do not have access to secure video conferencing platforms.

Note: Health care providers may not establish new patient relationships with members via asynchronous telehealth interaction, including store and forward, for any Medi-Cal covered benefit or service.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025). Pg. 2, 4, 10-11, 15. (Accessed Jan. 2026).

A health care provider shall not establish a new patient relationship with a Medi-Cal beneficiary via telephonic (audio-only) synchronous interaction except:

• when the visit is related to sensitive services, as defined in subdivision (n) of Section 56.05 of the Civil Code, and when established in accordance with department specific requirements and consistent with federal and state law, regulations and guidance
• when the patient requests an audio-only modality or attests they do not have access to video, and when established in accordance with department specific requirements and consistent with federal and state laws, regulations and guidance.

The department shall reimburse health care providers of applicable health care services delivered via synchronous audio-only modality at payment amounts that are not less than the amounts the provider would receive if the services were delivered via in-person, face-to-face contact, so long as the services or settings meet the applicable standard of care and meet the requirements of the service code being billed.

A Medi-Cal provider furnishing applicable health care services via audio-only synchronous interaction shall also offer those same health care services via video synchronous interaction to preserve beneficiary choice. The department may provide specific exceptions to this requirement specified in subparagraph based on a Medi-Cal provider’s access to requisite technologies, which shall be developed in consultation with affected stakeholders and published in departmental guidance.

A provider furnishing services through video synchronous interaction or audio-only synchronous interaction shall also maintain and follow protocols to do one of the following:

• Offer those services via in-person, face-to-face contact.
• Arrange for a referral to, and a facilitation of, in-person care that does not require a patient to independently contact a different provider to arrange for that care. (This clause does not require a provider to schedule an appointment with a different provider on behalf of the patient.)
• In implementing this subdivision, the department shall consider additional recommendations from affected stakeholders regarding the need to maintain access to in-person services without unduly restricting access to telehealth services.

SOURCE: Welfare and Institutions Code 14132.725. (Accessed Jan. 2026).

Patient Choice of Telehealth Modality

Health care providers can offer a variety of telehealth modalities for covered Medi-Cal benefits and services to the extent that the benefit or service can be appropriately rendered via the allowable telehealth modalities under this policy. However, health care providers are not required to offer telehealth modality options, although DHCS strongly encourages them to do so to promote greater access to care and reduce barriers.

Health care providers who choose to offer telehealth modalities are required to offer members the ability to choose whether they want to receive covered Medi-Cal services via:

• Synchronous, interactive audio/visual telecommunication systems (for example, video), or
• Synchronous, telephone or other interactive audio-only telecommunications systems.

While health care providers may offer both video and audio-only (telephone) telehealth modalities, members may freely choose, and change at any time, their desired telehealth modalities, which includes the ability to decline video modalities and select audio-only (telephone) modalities if preferred and/or necessary given the member’s needs.

For example, if the visit is related to sensitive services as defined in subsection(s) of Section 56.05 of the Civil Code, then the member may prefer to utilize an audio-only (telephone) modality.

Members shall be given the choice of how they receive their covered Medi-Cal benefits and services that may be delivered appropriately via telehealth modalities.

Exception to Telehealth Modalities Provider Requirement

Since broadband is necessary to ensure quality and effective visual communication between health care providers and members, health care providers are exempt from the requirement to offer both telehealth modalities if the health care provider does not have access to broadband.

• Note: Broadband refers to high-speed internet access that is always on and faster than traditional dial-up access. Broadband includes several high-speed transmission technologies, such as fiber, wireless, satellite, digital subscriber line, and cable. For the purposes of delivering telehealth services to members, DHCS uses the Federal Communications Commission’s (FCC) definition of broadband and the FCC minimum mbps upload/download speeds.

Health care providers claiming this exception must maintain appropriate supporting documentation, which should be made available to DHCS upon request. For example, supporting documentation might include confirmation from an internet services provider regarding the lack of broadband service in a particular coverage area.

Right to In-person Services 

Health care providers furnishing services to members through telehealth modalities must also either offer services in-person or have a documented process in place to link members to in-person care within a reasonable time if in-person services are unavailable from the health care provider.

If the health care provider chooses to link the member to in-person care to satisfy this requirement, then they must provide a referral to and facilitation of in-person care that does not require a member to independently contact a different health care provider to arrange for such care. The health care provider may initiate a process by which a different health care provider in their office or an affiliated in-person care site contacts the member directly to schedule an in-person visit.

The referring health care provider or a member of their staff must confirm they have at least attempted to contact the member to schedule an in-person appointment. However, the referring health care provider is not required to schedule an appointment with a different provider on behalf of the member. The health care provider must offer referral and facilitation support that is minimally burdensome to the member.

Health care providers must maintain documentation of their process to link members to in person care, which should be made available to DHCS upon request.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025). Pg. 8-9. (Accessed Jan. 2026).

FQHCs/RHCs 

An audio-only synchronous interaction is eligible for reimbursement if provided by a billable provider and FQHC or RHC patient.

Medi-Cal benefits or services being provided are clinically appropriate and meet the procedural and billing requirements that would have applied if the applicable services were delivered via a face-to-face encounter.

A patient may not be “established” using an audio-only synchronous interaction unless the visit is related to a “sensitive service”, as defined in the California Civil Code, section 56.05, subdivision (n), or if the patient requests “audio only” or does not have access to video.

SOURCE: CA Dept. Health Care Services, Medi-Cal Part 2 RHCs and FQHCs Manual, (Mar. 2024), p 16. (Accessed Jan. 2026).

Visits shall also include an encounter between an FQHC or RHC patient and a physician, physician assistant, nurse practitioner, certified nurse-midwife, clinical psychologist, licensed clinical social worker, licensed professional clinical counselor, visiting nurse, comprehensive perinatal services program practitioner, dental hygienist, dental hygienist in alternative practice, or marriage and family therapist using audio-only synchronous interaction, when services delivered through that modality meet the applicable standard of care. A visit described in this clause shall be reimbursed at the applicable FQHC’s or RHC’s per-visit PPS rate to the extent the department determines that the FQHC or RHC has met all billing requirements that would have applied if the applicable services were delivered via a face-to-face encounter.

An FQHC or RHC may not establish a new patient relationship using an audio-only synchronous interaction. Notwithstanding this prohibition, the department may provide for specific exceptions to this prohibition, which shall be developed in consultation with affected stakeholders and published in departmental guidance. Exceptions shall include but not be limited to:

• An FQHC or RHC may establish a new patient relationship using an audio-only synchronous interaction when the visit is related to sensitive services, as defined in subdivision (n) of Section 56.05 of the Civil Code, or when the patient requests an audio-only modality or attests they do not have access to video – in accordance with department-specific requirements and consistent with federal and state laws, regulations, and guidance.

An FQHC or RHC furnishing applicable health care services via audio-only synchronous interaction shall also offer those same health care services via video synchronous interaction to preserve beneficiary choice. The department may provide specific exceptions to the requirement based on an FQHC’s or RHC’s access to requisite technologies, which shall be developed in consultation with affected stakeholders and published in departmental guidance.

An FQHC or RHC furnishing services through video synchronous interaction or audio-only synchronous interaction shall also do one of the following:

• Offer those services via in-person, face-to-face contact.
• Arrange for a referral to, and a facilitation of, in-person care that does not require a patient to independently contact a different provider to arrange for that care.

SOURCE: Welfare and Institutions Code 14132.100 (slight updates to this section scheduled to take effect July 1, 2026 pursuant to AB 116 (2025 Session). (Accessed Jan. 2026).

In regard to patient choice of telehealth modality and right to in-person services requirements, FQHC/RHC providers are directed to refer to the policies found in more detail in the Telehealth Manual.

SOURCE: CA Dept. of Health Care Services, Part 2 Manual, Medi-Cal Rural Health Clinics and Federally Qualified Health Centers (Nov. 2025), p. 15.  (Accessed Jan. 2026).

Telehealth services, telephonic services and other specified services must be reimbursed when provided by specific entities during or immediately following an emergency, subject to the Department obtaining federal approval and matching funds and Department guidance.

SOURCE: Welfare and Institutions Code Sec. 14132.723. (Accessed Jan. 2026).

The department shall seek any federal approvals it deems necessary to extend the approved waiver or flexibility implemented pursuant to subdivision (a), as of July 1, 2021, that are related to the delivery and reimbursement of services via telehealth modalities in the Medi-Cal program, including audio-only. The department shall implement those extended waivers or flexibilities for which federal approval is obtained, to commence on the first calendar day immediately following the last calendar day of the federal COVID-19 public health emergency period, and through December 31, 2022.

For purposes of informing the 2022–23 proposed Governor’s Budget, released in January 2022, the department shall convene an advisory group consisting of consultants, subject matter experts, and other affected stakeholders to provide recommendations to inform the department in establishing and adopting billing and utilization management protocols for telehealth modalities to increase access and equity and reduce disparities in the Medi-Cal program. The advisory group shall analyze the impact of telehealth in increased access for patients, changes in health quality outcomes and utilization, best practices for the appropriate mix of in-person visits and telehealth, and the benefits or liabilities of any practice or care model changes that have resulted from telephonic visits.

SOURCE: AB 133, Sec. 380 (2021 Session). (Accessed Jan. 2026).

IHS-MOA/Tribal FQHC

An audio-only visit is eligible for reimbursement if provided by a billable provider, regardless of the location of the patient or provider.

SOURCE: DHCS IHS Manual. May 2023. Pg. 9; Tribal FQHC Nov. 2025, p. 13. (Accessed Jan. 2026).

Vision Services

Asynchronous telecommunications system (store and forward telehealth) in single media format does not include telephone calls, images transmitted via facsimile machine, and text messages without visualization of the patient (electronic mail). Audio clips, video clips, still images and photographs must be specific to the patient’s condition and adequate for rendering or confirming a diagnosis and/or treatment plan.

SOURCE: CA Department of Health Care Services. Medi-Cal Professional Services Manual. Page 6. (Dec. 2022). (Accessed Jan. 2026).

LEA Services

Allowable services delivered via telehealth must be synchronous telehealth service rendered via a real-time interactive audio and video telecommunications system only. LEA-BOP does not currently allow audio-only telehealth (Modifier 93).

SOURCE: CA Department of Health Care Services. Medi-Cal Local Educational Agency (LEA) Telehealth Manual. Page 3-4. (Jun. 2023); DHCS Telehealth Modifier Reference Sheet. (Accessed Jan 2026).

SOURCE: CA Department of Health Care Services. Family PACT Clinical Services manual. May 2024. Pg. 8, 10. (Accessed Jan. 2026).

A Family PACT provider may enroll and recertify clients through synchronous video or audio-only synchronous telehealth modalities. See manual for more information.

SOURCE: CA Department of Health Care Services. Family PACT Client Eligibility Manual. Apr. 2023. Pg. 1. (Accessed Jan. 2026).

Children’s Services Program

CCS providers must request prior authorization services from CCS paneled physicians (22, CCR Section 41412) who are available to provide telehealth services. Prior authorization requests are also authorized to CCS-approved hospitals and outpatient special care centers. GHPP providers must be Medi-Cal enrolled providers.

Physical and Occupational Therapy may be offered through appropriate telehealth modalities. Medical Therapy Unit therapists may offer remote/virtual teletherapy services as an alternative to in-person visits, as appropriate and directed by the Medical Therapy Conference and directing physicians. CCS clients receiving services through a Special Care Center and/or Medical Therapy Program Medical Therapy Conference must have an annual in-person evaluation by a CCS-paneled physician. GHPP clients require an annual evaluation to ensure continued program coverage.

Billing for telehealth services is contingent upon the CCS Program or GHPP clients meeting all eligibility criteria, with an approved CCS Program/GHPP SAR, and in conformance with required Medi-Cal claims submission procedures as outlined in the DHCS Medi-Cal Telehealth Policy.

• When submitting a SAR for synchronous telemedicine services, the provider must use codes provided in the American Medical Association (AMA’s) CPT Manual, Appendix P.
• Telehealth modifiers (93, 95 or GQ) are required on SARs to differentiate the telehealth service from the equivalent in-person service.
• For services or benefits provided via synchronous, telephone or other interactive audio-only telecommunications systems, the health care provider bills with modifier 93.
• For services or benefits provided via asynchronous store-and-forward telecommunications systems, the health care provider bills with modifier GQ.

For Whole Child Model (WCM) counties, the client’s managed care plan (MCP) shall be responsible for authorizing, coordinating, and covering CCS telehealth services.

For eligible California Children’s Services (CCS) Service Code Grouping (SCG) codes, see the California Children’s Services (CCS) Program Service Code Groupings excel sheet.

SOURCE: Department of Health Care Services. Numbered letter 03-0723 to the Children’s Services Program and Genetically Handicapped Persons Program (GHPP). Jul. 7, 2023 – supersedes Department of Health Care Services. Numbered letter 16-1217 to the CA Children’s Services Program and Genetically Handicapped Persons Program (GHPP).  Dec. 22, 2017. (Accessed Jan. 2026).

Last updated 01/07/2026

Live Video

POLICY

“Synchronous interaction” means a real-time, two-way interaction between a member located at an originating site and a health care provider located at a distant site. This type of telehealth modality mirrors a traditional, face-to-face interaction and is supported by Health Insurance Portability and Accountability Act (HIPAA)-compliant video conferencing platforms or telephone calls. For more information, see the comparison chart below. Key features of synchronous interactions include, but are not limited to, the following:

• The member and health care provider are communicating in real-time or near real time.
• The member and health care provider can interact in real-time with immediate feedback, ask follow-up questions, and the provider can engage in informed clinical decision-making.

Synchronous vs. Asynchronous Interaction

• Synchronous Interaction
  • Real-time (live interaction)
  • Two-way, interactive
  • Video conferencing or telephone
  • Typically requires advance scheduling by the health care provider and simultaneous communication between member and health care provider.
• Asynchronous Interaction
  • Not real-time (data or imagine sent for review, may be later)
  • One-way, non-interactive
  • HIPAA-compliant messaging platform, image upload system
  • No advance scheduling required and information can be sent anytime. Interaction initiated by the provider. Member and health care provider have increased flexibility.

Health care providers may establish new patient relationships with members via two-way, audio-visual synchronous interactions (for example, HIPAA-compliant video conferencing platforms).

In limited circumstances, health care providers may also establish new patient relationships with members via audio-only synchronous interactions, see Email, Phone, & Fax section for more information.

The amount reimbursed by DHCS to Medi-Cal enrolled fee-for-service health care providers and by Medi-Cal managed care plans to contracted providers for Medi-Cal covered services rendered via telehealth modalities are the same as the amount paid for the applicable service when rendered in-person.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025). Pg. 2, 6. (Accessed Jan. 2026).

Medi-Cal covered benefits or services, identified by CPT or HCPCS codes and subject to all existing Medi-Cal coverage and reimbursement policies, including any treatment authorization request requirements, may be provided via a telehealth modality, as outlined in this section, only if all of the following are satisfied:

• The treating health care provider at the distant site believes that the benefits or services being provided are clinically appropriate based upon evidence-based medicine and/or best practices to be delivered via telehealth;
• The benefits or services delivered via telehealth meet the procedural definition and components of the CPT or HCPCS code(s), as defined by the American Medical Association (AMA), associated with the Medi-Cal covered service or benefit, as well as any extended guidelines as described in this section of the Medi-Cal provider manual;
• The benefits or services provided via telehealth meet all laws regarding confidentiality of health care information and a patient’s right to his or her medical information.

Covered benefits or services provided via a telehealth modality are reimbursable when billed as follows:

• For services or benefits provided via synchronous, interactive audio and visual telecommunications systems, the health care provider bills with modifier 95.
• For services or benefits provided via asynchronous interactions, including store and forward, telecommunications systems, the health care provider bills with modifier GQ.
• For services or benefits provided via synchronous interactions, including telephone or other real-time interactive audio-only telecommunications systems, the health care provider bills with modifier 93.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025). Pg. 10. (Accessed Jan. 2026).

CA Medicaid and Medi-Cal managed care plans are required to reimburse health care providers of applicable health care services delivered via video synchronous interaction, synchronous audio-only modality, or asynchronous store and forward, as applicable, at payment amounts that are not less than the amounts the provider would receive if the services were delivered via in-person, face-to-face contact, so long as the services or settings meet the applicable standard of care and meet the requirements of the service code being billed.

In-person, face-to-face contact between a health care provider and a patient is not required under the Medi-Cal program for covered health care services and provider types designated by the department, when provided by video synchronous interaction, asynchronous store and forward, as defined in subdivision (a) of Section 2290.5 of the Business and Professions Code, audio-only synchronous interaction, remote patient monitoring, or other permissible virtual communication modalities, when those services and settings meet the applicable standard of care and meet the requirements of the service code being billed.

Applicable health care services appropriately provided through video synchronous interaction, asynchronous store and forward, audio-only synchronous interaction, remote patient monitoring, or other permissible virtual communication modalities are subject to billing, reimbursement, and utilization management policies imposed by the department. Utilization management protocols adopted by the department pursuant to this section shall be consistent with, and no more restrictive than, those authorized for health care service plans pursuant to Section 1374.13 of the Health and Safety Code.

Pursuant to an effective date designated by the department that is no sooner than January 1, 2024, a provider furnishing services through video synchronous interaction or audio-only synchronous interaction shall also maintain and follow protocols to do one of the following:

• Offer those services via in-person, face-to-face contact.
• Arrange for a referral to, and a facilitation of, in-person care that does not require a patient to independently contact a different provider to arrange for that care. (This clause does not require a provider to schedule an appointment with a different provider on behalf of a patient.)

In implementing this subdivision, the department shall consider additional recommendations from affected stakeholders regarding the need to maintain access to in-person services without unduly restricting access to telehealth services.

SOURCE: Welfare and Institutions Code 14132.725. (Accessed Jan. 2026).

In-person contact between a health care provider and a patient shall not be required under the Medi-Cal program for services appropriately provided through telehealth, subject to reimbursement policies adopted by the department to compensate a licensed health care provider who provides health care services through telehealth that are otherwise reimbursed pursuant to the Medi-Cal program.

SOURCE: Sec. 14132.72 of the Welfare and Institutions Code. (Accessed Jan. 2026).

Patient Choice of Telehealth Modality

Medi-Cal providers can offer a variety of telehealth modalities for covered Medi-Cal services to the extent that the service can be appropriately rendered via the allowable telehealth modalities. However, health care providers are not required to offer telehealth modality options, although DHCS strongly encourages them to do so to promote greater access to care and reduce barriers. Providers who choose to offer telehealth modalities are required to offer members the ability to choose whether they want to receive covered Medi-Cal services via:

• Synchronous, interactive audio/visual telecommunication systems (for example, video) or
• Synchronous, telephone or other interactive audio-only telecommunications systems.

While Medi-Cal providers may offer both video and audio-only (telephone) telehealth modalities, members may freely choose, and change at any time, their desired telehealth modalities, which includes the ability to decline video modalities and select audio-only (telephone) modalities if preferred and/or necessary given the member’s needs. For example, if the visit is related to sensitive services as defined in subsection (s) of Section 56.05 of the Civil Code, then the member may prefer to utilize an audio-only (telephone) modality. Members shall be given the choice of how they receive their covered Medi-Cal benefits and services that may be delivered appropriately via telehealth modalities.

Exception to Telehealth Modalities Provider Requirement

Since broadband is necessary to ensure quality and effective visual communication between Medi-Cal providers and members, Medi-Cal providers are exempt from the requirement to offer both telehealth modalities if the Medi-Cal provider does not have access to broadband. Note: Broadband refers to high-speed internet access that is always on and faster than traditional dial-up access. Broadband includes several high-speed transmission technologies, such as fiber, wireless, satellite, digital subscriber line, and cable. For the purposes of delivering telehealth services to members, DHCS uses the Federal Communications Commission’s (FCC) definition of broadband and the FCC minimum mbps upload/download speeds. Medi-Cal providers claiming this exception must maintain appropriate supporting documentation, which should be made available to DHCS upon request. For example, supporting documentation might include confirmation from an internet services provider regarding the lack of broadband service in a particular coverage area.

Right to In-person Services

Health care providers furnishing services to members through telehealth modalities must also either offer services in-person or have a documented process in place to link members to in-person care within a reasonable time if in-person services are unavailable from the health care provider.

If the health care provider chooses to link the member to in-person care to satisfy this requirement, then they must provide a referral to and facilitation of in-person care that does not require a member to independently contact a different health care provider to arrange for such care. The health care provider may initiate a process by which a different health care provider in their office or an affiliated in-person care site contacts the member directly to schedule an in-person visit.

The referring health care provider or a member of their staff must confirm they have at least attempted to contact the member to schedule an in-person appointment. However, the referring health care provider is not required to schedule an appointment with a different provider on behalf of the member. The health care provider must offer referral and facilitation support that is minimally burdensome to the member.

Health care providers must maintain documentation of their process to link members to in person care, which should be made available to DHCS upon request.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025). Pg. 8-9; Medi-Cal: Family PACT – Benefits: Clinical Services Overview (May 2024), p. 10. (Accessed Jan. 2026).

Managed Care

To ensure proper payment and record of Covered Services provided via Telehealth, all Providers must use the modifiers defined in the Medi-Cal Provider Manual with the appropriate CPT-4 or HCPCS codes when coding for services delivered through both synchronous interactions and asynchronous store and forward telecommunications. Regarding the rate of reimbursement, unless otherwise agreed to by the MCP and Provider, MCPs must reimburse Network Providers at the same rate, whether a Covered Service is provided in-person or through Telehealth, if the service is the same regardless of the modality of delivery, as determined by the Provider’s description of the service on the claim.

SOURCE: CA Department of Health Care Services (DHCS). All Plan Letter 23-007: Telehealth Services Policy. Apr. 10, 2023. (Accessed Jan. 2026).

Brief Virtual Communications and Check-ins

Virtual or telephonic communication includes a brief communication initiated by the member between a health care provider and a member when the member is not physically present (in-person). The member must already have an established patient relationship with the health care provider. This code cannot be used to establish a new patient relationship. Health care providers may be reimbursed using HCPCS code G2010 or CPT code 98016 for brief virtual communications.

HCPCS code G2010: Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 hours, not originating from a related evaluation and management (E/M) service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment.

CPT code 98016: Brief communication technology-based service by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related E&M service provided within the previous seven days nor leading to an E&M service or procedure within the next 24 hours or soonest available appointment; five to 10 minutes of medical discussion. Code 98016 can be billed when the virtual communication is via a telephone call.

The brief virtual communication policy is not applicable for FQHCs, RHCs, or IHS-MOA , or Tribal FQHC Clinics, and they may not separately bill for it.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025). Pg. 15. (Accessed Jan. 2026).

Federally Qualified Health Center (FQHC) & Rural Health Clinic (RHC) 

Telehealth services must meet all billing requirements that would have applied if the applicable services were delivered via a face-to-face encounter with a billable provider and meet the applicable standard of care.

Services rendered via telehealth must be FQHC or RHC covered services.  Synchronous interaction means a real-time audio-visual, two-way interaction between a new or established patient and an FQHC or RHC billable provider at a distant site. Medi-Cal benefits or services being provided are clinically appropriate and meet the procedural and billing requirements that would have applied if the applicable services were delivered via a face-to-face encounter. An FQHC patient who receives telehealth services shall otherwise be eligible to receive in-person services from the FQHC pursuant to the federal Health Resources Services Administration requirements. A patient may be “established” via synchronous interaction if all of the conditions of the “New Patient” requirements in this manual section are met.

Telehealth services are billed utilizing existing claiming processes that include billing the appropriate managed care plan first. If applicable, once the managed care plan payment is received, submit the claim to the Med-Cal Fiscal Intermediary for the Prospective Payment System (PPS) rate wrap. FQHCs and RHCs must use the appropriate telehealth modifier when billing for the covered service.

See manual for billing examples.

In regard to patient choice of telehealth modality and right to in-person services requirements, FQHC/RHC providers are directed to refer to the policies found in more detail in the Telehealth Manual.

SOURCE: CA Dept. of Health Care Services, Part 2 Manual, Medi-Cal Rural Health Clinics and Federally Qualified Health Centers (Nov. 2025), p. 12, 15-17. (Accessed Jan. 2026).

Visits shall also include an encounter between an FQHC or RHC patient and a physician, physician assistant, nurse practitioner, certified nurse-midwife, clinical psychologist, licensed clinical social worker, licensed professional clinical counselor, visiting nurse, comprehensive perinatal services program practitioner, dental hygienist, dental hygienist in alternative practice, or marriage and family therapist using video synchronous interaction, when services delivered through that interaction meet the applicable standard of care and are eligible for federal financial participation. A visit described in this clause shall be reimbursed at the applicable FQHC’s or RHC’s per-visit PPS rate to the extent the department determines that the FQHC or RHC has met all billing requirements that would have applied if the applicable services were delivered via a face-to-face encounter.

An FQHC or RHC is not precluded from establishing a new patient relationship through video synchronous interaction. An FQHC or RHC furnishing services through video synchronous interaction or audio-only synchronous interaction shall also do one of the following:

• Offer those services via in-person, face-to-face contact.
• Arrange for a referral to, and a facilitation of, in-person care that does not require a patient to independently contact a different provider to arrange for that care.

SOURCE: Welfare and Institutions Code 14132.100 (slight updates to this section scheduled to take effect July 1, 2026 pursuant to AB 116 (2025 Session). (Accessed Jan. 2026).

Indian Health Services, Memorandum of Understanding Agreement (IHS-MOA)

Services rendered via telehealth must be IHS-MOA covered services.

Services provided through synchronous telehealth for an established patient are subject to the same program restrictions, limitations and coverage that exist when the service is provided in-person.

• IHS-MOA clinics must submit claims for telehealth services using the appropriate per visit IHS-MOA billing codes, modifiers and related claims submission requirements. Providers may refer to the Indian Health Services (IHS), Memorandum of Agreement (MOA) 638, Clinics: Billing Codes section in the appropriate Part 2 manual.
• IHS-MOA clinics are not eligible to bill an originating site fee or transmission charges. The costs of these services should be included in the IHS-MOA rate.

See manual for billing examples.

SOURCE: CA Department of Health Care Services (DHCS).  Indian Health Services, Memorandum of Agreement (MOA) 638, Clinics Manual. Nov. 2025. Pg. 8. (Accessed Jan. 2026).

Family PACT

Family PACT providers must ensure that the covered Family PACT service or benefit being delivered via telehealth meets the procedural definition and components of the CPT or HCPCS code(s) associated with the Family PACT covered service or benefit, as well as any other requirements described in this manual. In addition, Family PACT services rendered by the use of a telehealth modality must follow ICD-10-CM diagnosis code billing policy as noted in this manual. All healthcare practitioners rendering Family PACT covered benefits or services under this policy must comply with all applicable state and federal laws.

SOURCE: CA Department of Health Care Services.  Family Planning, Access, Care and Treatment Program. Benefits Manual. May 2024, Pg. 7. (Accessed Jan. 2026).

A Family PACT provider may enroll and recertify clients through synchronous video or audio-only synchronous telehealth modalities. See manual for more information.

SOURCE: CA Department of Health Care Services. Family PACT Client Eligibility Manual. Apr. 2023. Pg. 1. (Accessed Jan. 2026).

Local Educational Agency (LEA)

LEAs may bill for covered direct medical services under the LEA Medi-Cal Billing Option Program according to the following guidelines. All LEA services covered under the LEA Medi-Cal Billing Option Program may be billed by participating LEAs when performed via telehealth, except for services that preclude a telehealth modality, such as specialized medical transportation services. Services delivered via telehealth must meet the requirements described in the Medi-Cal provider manual.

Practitioners must use the “LEA Services Billing Codes Chart” in the Local Educational Agency (LEA) Billing Codes and Reimbursement Rates provider manual section to find LEA services that are reimbursable when rendered by telehealth. The first column of the chart indicates “Add modifier 95 if via telehealth” when the telehealth service is reimbursable under the LEA Medi-Cal Billing Option Program.

SOURCE: CA Department of Health Care Services (DHCS). Local Education Agency (LEA) Telehealth. Nov. 2025. Pg. 1, 5. (Accessed Jan. 2026).

Effective retroactively for dates of service on or after July 1, 2023, CPT^® codes 99402, 99403 and 99404 (preventive medicine counseling and/or risk factor reduction intervention) have been added for Provider Type 55 to allow for additional minutes of service for Health Education and Anticipatory Guidance Individualized Education Plan (IEP)/Individualized Family Services Plan (IFSP) under the Local Educational Agency (LEA) Medi-Cal Billing Option Program (BOP). The chart notes that the codes are eligible via telehealth when billed with the addition of modifier 95.

SOURCE: CA Department of Health Care Services. (DHCS). Addition of CPT Codes for LEA BOP. Apr. 2024. (Accessed Jan. 2026).

Dental Services

The Department of Health Care Services has opted to permit the use of teledentistry (including live video) as an alternative modality for the provision of select dental services.

Synchronous interaction, or live transmission, is a real-time interaction between a member and a provider located at a distant site. Live transmissions are limited to 90 minutes per member per provider, per day.  Please note, live transmissions may be provided at the member’s request or if the health care provider believes the service is clinically appropriate.  See manual for billing codes.

A patient who receives teledentistry services under these provisions shall also have the ability to receive in-person services from the dentist or dental practice or assistance in arranging a referral for in-person services.

SOURCE: CA Department of Health Care Services (DHCS). Dental Provider Handbook. (2025) Pg. 4-29 – 4-30. (Accessed Jan. 2026).

Drug Medi-Cal Treatment Program

A county that enters into a Drug Medi-Cal Treatment Program contract with the department shall reimburse Drug Medi-Cal certified providers for medically necessary Drug Medi-Cal reimbursable services, as defined in Section 14124.24, provided by a licensed practitioner of the healing arts, or a registered or certified alcohol or other drug counselor or other individual authorized by the department to provide Drug Medi-Cal reimbursable services when those services meet the standard of care, meet the requirements of the service code being billed, and are delivered through video synchronous interaction or audio-only synchronous interaction.

SOURCE: Welfare and Institutions Code 14132.731. (Accessed Jan. 2026).

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ELIGIBLE SERVICES/SPECIALTIES

Medi-Cal covered benefits or services, identified by CPT or HCPCS codes and subject to all existing Medi-Cal coverage and reimbursement policies, including any treatment authorization request requirements, may be provided via a telehealth modality if all of the following are satisfied:

• The treating health care provider at the distant site believes that the benefits or services being provided are clinically appropriate based upon evidence-based medicine and/or best practices to be delivered via telehealth;
• The benefits or services delivered via telehealth meet the procedural definition and components of the CPT or HCPCS code(s), as defined by the American Medical Association, associated with the Medi-Cal covered service or benefit, as well as any extended guidelines as described in this section of the Medi-Cal provider manual; and
• The benefits or services provided via telehealth meet all laws regarding confidentiality of health care information and a patient’s right to his or her medical information.

Covered benefits or services provided via a telehealth modality are reimbursable when billed as follows:

• For services or benefits provided via synchronous interactions, interactive audio and visual telecommunications systems, the health care provider bills with modifier 95.
• For services or benefits provided via asynchronous interactions, including store and forward, telecommunications systems, the health care provider bills with modifier GQ.
• For services or benefits provided via synchronous interactions, including telephone or other real-time interactive audio-only telecommunications systems, the health care provider bills with modifier 93.

Certain types of Medi-Cal covered benefits or services that would not be expected to be appropriately delivered via telehealth include, but are not limited to, Medi-Cal covered benefits or services that are performed in an operating room or while the member is under anesthesia, require direct visualization or instrumentation of bodily structures, involve sampling of tissue or insertion/removal of medical devices and/or otherwise require the inperson presence of the member for any reason.

The amount reimbursed by DHCS to Medi-Cal enrolled fee-for-service health care providers and by Medi-Cal managed care plans to contracted providers for Medi-Cal covered services rendered via telehealth modalities are the same as the amount paid for the applicable service when rendered in-person.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025). Pg. 6, 10. (Accessed Jan. 2026).

According to a November 2025 update to Medi-Cal’s Telehealth Manual, Medi-Cal no longer covers ‘e-visits’, defined as non-face-to-face synchronous communications between members and their health care providers through secure, online portals: E-visits are not allowable telehealth modalities for delivery of health care services covered by Medi-Cal.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025). Pg. 3. (Accessed Jan. 2026).

Federally Qualified Health Center (FQHC) & Rural Health Clinic (RHC)

Synchronous interaction means a real-time audio-visual, two-way interaction between a new or established patient and an FQHC or RHC billable provider at a distant site.

Medi-Cal benefits or services being provided are clinically appropriate and meet the procedural and billing requirements that would have applied if the applicable services were delivered via a face-to-face encounter.

A patient may be “established” via synchronous interaction or on an asynchronous store and forward service, if all of the conditions of the “New Patient” requirements in this manual section are met. A patient may not be “established” using an audio-only synchronous interaction unless the visit is related to a “sensitive service”, as defined in the California Civil Code, section 56.05, subdivision (n), or if the patient requests “audio only” or does not have access to video.

SOURCE: CA Department of Health Care Services (DHCS).  Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHC) Outpatient Services Manual. Mar. 2024. Pg. 16. (Accessed Jan. 2026).

Indian Health Services, Memorandum of Understanding Agreement (IHS-MOA)/Tribal FQHCs

Services provided through synchronous telehealth for an established patient are subject to the same program restrictions, limitations and coverage that exist when the service is provided in-person.

• Tribal FQHCs may bill for a telehealth visit if it is medically necessary for a billable provider to be present with a patient during the telehealth visit.
• IHS-MOA clinics/tribal FQHCs must submit claims for telehealth services using the appropriate per visit IHS-MOA billing codes/tribal FQHC all-inclusive billing code sets, modifiers and related claims submission requirements. Providers may refer to the Indian Health Services (IHS), Memorandum of Agreement (MOA) 638, Clinics: Billing Codes section in the appropriate Part 2 manual. Tribal FQHC providers may refer to the Tribal Federally Qualified Health Centers (Tribal FQHCs): Billing Codes section in the appropriate Part 2 manual.

SOURCE: CA Department of Health Care Services (DHCS).  Indian Health Services, Memorandum of Agreement (MOA) 638, Clinics Manual. Nov. 2025, Pg. 7-8; Tribal FQHC Nov. 2025, p. 13. (Accessed Jan. 2026).

FQHCs/RHCs/IHS

Effective September 30, 2024, Federally Qualified Health Center (FQHC), Rural Health Clinic (RHC), Indian Health Services – Memorandum of Agreement (IHS-MOA) and Tribal FQHC providers must submit claims for telehealth services with the applicable telehealth modifier below on the “informational line” of the claim. The modifiers should also be used, with appropriate billing codes, when submitting claims to Managed Care Plans (MCPs).

• 93 – Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system
• 95 – Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system
• GQ – Asynchronous Store and Forward Telecommunications Systems

An Erroneous Payment Correction (EPC) will be implemented to reprocess denied claims with dates of service on or after January 1, 2023, that were appropriately submitted based on the guidance in the previously published article titled, “Coming Soon: Telehealth Modifiers for FQHC, RHC, IHS-MOA and Tribal FQHC Providers,” but erroneously denied because Medi-Cal had not yet implemented the system changes to support appropriate adjudication. Providers may also elect to use this updated billing policy to correct and resubmit previously denied claims as described in the CIF Submission and Timeliness Instructions section of the Provider Manual.

SOURCE: DHCS Medi-Cal Provider News, Sept. 2024. (Accessed Jan. 2026).

Dental Services

Synchronous interaction, or live transmission, is a real-time interaction between a member and a provider located at a distant site. Live transmissions are limited to 90 minutes per member per provider, per day. Please note, live transmissions may be provided at the member’s request or if the health care provider believes the service is clinically appropriate. All dental information transmitted during the delivery of Medi-Cal covered benefits or services via a telehealth modality must become part of the patient’s dental record maintained by the Medi-Cal provider at the distant site.

SOURCE: CA Department of Health Care Services (DHCS). Denti-Cal Manual. 2025. Pg. 4-30. (Accessed Jan. 2026).

Home Health & Durable Medical Equipment

Telehealth may be used to deliver a face-to-face encounter related to the primary reason a recipient requires home health services or a durable medical equipment item.

SOURCE: Department of Health Care Services. Home Health Agencies (HHA) Provider Handbook. (Feb. 2021), Pg. 3. & Department of Health Care Services. Durable Medical Equipment (DME): An Overview. (July 2021), Pg. 6. (Accessed Jan. 2026).

CA Children’s Services (CCS)

CA Children’s Services Program lists eligible CPT/HCPCS codes in Numbered Letters 16-1217 & 09-0718.  Codes specifically include tele-speech, tele-auditory verbal therapy, tele-auditory habilitation and tele-auditory rehabilitation services in the home, with the parent or guardian working with the speech therapist at the distant site.

SOURCE: Number Letter 09-0718 to CA Children’s Services Program.  Jul. 10, 2018.  (Accessed Jan. 2026).

CCS providers must request prior authorization services from CCS paneled physicians (22, CCR Section 41412) who are available to provide telehealth services. Prior authorization requests are also authorized to CCS-approved hospitals and outpatient special care centers. GHPP providers must be Medi-Cal enrolled providers.

Physical and Occupational Therapy may be offered through appropriate telehealth modalities. Medical Therapy Unit therapists may offer remote/virtual teletherapy services as an alternative to in-person visits, as appropriate and directed by the Medical Therapy Conference and directing physicians. CCS clients receiving services through a Special Care Center and/or Medical Therapy Program Medical Therapy Conference must have an annual in-person evaluation by a CCS-paneled physician. GHPP clients require an annual evaluation to ensure continued program coverage.

Billing for telehealth services is contingent upon the CCS Program or GHPP clients meeting all eligibility criteria, with an approved CCS Program/GHPP SAR, and in conformance with required Medi-Cal claims submission procedures as outlined in the DHCS Medi-Cal Telehealth Policy.

• When submitting a SAR for synchronous telemedicine services, the provider must use codes provided in the American Medical Association (AMA’s) CPT Manual, Appendix P.
• Telehealth modifiers (93, 95 or GQ) are required on SARs to differentiate the telehealth service from the equivalent in-person service.
• For services or benefits provided via synchronous, interactive audio, and telecommunications systems, the health care provider bills with modifier 95.
• For services or benefits provided via synchronous, telephone or other interactive audio-only telecommunications systems, the health care provider bills with modifier 93.
• For services or benefits provided via asynchronous store-and-forward telecommunications systems, the health care provider bills with modifier GQ.

For Whole Child Model (WCM) counties, the client’s managed care plan (MCP) shall be responsible for authorizing, coordinating, and covering CCS telehealth services.

SOURCE: Department of Health Care Services. Numbered letter 03-0723 to the Children’s Services Program and Genetically Handicapped Persons Program (GHPP). Jul. 7, 2023 – supersedes Department of Health Care Services. Numbered letter 16-1217 to the CA Children’s Services Program and Genetically Handicapped Persons Program (GHPP). Dec. 22, 2017. (Accessed Jan. 2026).

Opioid Use Disorder Treatment Services

Outpatient treatment services for opioid use disorder (OUD), which include management, care coordination, psychotherapy and counseling are reimbursable using HCPCS codes G2086, G2087 and G2088. At least one psychotherapy service must be furnished in order to bill for HCPCS codes G2086 thru G2088. Although the descriptions for these codes refer to “office-based treatment,” these services may be delivered via telehealth when they meet Medi-Cal requirements. See Medi-Cal Telehealth Provider Manual.

HCPCS codes G2086 thru G2088 are not reimbursable for treatment in state-licensed Opioid Treatment Programs as defined in Health and Safety Code Section 11875. HCPCS codes G2086 and G2087 each have a frequency limit of once per calendar month, per recipient, any provider and G2088 has a frequency limit of two per calendar month, per recipient, any provider. Only one provider can be reimbursed for HCPCS code G2086, G2087 or G2088 per calendar month.

SOURCE: Department of Health Care Services. Evaluation & Management Manual. Page 39. Nov. 2025 (Accessed Jan. 2026).

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ELIGIBLE PROVIDERS

Health care providers rendering Medi-Cal covered benefits or services using telehealth modalities must meet the requirements of Business and Professions Code (B&P Code), Section 2290.5(a)(3), or must be otherwise designated by the Department of Health Care Services (DHCS) pursuant to WIC Section 14132.725 (b)(2)(A). Health care providers must satisfy all Medi-Cal provider enrollment requirements.

Health care providers rendering Medi-Cal covered benefits or services via a telehealth modality must be licensed in California and enrolled as a Medi-Cal rendering provider or affiliated with an enrolled Medi-Cal provider group that is physically located in California. The enrolled Medi-Cal provider group for which the health care provider renders services via telehealth must meet all Medi-Cal program enrollment requirements and must be located in California or a border community.

Note: Subject to very limited exceptions for some provider types established by DHCS, all health care providers must meet Established Place of Business (EPOB) requirements (California Code of Regulations, Title 22, section 51000.60). As a result, the EPOB requirement does not apply to fully remote, non-California based health care providers who offer services exclusively through telehealth modalities or at an administrative location that does not meet all EPOB and/or other Medi-Cal provider enrollment requirements.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025). Pg. 5. (Accessed Jan. 2026).

Federally Qualified Health Center (FQHC) & Rural Health Clinic (RHC)

Billable providers are eligible to deliver covered FQHC/RHC services. Providers may refer to “RHC/FQHC Covered Services” in this manual section.

Telehealth services must meet all billing requirements that would have applied if the applicable services were delivered via a face-to-face encounter with a billable provider and meet the applicable standard of care. An FQHC patient who receives telehealth services shall otherwise be eligible to receive in-person services from that FQHC pursuant to Health Resources Services Administration requirements.

SOURCE: CA Department of Health Care Services (DHCS).  Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHC) Outpatient Services Manual. Nov. 2025. Pg. 12, 16. ( (Accessed Jan. 2026).

Indian Health Services, Memorandum of Understanding Agreement (IHS-MOA)

Billable providers are eligible to deliver available services offered under IHS-MOA services.

SOURCE: CA Department of Health Care Services (DHCS). Indian Health Services, Memorandum of Agreement (MOA) 638, Clinics Manual. Nov. 2025. Pg. 7-8. (Accessed Jan. 2026).

Dental Professionals

For Medi-Cal dental benefits or services, Medi-Cal enrolled dentists and allied dental professionals (under the supervision of a dentist) may render limited services via synchronous/live transmission teledentistry, so long as such services are within their scope of practice, when billed using CDT code D9995 for dates of service on or after May 16, 2020.

SOURCE: CA Department of Health Care Services (DHCS). Denti-Cal Manual. 2025. Pg. 4-30-31. (Accessed Jan. 2026).

Psychiatrists

Psychiatrists may bill for services delivered through telehealth in accordance with the Medicaid state plan.

SOURCE: Sec. 14132.73 of the Welfare and Institutions Code. (Accessed Jan. 2026).

Doula, Community Health Worker (CHW) and Asthma Preventive Services

Doulas may provide services described in the Doula Services manual via synchronous telehealth.

CHWs may provide services described in the Community Health Worker (CHW) Preventive Services manual via synchronous telehealth. CHWs may not provide services via store and forward.

Asthma preventive education and training services described in the Asthma Preventive Services (APS) manual may be provided via synchronous telehealth by unlicensed asthma preventive service providers. In-home environmental trigger assessments for asthma may not be conducted via telehealth and must be conducted in-person.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025). Pg. 5. (Accessed Jan. 2026).

Non-Physician Medical Practitioners

Licensed Midwife Code – T1014 Telehealth.

SOURCE: CA Dept. of Health Care Services, Medi-Cal, Non-Physician Medical Practitioners, May 2025, p. 24. (Accessed Jan. 2026).

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ELIGIBLE SITES

“Originating site” means a site where a member is located at the time Medi-Cal covered benefits or services are provided via synchronous interaction using a telecommunications system or where the asynchronous interaction, including store and forward, originates. For purposes of reimbursement for Medi-Cal covered treatment or services provided through telehealth modalities, the originating site is not limited (WIC Section 14132.72[e]) and may include, but is not limited to, a hospital, medical office, community clinic, or the member’s home.

“Distant site” means a site where the rendering health care provider is located while providing Medi-Cal covered benefits or services via a telecommunications system.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025). Pg. 1. (Accessed Jan. 2026).

Federally Qualified Health Center (FQHC) & Rural Health Clinic (RHC)

The billable provider, employed or under direct contract with an FQHC or RHC can respond from any location, including their home, during a time that they are scheduled to work for the FQHC or RHC.

For the purposes of payment for covered treatment or services provided through telehealth, the department shall not limit the type of setting where services are provided for the patient or by the health care provider.

SOURCE: CA Department of Health Care Services (DHCS).  Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHC) Outpatient Services Manual. Nov. 2025. Pg. 17. (Accessed Jan. 2026).

Indian Health Services, Memorandum of Understanding Agreement (IHS-MOA)

Refers to fee-for-service policy for the definition of an ‘originating site’ and ‘distant site’.

SOURCE: CA Department of Health Care Services (DHCS). Indian Health Services, Memorandum of Agreement (MOA) 638, Clinics Manual. Nov. 2025. Pg. 7. (Accessed Jan. 2026).

Family PACT

“Distant site” means a site where a health care provider who provides health care services is located while providing these services via a telecommunications system. The distant site can be different from the enrolled Family PACT service site for telehealth purposes only.

“Originating site” means a site where a patient is located at the time health care services are provided via a telecommunications system or where the asynchronous store and forward service originates. For purposes of reimbursement for Family PACT covered services provided through telehealth, the type of setting where services are provided for the client or by the health care provider is not limited. The type of setting may include, but is not limited to, an enrolled Family PACT site such as a FQHC, medical office, community clinic, or the client’s home.

SOURCE: CA Department of Health Care Services.  Family Planning, Access, Care and Treatment Program. Benefits Manual. May 2024, Pg. 8. (Accessed Jan. 2026).

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GEOGRAPHIC LIMITS

No Reference Found.

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FACILITY/TRANSMISSION FEE

The originating site facility fee is reimbursable only to the originating site when billed with HCPCS code Q3014 (telehealth originating site facility fee).  Transmission costs incurred from providing telehealth services via audio/video communication is reimbursable when billed with HCPCS code T1014 (telehealth transmission, per minute, professional services bill separately).

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025). Pg. 15. (Accessed Jan. 2026).

FQHC & RHC/IHS-MOA

FQHCs/RHCs/IHS-MOA are not eligible to bill an originating site fee or transmission charges. The costs of these services should be included in the PPS/AIR/IHS-MOA rates, as applicable.

SOURCE: CA Department of Health Care Services (DHCS).  Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHC) Outpatient Services Manual. Mar. 2024. Pg. 13; CA Department of Health Care Services (DHCS). Indian Health Services, Memorandum of Agreement (MOA) 638, Clinics Manual. Nov. 2025. Pg. 8.  (Accessed Jan. 2026).

Local Education Agency

Ancillary costs, such as equipment, technical support, facility fee, and transmission charges incurred while providing telehealth services via audio/video communication are not reimbursable.

SOURCE: CA Department of Health Care Services (DHCS). Local Education Agency (LEA) Telehealth. Jun. 2023. Pg. 5 (Accessed Jan. 2026).

Every Woman Counts Program

Effective retroactively for dates of service on or after November 1, 2013, HCPCS codes Q3014 (telehealth originating site facility fee) and T1014 (telehealth transmission, per minute, professional services bill separately) are benefits of the Every Woman Counts (EWC) program.

SOURCE: Department of Health Care Services. Every Woman Counts Program Manual. Pgs. 44-45. May 2025. (Accessed Jan. 2026).

Rates: Maximum Reimbursement for Optometry Services

T1014 – Telehealth transmission, per minute, profesional services bill separately.

SOURCE: Dept. of Health Care Services, Medi-Cal, Rates: Maximum Reimbursement for Optometry Services, Oct. 2021, p. 6.  (Accessed Jan. 2026).

Last updated 01/08/2026

Miscellaneous

Establishing New Patients via Telehealth

Health care providers may establish new patient relationships with members via two-way, audio-visual synchronous interactions (for example, HIPAA-compliant video conferencing platforms).

In limited circumstances, health care providers may also establish new patient relationships with members via audio-only synchronous interactions only if one or more of the following applies:

• The visit is related to sensitive services as defined in subsection (s) of Section 56.05 of the Civil Code. Section 56.05 (s) of the Civil Code defines “sensitive services” as all health care services related to mental or behavioral health, sexual and reproductive health, sexually transmitted infections, substance use disorder, gender-affirming care, and intimate partner violence, and includes services described in Sections 6924 through 6930 of the Family Code, and Sections 121020 and 124260 of the Health and Safety Code, obtained by a member at or above the minimum age specified for consenting to the service specified in the section.
• The member requests an audio-only modality.
• The member attests that they do not have access to secure video conferencing platforms.

Note: Health care providers may not establish new patient relationships with members via asynchronous telehealth interaction, including store and forward, for any Medi-Cal covered benefit or service.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth. (Nov. 2025), Pg. 4. (Accessed Jan. 2026).

Documentation

All health care providers providing Medi-Cal covered benefits or services to members must maintain appropriate documentation to substantiate the corresponding technical and professional components of billed CPT® or HCPCS codes. Documentation for Medi-Cal covered benefits or services delivered via telehealth should be the same as for a comparable in-person service. The distant site provider can bill for Medi-Cal covered benefits or services delivered via telehealth using the appropriate CPT or HCPCS codes with the corresponding modifier and is responsible for maintaining appropriate supporting documentation. This documentation should be maintained in the member’s medical record.

Health care providers should note the following:

• Health care providers at the distant site must determine that the covered Medi-Cal service or benefit being delivered via telehealth meets the procedural definition and components of the CPT or HCPCS code(s) associated with the Medi-Cal covered service or benefit as well as any other requirements described in this section of the Medi-Cal provider manual.
• Health care providers are not required to document a barrier to an in-person visit for Medi-Cal coverage of services provided via telehealth (WIC, Section 14132.72[d]).
• Health care providers at the distant site are not required to document cost effectiveness of telehealth to be reimbursed for telehealth services or store and forward services.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth. (Nov. 2025), Pg. 6. (Accessed Jan. 2026).

Family PACT

Documentation for benefits or services delivered via telehealth should be the same as for a comparable in-person service. The distant site provider can bill for Family PACT covered benefits or services delivered via telehealth using the appropriate CPT® or HCPCS codes with the corresponding modifier and is responsible for maintaining appropriate supporting documentation. This documentation must be maintained in the client’s medical record.

SOURCE: CA DHCS Medi-Cal Provider Enrollment and Responsibilities Manual. (Oct. 2025). Pg. 19. (Accessed Jan. 2026).

Disabled Individuals

Telehealth services and supports are among the services and supports authorized to be included by individual program plans developed for disabled individuals by regional centers that contract with the State Department of Developmental Disabilities.

SOURCE: Welfare and Institutions Code Sec. 4512. (Accessed Jan. 2026).

FQHCs APM Program

Effective retroactively as of July 1, 2024, the Department of Health Care Services (DHCS) has implemented the Alternative Payment Methodology (APM) for participating Federally Qualified Health Center (FQHC). This new program moves selected FQHCs from a utilization-based reimbursement methodology to a per-member per-month reimbursement methodology. Providers that apply and are selected have two new requirements in addition to the prospective payment system (PPS) requirements. According to the FQHC APM Program Guide, FQHCs are eligible to apply with DHCS to participate in the APM. DHCS anticipates releasing applications for the APM every year, year-over-year. While the APM is voluntary and FQHCs may select the parent NPIs to participate in the APM, all affected sites under each parent NPI’s PPS rate in the APM must participate, including intermittent and mobile units/sites. FQHC application content requirements reference data collection around alternative encounters, including data for alternative patient contacts (including telehealth) and office visit codes billed with telehealth modifiers. Additional information is provided regarding calculating the APM and how alternative encounters will be factored in and not variable in rate setting.

See the included Alternative Care Service Coding guidance which lists the HCPCS and CPT codes that must be used by MCPs and FQHCs for Alternative Encounters for non-traditional providers and/or non-traditional FQHC services. If an alternative care service is provided through telehealth, the additional modifier GQ must be used. All telehealth services must be provided in accordance with DHCS policy.

SOURCE: CA Dept. of Health Care Services. Medi-Cal Provider News: New Alternative Payment Methodology Program for FQHC Providers. Feb. 7, 2025. (Accessed Jan. 2026).

New Public Fee-For-Service Provider Directory

Providers must input information for each of their service locations that are enrolled with Medi-Cal. Provider Portal Organization Administrators and National Provider Identifier (NPI) Administrators will answer a series of questions, including whether providers are offering covered services via telehealth.

SOURCE: CA Dept. of Health Care Services. Medi-Cal Provider News: New Public Fee-For-Service Provider Directory. May 19, 2025; CA Dept. of Health Care Services (DHCS). All Plan Letter 25-014. Sept. 26, 2025; CA Dept. of Health Care Services. BHIN 25-026. Jul. 2025. (Accessed Jan. 2026).

Network Adequacy

Medicaid must ensure that all managed care covered services are available and accessible to enrollees of Medicaid managed care plans in a timely manner. Telehealth can be used as a means to meet time and distance standards in some circumstances.

See APL and recently updated statute for additional details.

SOURCE: CA Welfare and Institutions Code Sec. 14197 as amended by SB 530 (2025 Session) & CA Department of Health Care Services (DHCS). All Plan Letter 23-001: Network Certification Requirements. Jan. 6, 2023. (Accessed Jan. 2026).

Behavioral health plans are permitted to use the synchronous mode of telehealth services to meet network adequacy standards, and/or as a basis for an Alternative Access Standard (AAS) request. However, 85% of members must reside within the required time or distance standards for provider types by zip code. In order to utilize telehealth to fulfill network adequacy requirements for time or distance standards, telehealth services must be provided to members in the defined service area. In addition, the physical location where members receive telehealth services must meet the State’s time or distance standards or approved AAS. If using telehealth to meet either network adequacy standards or AAS, BHPs, IBHPs and DMC-IBHDS’ must submit information to DHCS on their telehealth providers.

See APL for additional details.

SOURCE: CA Department of Health Care Services. Behavioral Health Information Notice 25-013: 2024 Network Certification Requirements for County MHPs and DMC-ODS Plans. Apr. 25, 2025. (Accessed Jan. 2026).

Timely Access Standards – The Department of Health Care Services (DHCS) may allow telehealth appointments to account for Medi-Cal managed care plan (MCP) compliance with timely access standards as long as Members have a right to choose an in-person appointment. If a Provider offers a telehealth appointment sooner than an in-person appointment, DHCS may use the telehealth appointment when calculating the minimum performance level (MPL). See ongoing guidance APL and the following attachments for additional information:

• Attachment A- Network Adequacy Enforcement – MCPs may use various methods to improve their compliance with Network adequacy requirements including, but not limited to, utilizing telehealth, correcting data quality issues, and expanding their Provider Network.
• Attachment B- Timely Access Standards Enforcement – MCPs may use various methods to improve their compliance with timely access requirements including, but not limited to, utilizing Telehealth, electronic consultations, and offering advanced access scheduling when clinically appropriate and Medically Necessary

SOURCE: CA Dept. of Health Care Services. All Plan Letter (APL) 25-006: Timely Access Requirements. Revised Nov. 18, 2025. (Accessed Jan. 2026).

Emergency Clinic Telephonic Services

Telehealth services, telephonic services and other specified services must be reimbursed when provided by specific entities during or immediately following an emergency, subject to the Department obtaining federal approval and matching funds. The Department is required to issue guidance for entities to facilitate reimbursement for telehealth or telephonic services in emergency situations by July 1, 2020.

SOURCE: Welfare and Institutions Code Sec. 14132.723 & 724. (Accessed Jan. 2026).

Privileges/Credentialing

Issues of privileges and credentialing for distant physicians to care for patients via telehealth are determined by the policies of the originating hospital. Hospitals can accept the privileges and credentials for providers at distant hospitals.

SOURCE: Telehealth FAQs, Providers. (Accessed Jan. 2026).

COVID Telehealth Flexibilities

The department shall seek any federal approvals it deems necessary to extend the approved waiver or flexibility implemented pursuant to subdivision (a), as of July 1, 2021, that are related to the delivery and reimbursement of services via telehealth modalities in the Medi-Cal program. Subject to subdivision (e), the department shall implement those extended waivers or flexibilities for which federal approval is obtained, to commence on the first calendar day immediately following the last calendar day of the federal COVID-19 public health emergency period, and through December 31, 2022.

The department may authorize the use of remote patient monitoring as an allowable telehealth modality for covered health care services and provider types it deems appropriate for dates of service on or after July 1, 2021. The department may establish a fee schedule for applicable health care services delivered via remote patient monitoring.

For purposes of informing the 2022–23 proposed Governor’s Budget, released in January 2022, the department shall convene an advisory group consisting of consultants, subject matter experts, and other affected stakeholders to provide recommendations to inform the department in establishing and adopting billing and utilization management protocols for telehealth modalities to increase access and equity and reduce disparities in the Medi-Cal program. The advisory group shall analyze the impact of telehealth in increased access for patients, changes in health quality outcomes and utilization, best practices for the appropriate mix of in-person visits and telehealth, and the benefits or liabilities of any practice or care model changes that have resulted from telephonic visits.

SOURCE: AB 133, Sec. 380 (2021 Session). (Accessed Jan. 2026).

Consent

The department shall develop, in consultation with affected stakeholders, an informational notice to be distributed to fee-for-service Medi-Cal beneficiaries and for use by Medi-Cal managed care plans in communicating to their enrollees. Information in the notice shall include, but not be limited to, all of the following:

• The availability of Medi-Cal covered telehealth services.
• The beneficiary’s right to access all medically necessary covered services through in-person, face-to-face visits, and a provider’s and Medi-Cal managed care plan’s responsibility to offer or arrange for that in-person care, as applicable.
• An explanation that use of telehealth is voluntary and that consent for the use of telehealth can be withdrawn by the Medi-Cal beneficiary at any time without affecting their ability to access covered Medi-Cal services in the future.
• An explanation of the availability of Medi-Cal coverage for transportation services to in-person visits when other available resources have been reasonably exhausted.
• Notification of the beneficiary’s right to make complaints about the offer of telehealth services in lieu of in-person care or about the quality of care delivered through telehealth.

The informational notice shall be translated into threshold languages determined by the department pursuant to subdivision (b) of Section 14029.91 and provided in a format that is culturally and linguistically appropriate.

This subdivision does not apply to Medi-Cal covered services delivered by providers via any telehealth modality to eligible inmates in state prisons, county jails, or youth correctional facilities.

SOURCE: Welfare and Institutions Code 14132.725 (e). (Accessed Jan. 2026).

DHCS Telehealth Research and Evaluation Plan

On or before January 1, 2023, the department shall develop a research and evaluation plan that does all of the following:

• Proposes strategies to analyze the relationship between telehealth and the following: access to care, access to in-person care, quality of care, and Medi-Cal program costs, utilization, and program integrity.
• Examines issues using an equity framework that includes stratification by available geographic and demographic factors, including, but not limited to, race, ethnicity, primary language, age, and gender, to understand inequities and disparities in care.
• Prioritizes research and evaluation questions that directly inform Medi-Cal policy.

SOURCE: Welfare and Institutions Code 14132.725 (g). (Accessed Jan. 2026).

Medi-Cal Telehealth Utilization Dashboard

As part of an overall initiative aimed at monitoring telehealth utilization within Medi-Cal, the Department of Health Care Services (DHCS) is building a foundation to further evaluate telehealth data in the form of data analytics which includes the below Interactive Telehealth Dashboard. The dashboard includes comprehensive data on Medical Services, Mental Health, Drug Medi-Cal, and Dental services related to telehealth utilization, offering insights across multiple years and demographic dimensions. See Telehealth Dashboard and Medi-Cal Telehealth website for more information.

SOURCE: CA Department of Health Care Services. Medi-Cal & Telehealth & CA Department of Health Care Services. Medi-Cal Telehealth Utilization Dashboard. (Accessed Jan. 2026).

HIPAA/Privacy Compliance

Applicable health care services provided through asynchronous store and forward, video synchronous interaction, audio-only synchronous interaction, remote patient monitoring, or other permissible virtual communication modalities as described in this section shall comply with the privacy and security requirements contained in the federal Health Insurance Portability and Accountability Act of 1996 found in Parts 160 and 164 of Title 45 of the Code of Federal Regulations, the Medicaid State Plan, and any other applicable state and federal statutes and regulations.

SOURCE: Welfare and Institutions Code 14132.725 (h). (Accessed Jan. 2026).

Telehealth Requirements

Pursuant to an effective date designated by the department that is no sooner than January 1, 2024, a Medi-Cal provider – including FQHCs/RHCs – furnishing applicable health care services via audio-only synchronous interaction shall also offer those same health care services via video synchronous interaction to preserve beneficiary choice. The department may provide specific exceptions to the requirement based on a Medi-Cal provider’s access to requisite technologies, which shall be developed in consultation with affected stakeholders and published in departmental guidance. In making such exceptions, the department may also take into consideration the availability of broadband access based on speed standards set by the Federal Communications Commission or other applicable federal law or regulation.

Pursuant to an effective date designated by the department that is no sooner than January 1, 2024, a Medi-Cal provider – including FQHCs/RHCs – furnishing applicable health care services via synchronous video interaction or audio-only synchronous interaction shall also offer those same health care services in-person or facilitate access to in-person services for the patient. The department shall consider additional recommendations from affected stakeholders regarding the need to maintain access to in-person services without unduly restricting access to telehealth services.

SOURCE: Welfare and Institutions Code 14132.725 & Welfare and Institutions Code 14132.100 (slight updates to this section scheduled to take effect July 1, 2026 pursuant to AB 116 (2025 Session). (Accessed Jan. 2026).

Patient Choice of Telehealth Modality

Medi-Cal providers can offer a variety of telehealth modalities for covered Medi-Cal services to the extent that the service can be appropriately rendered via the allowable telehealth modalities. However, health care providers are not required to offer telehealth modality options, although DHCS strongly encourages them to do so to promote greater access to care and reduce barriers. Providers who choose to offer telehealth modalities are required to offer members the ability to choose whether they want to receive covered Medi-Cal services via:

• Synchronous, interactive audio/visual telecommunication systems (for example, video) or
• Synchronous, telephone or other interactive audio-only telecommunications systems.

While Medi-Cal providers may offer both video and audio-only (telephone) telehealth modalities, members may freely choose, and change at any time, their desired telehealth modalities, which includes the ability to decline video modalities and select audio-only (telephone) modalities if preferred and/or necessary given the member’s needs. For example, if the visit is related to sensitive services as defined in subsection (s) of Section 56.05 of the Civil Code, then the member may prefer to utilize an audio-only (telephone) modality. Members shall be given the choice of how they receive their covered Medi-Cal benefits and services that may be delivered appropriately via telehealth modalities.

Exception to Telehealth Modalities Provider Requirement

Since broadband is necessary to ensure quality and effective visual communication between Medi-Cal providers and members, Medi-Cal providers are exempt from the requirement to offer both telehealth modalities if the Medi-Cal provider does not have access to broadband. Note: Broadband refers to high-speed internet access that is always on and faster than traditional dial-up access. Broadband includes several high-speed transmission technologies, such as fiber, wireless, satellite, digital subscriber line, and cable. For the purposes of delivering telehealth services to members, DHCS uses the Federal Communications Commission’s (FCC) definition of broadband and the FCC minimum mbps upload/download speeds. Medi-Cal providers claiming this exception must maintain appropriate supporting documentation, which should be made available to DHCS upon request. For example, supporting documentation might include confirmation from an internet services provider regarding the lack of broadband service in a particular coverage area.

Right to In-person Services

Health care providers furnishing services to members through telehealth modalities must also either offer services in-person or have a documented process in place to link members to in-person care within a reasonable time if in-person services are unavailable from the health care provider.

If the health care provider chooses to link the member to in-person care to satisfy this requirement, then they must provide a referral to and facilitation of in-person care that does not require a member to independently contact a different health care provider to arrange for such care. The health care provider may initiate a process by which a different health care provider in their office or an affiliated in-person care site contacts the member directly to schedule an in-person visit.

The referring health care provider or a member of their staff must confirm they have at least attempted to contact the member to schedule an in-person appointment. However, the referring health care provider is not required to schedule an appointment with a different provider on behalf of the member. The health care provider must offer referral and facilitation support that is minimally burdensome to the member.

Health care providers must maintain documentation of their process to link members to in person care, which should be made available to DHCS upon request.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025). Pg. 8-9. (Accessed Jan. 2026).

Medi-Cal Enrollment Procedure and Exemptions for Remote Mental Health Services

Effective March 29, 2023, the Department of Health Care Services (DHCS) is establishing Medi-Cal provider enrollment requirements and procedures that will be exempt from certain established place of business requirements for the following modes of service:

• Remote service providers who offer mental health services exclusively through telehealth modalities, and
• Transportation providers located in California.

In accordance with Welfare & Institutions (W&I) Code Section 14043.75(b), enrollment requirements and procedures are established for providers offering Medi-Cal covered mental health services exclusively through telehealth modalities, including non-specialty mental health services (NSMHS) covered under Medi-Cal Fee-For-Service and Medi-Cal Managed Care Plans and Specialty Mental Health Services (SMHS) covered by county mental health plans, and for Non-Emergency Medical Transportation (NEMT) and Non-Medical Transportation (NMT) providers.

The following provider types are able to apply for enrollment as remote service-only providers:

• Licensed Clinical Social Workers;
• Licensed Marriage and Family Therapists;
• Licensed Professional Clinical Counselors;
• Nurse Practitioners specializing in Psychiatry;
• Physicians specializing in Psychiatry; and
• Psychologists

Remote service providers requesting consideration for enrollment in the Medi-Cal program must complete and submit an application for their appropriate provider type through the Provider Application and Validation for Enrollment (PAVE) portal with the required supporting documents and a completed and signed Remote Services-Only Provider Attestation. For more detailed information, providers may refer to the Requirements and Procedures for the Medi-Cal Enrollment of Providers Offering Services Remotely or Indirectly from their Business Address located on the Provider Enrollment page of the Medi-Cal Provider website.

SOURCE: CA Dept. of Health Care Services. Medi-Cal Update – Psychological Services. Feb. 2023. (Accessed Jan. 2026).

Community-Based Adult Services (CBAS)

CBAS Emergency Remote Services (ERS) are authorized under the California Advancing and Innovating Medi-Cal (CalAIM) 1115 Demonstration Waiver (Waiver) that was implemented October 1, 2022. CBAS supports and services delivered in the community, at the doorstep or in the home, and via telehealth allow for immediate response during participant emergencies. DHCS and MCPs are required to cover ERS as part of the CBAS benefit when participants meet the criteria established in ERS policy, including that ERS is determined to be the appropriate service for the participant and their emergency situation, and the CBAS provider meets the criteria specified in this ACL. See ACL for additional information.

SOURCE: CA Dept. of Health Care Services. All Center Letter 22-04. Launch of New CBAS ERS. Oct. 2023. (Accessed Jan. 2026).

Signature Requirement for Medication Delivery

In accordance with W&I Code, Section 14043.341, providers must obtain either a handwritten or electronic signature for prescription medications sent to a client. Providers may obtain the signature of a client or the recipient either before the medication is sent, or upon receipt when delivered to the client.

Signature Prior to Delivery – Providers have two options to obtain a client’s signature when the client is not in person, such as during a telehealth visit:

• Recorded oral signature: Providers must ensure that they are able to collect an audio or video recording that can be stored in the provider’s case record and retrieved upon request. Providers may use either of the following two options for audio or videorecorded signatures
  • Recording only the signature portion of the telehealth visit. When recording only the signature portion of the visit, providers must record the portion of the visit where the client acknowledges and confirms the medications they will be receiving and provides their understanding that the oral signature holds the same weight as a written signature; or –
  • Recording the entire visit with the oral signature included
• Electronic signature: Providers may obtain an electronic signature. Consistent with the Uniform Electronic Transactions Act, California Civil Code Section 1633.2, an “electronic signature” is an electronic sound, symbol, or process attached to or logically associated with an electronic record and executed or adopted by a person with the intent to sign the electronic record. An electronic signature includes a “digital signature” defined in subdivision (d) of Section 16.5 of the Government Code to mean an electronic identifier, created by a computer, intended by the party using it to have the same force and effect as a manual signature. Regardless of the type of electronic signature collected, providers must ensure that they are able to store and/or easily access documentation of the electronic signature in the client’s medical record

Signature upon Receipt of Delivery – Providers may obtain a client’s handwritten or electric signature upon receipt of delivery if the delivery service offers physical or electronic return receipts, such as those offered through the United States Postal Service. Providers must retain documentation of the signature in the client’s medical record.

SOURCE: CA DHCS Medi-Cal Provider Enrollment and Responsibilities Manual. (Jan. 2025). Pg. 20-21. (Accessed Jan. 2026).

Medi-Cal Managed Care and Behavioral Health Plans – Adult and Youth Screening and Transition of Care Tools for Medi-Cal Mental Health Services

The Screening and Transition of Care Tools for Medi-Cal Mental Health Services guide referrals to the Medi-Cal mental health delivery system (i.e., Medi-Cal Managed Care Plan (MCP) or county Behavioral Health Plan (BHP) that is expected to best support each Member. DHCS is requiring MCPs and BHPs to use the Screening and Transition of Care Tools for Members under age 21 (youth) and for Members ages 21 years and older (adults) unless the member is currently receiving mental health services through the MCP or BHP; or referred directly to a mental health delivery system by a Practitioner based on an understanding of the member’s needs and using their own clinical judgment; or the member reaches out directly to the mental health delivery system.

Screening and transition of care tools may be administered by designated MCP/BHP staff, licensed or unlicensed, who are trained by the MCP/BHP to administer the tools in alignment with MCP/BHP protocols, and may be administered in a variety of ways, including in person, by telephone, or by video conference.

SOURCE: CA Department of Health Care Services (DHCS). All Plan Letter 25-010: Adult and Youth Screening and Transition of Care Tools. Jun. 3, 2025 & DHCS. Behavioral Health Information Notice 25-020: Adult and Youth Screening and Transition of Care Tools. Jun. 3, 2025. (Accessed Jan. 2026).

Last updated 01/08/2026

Out of State Providers

Provider must be licensed in CA, enrolled as a Medi-Cal rendering provider or non-physician medical practitioner (NMP) and affiliated with an enrolled Medi-Cal provider group. The enrolled Medi-Cal provider group for which the health care provider renders services via telehealth must meet all Medi-Cal program enrollment requirements and must be located in California or a border community.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth. (Nov. 2025), Pg. 5.; Welfare and Institutions Code 14132.725. (Accessed Jan. 2026).

Health care providers rendering Medi-Cal covered benefits or services using telehealth modalities must meet the requirements of Business and Professions Code (B&P Code), Section 2290.5(a)(3), or must be otherwise designated by the Department of Health Care Services (DHCS) pursuant to WIC Section 14132.725 (b)(2)(A). Health care providers must satisfy all Medi-Cal provider enrollment requirements.

Subject to very limited exceptions for some provider types established by DHCS, all health care providers must meet Established Place of Business (EPOB) requirements (California Code of Regulations, Title 22, section 51000.60). As a result, the EPOB requirement does not apply to fully remote, non-California based health care providers who offer services exclusively through telehealth modalities or at an administrative location that does not meet all EPOB and/or other Medi-Cal provider enrollment requirements.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth. (Nov. 2025), Pg. 5.(Accessed Jan. 2026).

A person who is licensed as a health care practitioner in another state and is employed by a tribal health program does not need to be licensed in California to perform services for the tribal health program in California or a border community (Business and Professions Code section 719).

SOURCE: CA Department of Health Care Services. Telehealth FAQ. (Accessed Jan. 2026).

Dental providers billing for services delivered via teledentistry must be enrolled as Medi- Cal dental providers. The dental provider rendering MediCal covered benefits or services via a teledentistry modality must be licensed in California, enrolled as a Medi-Cal Dental rendering provider, operate within their allowable scope of practice, and meet applicable standards of care.

SOURCE: CA Department of Health Care Services (DHCS). Medi-Cal Dental Provider Handbook. 2025. Pg. 4-29. (Accessed Jan. 2026).

Last updated 01/04/2026

Overview

Medi-Cal allows providers to decide what modality, live video, store-and-forward, or audio-only, will be used to deliver eligible services to a Medi-Cal enrollee as long as the service is covered by Medi-Cal and meets all other Medi-Cal guidelines and policies, can be properly provided via telehealth, and meets the procedural and definition components of the appropriate CPT or HCPCS code. Medi-Cal also reimburses Medicare CTBS remote patient monitoring and e-consult codes.

Last updated 01/08/2026

Remote Patient Monitoring

POLICY

Remote physiologic monitoring (RPM) services for established patients are reimbursable when ordered by and billed by physicians or other qualified health professionals (QHP). RPM services may be delivered by auxiliary personnel including contracted employees, when under the supervision of the billing physician or qualified health professional.  See manual for codes.

Prior to or at the time RPM services are furnished, the patient must give consent to receive the services. Consent may be verbal (written consent is not required) but must be documented in the medical record, along with justification for the use of RPM services.

SOURCE: CA DHCS Evaluation and Management Manual (Sept. 2025), p. 34-35. (Accessed Jan. 2026).

Medi-Cal reimburses for 5 remote physiologic monitoring codes (99091, 99453, 99454, 99457, 99458), consistent with Medicare Communication Technology Based Services (CTBS) .

SOURCE: CA DHCS Evaluation and Management Manual (Sept. 2025), p. 35; Medi-Cal Rates Information. (Accessed Jan. 2026).

The department may authorize the use of remote patient monitoring as an allowable telehealth modality for covered health care services and provider types it deems appropriate for dates of service on or after July 1, 2021. The department may establish a fee schedule for applicable health care services delivered via remote patient monitoring.

SOURCE: Sec. 14124.12 (f)(1)(B) of the Welfare and Institutions Code. (Accessed Jan. 2026).

Continuous Glucose Monitoring

Effective for dates of service on or after May 1, 2023, CPT^® codes 95250 (ambulatory continuous glucose monitoring [CGM] of interstitial fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professional [office] provided equipment, sensor placement, hook-up, calibration of monitor, patient training, removal of a sensor, and printout of recording) and 95251 (ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpretation and report) are added as Medi-Cal benefits.

SOURCE: Durable Medical Equipment (DME): Billing Codes Manual, Nov. 2023, p. 52. (Accessed Jan. 2026).

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CONDITIONS

Chronic care management (CCM) services are provided when medical and/or psychosocial needs of the patient require establishing, implementing, revising, or monitoring the care plan.

Principal care management (PCM) services are provided when medical and/or psychological needs manifested by a single, complex chronic condition are expected to last at least three months.

See manual for codes.

SOURCE: CA DHCS Evaluation and Management Manual (Oct. 2025), p. 27-30, 32-34. (Accessed Jan. 2026).

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PROVIDER LIMITATIONS

Remote Physiologic Monitoring

Remote physiologic monitoring (RPM) services for established patients are reimbursable when ordered by and billed by physicians or other qualified health professionals (QHP). RPM services may be delivered by auxiliary personnel including contracted employees, when under the supervision of the billing physician or qualified health professional.  See manual for codes.

SOURCE: CA DHCS Evaluation and Management Manual (Sept. 2025), p. 34-35. (Accessed Jan. 2026).

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OTHER RESTRICTIONS

Remote Physiologic Monitoring

Remote physiologic monitoring (RPM) services are reimbursable for established patients.

CPT code 99453 is reimbursable once per episode of care but cannot be used for monitoring fewer than 16 days during a 30-day billing period. CPT code 99454 covers the cost associated with leasing a home-use medical device or devices to and for the patient. The interactive communication required for 99457 must be real-time synchronous with two-way audio with a minimum of 20 minutes per month and the patient must have a treatment plan for chronic care management. For additional information regarding minimum duration of service and definition of episode care, refer to the CPT book.

The frequency limit for 99453, 99454 and 99091 is one per 30 days, any provider. The frequency limit for 99457 is one per calendar month, any provider. The frequency limit for 99458 is three per interactive communication session.

Prior to or at the time RPM services are furnished, the patient must give consent to receive the services. Consent may be verbal (written consent is not required) but must be documented in the medical record, along with justification for the use of RPM services.

SOURCE: CA Department of Health Care Services. Evaluation & Management Manual. Page 34-35. Sept. 2025. (Accessed Jan. 2026).

The department may establish separate fee schedules for applicable health care services delivered via remote patient monitoring or other permissible virtual communication modalities.

SOURCE: Welfare and Institutions Code 14132.725. (Accessed Jan. 2026).

CCM/PCM Services

Chronic care management (CCM) CPT codes 99490 and 99491 each have a frequency limit of once per month any provider. CPT code 99439 has a frequency limit of two per month, any provider. CPT codes 99490, 99491, 99437, 99439 and G0506 are reimbursable when they meet the criteria noted in the manual.

Principal care management (PCM) CPT codes 99424 and 99426 each have a frequency limit of once per calendar month, any provider and 99427 has a frequency limit of two per calendar month, any provider.

SOURCE: CA DHCS Evaluation and Management Manual (Oct. 2025), p. 27-30, 32-34. (Accessed Jan. 2026).

Continuous Glucose Monitoring

CPT codes 95250 and 95251 cannot be reported more than once per month per patient, any provider, regardless of the duration of professional CGM or the number of times CGM is provided in a single month. CPT 95251 cannot be reported in conjunction with CPT 99091.

Refer to the Contracted Continuous Glucose Monitoring (CGM) Systems list and Medical Supplies and Diabetic Supplies: Continuous Glucose Monitoring (CGM) Systems section of the Medi-Cal Rx Provider Manual for coverage criteria, quantity limits and additional billing information.

SOURCE: CA Department of Health Care Services. Durable Medical Equipment (DME): Billing Codes Manual, Nov. 2023, p. 52. (Accessed Jan. 2026).

Last updated 01/08/2026

Store and Forward

POLICY

Asynchronous interaction, including “store and forward,” means the transmission of a member’s medical information (for example, images, videos, laboratory and medical records, or other documents/information) from an originating site to the health care provider at a distant site. This is commonly used in the areas of teledermatology (for example, skin condition images), teleradiology (for example, X-rays, CT scans, etc.), and teleopthamaology (for example, retina images). It does not include store and forward initiated by the member. See the “Brief Virtual Communication” policy in this section for asynchronous interaction, including store and forward, initiated by the member.

Note: This policy does not include consultations via asynchronous electronic transmission through mobile telephone applications, emails, online questionnaires or fillable forms, chats and text messages.

Synchronous vs. Asynchronous Interaction

• Synchronous Interaction
  • Real-time (live interaction)
  • Two-way, interactive
  • Video conferencing or telephone
  • Typically requires advance scheduling by the health care provider and simultaneous communication between member and health care provider.
• Asynchronous Interaction
  • Not real-time (data or imagine sent for review, may be later)
  • One-way, non-interactive
  • HIPAA-compliant messaging platform, image upload system
  • No advance scheduling required and information can be sent anytime. Interaction initiated by the provider. Member and health care provider have increased flexibility.

“E-consults” are a specific type of asynchronous interaction that falls under the auspice of store and forward. E-consults are asynchronous health record consultation services that provide an assessment and management service in which the member’s treating health care provider (attending or primary) requests the opinion and/or treatment advice of another health care provider (consultant) with specific specialty expertise to assist in the diagnosis and/or management of the member’s health care needs without face-to-face contact with the consultant provider. E-consults between health care providers are designed to offer coordinated multidisciplinary case reviews, advisory opinions and recommendations of care. E-consults are permissible only between health care providers.

“E-visits” are non-face-to-face synchronous communications between members and their health care providers through secure, online portals. E-visits are not allowable telehealth modalities for delivery of health care services covered by Medi-Cal.

“Brief virtual communications” are short/limited duration communications with members who already have an established patient relationship with a health care provider using either synchronous telehealth or asynchronous telehealth interactions (for example, recorded videos or images).

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025). Pg. 2-3. (Accessed Jan. 2026).

CA Medicaid and Medi-Cal managed care plans are required to reimburse health care providers of applicable health care services delivered via video synchronous interaction, synchronous audio-only modality, or asynchronous store and forward, as applicable, at payment amounts that are not less than the amounts the provider would receive if the services were delivered via in-person, face-to-face contact, so long as the services or settings meet the applicable standard of care and meet the requirements of the service code being billed.

A health care provider shall not establish a new patient relationship with a Medi-Cal beneficiary via asynchronous store and forward, telephonic (audio-only) synchronous interaction, remote patient monitoring, or other virtual communication modalities. The department may provide for specific exceptions to this prohibition, which shall be developed in consultation with affected stakeholders and published in departmental guidance. Additional exceptions apply for audio-only in particular as well. See Email, Phone & Fax Section for audio-only exception information.

In-person, face-to-face contact between a health care provider and a patient is not required under the Medi-Cal program for covered health care services and provider types designated by the department, when provided by video synchronous interaction, asynchronous store and forward, as defined in subdivision (a) of Section 2290.5 of the Business and Professions Code, audio-only synchronous interaction, remote patient monitoring, or other permissible virtual communication modalities, when those services and settings meet the applicable standard of care and meet the requirements of the service code being billed.

Applicable health care services appropriately provided through video synchronous interaction, asynchronous store and forward, audio-only synchronous interaction, remote patient monitoring, or other permissible virtual communication modalities are subject to billing, reimbursement, and utilization management policies imposed by the department. Utilization management protocols adopted by the department pursuant to this section shall be consistent with, and no more restrictive than, those authorized for health care service plans pursuant to Section 1374.13 of the Health and Safety Code.

SOURCE: Welfare and Institutions Code 14132.725. (Accessed Jan. 2026).

Brief Virtual Communications and Check-ins

Virtual or telephonic communication includes a brief communication initiated by the member between a health care provider and a member when the member is not physically present (in-person). The member must already have an established patient relationship with the health care provider. This code cannot be used to establish a new patient relationship. Health care providers may be reimbursed using HCPCS code G2010 or CPT code 98016 for brief virtual communications.

HCPCS code G2010: Remote evaluation of recorded video and/or images submitted by an established patient (for example, store and forward), including interpretation with follow-up with the patient within 24 hours, not originating from a related E&M service provided within the previous seven days nor leading to an E&M service or procedure within the next 24 hours or soonest available appointment.

The brief virtual communication policy is not applicable for FQHCs, RHCs, or IHS-MOA , or Tribal FQHC Clinics, and they may not separately bill for it.

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025). Pg. 15. (Accessed Jan. 2026).

FQHCs/RHCs 

Asynchronous store and forward means the transmission of a patient’s medical information from an originating site to the billable provider at a distant site.

Medi-Cal benefits or services being provided are clinically appropriate and meet the procedural and billing requirements that would have applied if the applicable services were delivered via a face-to-face encounter.

A patient may be “established” on an asynchronous store and forward service, if all of the conditions of the “New Patient” requirements in this manual section are met.

Only one visit or store and forward service may be billed at the PPS rate when there is a service payment contract with a non-FQHC/RHC, contractor, or another FQHC or RHC. Conversely, the non-FQHC/RHC or contractor may request fee-for-service reimbursement for a visit or store and forward service directly from the appropriate managed care plan or the Medi-Cal Fiscal Intermediary if no service payment contract exists with the FQHC or RHC.

FQHCs and RHCs must use the appropriate telehealth modifier when billing for the covered service.

RHCs and FQHCs cannot use billing codes G2010 and G2017, which are for Fee-For-Service (FFS) providers. Likewise, effective the end of the COVID-19 public health emergency, code G0071 may not be billed to Medi-Cal.

An e-consult, e-visit, or remote patient monitoring is not a reimbursable telehealth service for FQHCs or RHCs.

SOURCE: CA Department of Health Care Services (DHCS). Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHC) Outpatient Services Manual. Nov. 2025. Pg. 15-17. (Accessed Jan. 2026).

Visits shall also include an encounter between an FQHC or RHC patient and a physician, physician assistant, nurse practitioner, certified nurse-midwife, clinical psychologist, licensed clinical social worker, licensed professional clinical counselor, visiting nurse, comprehensive perinatal services program practitioner, dental hygienist, dental hygienist in alternative practice, or marriage and family therapist using an asynchronous store and forward modality, when services delivered through that modality meet the applicable standard of care. A visit described in this clause shall be reimbursed at the applicable FQHC’s or RHC’s per-visit PPS rate to the extent the department determines that the FQHC or RHC has met all billing requirements that would have applied if the applicable services were delivered via a face-to-face encounter.

An FQHC or RHC is not precluded from establishing a new patient relationship through an asynchronous store and forward modality, as defined in subdivision (a) of Section 2290.5 of the Business and Professions Code, if the visit meets all of the following conditions:

• The patient is physically present at the FQHC or RHC, or at an intermittent site of the FQHC or RHC, at the time the service is performed.
• The individual who creates the patient records at the originating site is an employee or contractor of the FQHC or RHC, or other person lawfully authorized by the FQHC or RHC to create a patient record.
• The FQHC or RHC determines that the billing provider is able to meet the applicable standard of care.
• An FQHC patient who receives telehealth services shall otherwise be eligible to receive in-person services from that FQHC pursuant to HRSA requirements.

SOURCE: Welfare and Institutions Code 14132.100 (slight updates to this section scheduled to take effect July 1, 2026 pursuant to AB 116 (2025 Session). (Accessed Jan. 2026).

Family PACT

“Asynchronous store and forward” means the transmission of a patient’s medical information from an originating site to the health care provider at a distant site. Consultations via asynchronous electronic transmission initiated directly by patients, including through mobile phone applications, are not covered under this policy.

SOURCE: CA Department of Health Care Services. Family Planning, Access, Care and Treatment Program. Benefits Manual. Nov. 2025, Pg. 7-11. (Accessed Jan. 2026).

Managed Care

To ensure proper payment and record of Covered Services provided via Telehealth, all Providers must use the modifiers defined in the Medi-Cal Provider Manual with the appropriate CPT-4 or HCPCS codes when coding for services delivered through both synchronous interactions and asynchronous store and forward telecommunications. Regarding the rate of reimbursement, unless otherwise agreed to by the MCP and Provider, MCPs must reimburse Network Providers at the same rate, whether a Covered Service is provided in-person or through Telehealth, if the service is the same regardless of the modality of delivery, as determined by the Provider’s description of the service on the claim.

SOURCE: CA Department of Health Care Services (DHCS). All Plan Letter 23-007: Telehealth Services Policy. Apr. 10, 2023, Pg. 5. (Accessed Jan. 2026).

Indian Health Services, Memorandum of Understanding Agreement (IHS-MOA)/Tribal FQHCs

A patient may not be “established” on an asynchronous store and forward service with the exception of a homeless patient. Reimbursement is permitted for an established patient by a billable provider at the distant site.

SOURCE: CA Department of Health Care Services (DHCS). Indian Health Services, Memorandum of Agreement (MOA) 638, Clinics Manual. May 2023. Pg. 9; CA Department of Health Care Services (DHCS) Tribal FQHC Manual. Nov. 2025, p. 13. (Accessed Jan. 2026).

Local Education Agency

For purposes of LEA policy, the telehealth definition only includes synchronous, real-time interactions between a patient and a health care provider located at a distant site.

SOURCE: CA Department of Health Care Services (DHCS). Local Education Agency (LEA) Telehealth. Nov. 2025. Pg. 1. (Accessed Jan. 2026).

Dental Services

The Department of Health Care Services has opted to permit the use of teledentistry (includes store-and-forward) as an alternative modality for the provision of select dental services.  See manual for codes and requirements.

DHCS has expanded its teledentistry policy to allow Medi-Cal dental Fee-for-Service (FFS) and Dental Managed Care (DMC) providers the ability to establish new patient relationships through an asynchronous store and forward modality, consistent with Federally Qualified Health Center/Rural health Clinic (FQHC/RHC) providers.

A patient who receives teledentistry services under these provisions shall also have the ability to receive in-person services from the dentist or dental practice or assistance in arranging a referral for in-person services.

A member receiving teledentistry services by store and forward may also request to have real-time communication with the distant dentist at the time of the consultation or within 30 days of the original consultation.

SOURCE: CA Department of Health Care Services (DHCS). Medi-Cal Dental Provider Handbook. 2025. Pg. 4-29 – 4-30. (Accessed Jan. 2026).

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ELIGIBLE SERVICES/SPECIALTIES

Modifier GQ must be used for Medi-Cal covered benefits or services, including, but not limited to, teleophthalmology, teledermatology, teledentistry and teleradiology, delivered via asynchronous store and forward telecommunications systems, including e-consults. Only the service(s) rendered from the distant site must be billed with modifier GQ.

The use of modifier GQ does not alter reimbursement for the CPT or HCPCS code billed. For additional information about policy and billing requirements relating to teledentistry, providers may refer to “Teledentistry” in the Medi-Cal Dental Provider Handbook.

For billing purposes, health care providers must ensure that the documentation, typically images, sent via store and forward be specific to the patient’s condition and adequate for meeting the procedural definition and components of the CPT or HCPCS code that is billed. In addition, all services billed via store and forward, including e-consult, are subject to all existing Medi-Cal coverage and reimbursement policies.

E-Consults

A health care provider at the distant site (consultative provider) may bill for an e-consult with CPT code 99451, described below when the benefits or services delivered meet the procedural definition and components of the CPT code as defined by the AMA as well as any requirements described in this section of the Medi-Cal provider manual.

A health care provider at the originating site (treating/referring provider) may bill for an econsult with CPT code 99452, described below when the benefits or services delivered meet the procedural definition and components of the CPT code as defined by the AMA as well as any requirements described in this section of the Medi-Cal provider manual.

When billing for e-consults, health care providers at the originating and distant sites must clearly document the following information relating to previous and/or pertinent health care services, maintain this information in the patient’s medical record and make it available to DHCS upon request:

• A health care provider at the originating site (treating/referring provider) must create and maintain the following: A record that the e-consult is the result of patient care that has occurred or will occur and relates to ongoing patient management; and A record of a request for an e-consult by the health care provider at the originating site.
• In order to bill for e-consults, the health care provider at the distant site (consultative provider) must create and maintain the following: A record of the review and analysis of the transmitted medical information with written documentation of date of service and time spent; and A written report of case findings and recommendations with conveyance to the originating site.

The health care provider at the distant site (consultant) may use CPT code 99451 to bill for e-consults in conjunction with modifier GQ. The health care provider at the originating site (treating/referring) may use CPT code 99452 to bill for e-consults in conjunction with modifier GQ. See manual for additional requirements specific to each code.

E-consults are not applicable for FQHCs, RHCs, or IHS-MOA clinics.

See Telehealth Modifier Reference Sheet- Organized by Delivery System​​ ​for more information on modifiers.

SOURCE: CA Department of Health Care Services.  Medi-Cal Part 2 General Medicine Manual. Telehealth (Nov. 2025), Pg. 12-14. (Accessed Jan. 2026).

Managed Care

All Providers, with the exception of Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Tribal Health Providers (THPs), are allowed to be reimbursed for consultations provided via a Telehealth modality. These electronic consultations (e-consults) are permissible using the appropriate CPT-4 code, modifier(s), and Medical Record documentation defined in the Medi-Cal Provider Manual. Members cannot initiate e-consults as they are interprofessional interactions, and therefore only permissible between Providers. Providers are permitted to be reimbursed for brief virtual communications that consist of a brief communication with a Member who is not physically present (face-to-face) at the FFS rate. Virtual communications reimbursement for FQHCs, RHCs, and THPs is no longer allowed consistent with the end of the COVID-19 Public Health Emergency on May 11, 2023.

SOURCE: CA Department of Health Care Services (DHCS). All Plan Letter 23-007: Telehealth Services Policy. Apr. 10, 2023. Pg. 3. (Accessed Jan. 2026).

Vision Care

Teleophthalmology and by store and forward means an asynchronous transmission of medical information to be reviewed at a later time by a physician or optometrist at a distant site, where the physician or optometrist at the distant site reviews the medical information without the patient being present in real-time. If the reviewing optometrist identifies a disease or condition requiring consultation or referral pursuant to Section 3041 of the Business and Professions Code, a referral must be made with an appropriate physician and surgeon or ophthalmologist, as required. Teleophthalmology services by store and forward must be billed with modifier GQ (service rendered by store and forward telecommunications system). Only the portion(s) rendered from the distant site (hub) are billed with modifier GQ. The use of modifier GQ does not alter reimbursement for the CPT or HCPCS code billed.

Asynchronous telecommunications system (store and forward telehealth) in single media format does not include telephone calls, images transmitted via facsimile machine, and text messages without visualization of the patient (electronic mail). Audio clips, video clips, still images and photographs must be specific to the patient’s condition and adequate for rendering or confirming a diagnosis and/or treatment plan.

SOURCE: CA Department of Health Care Services, Vision Care: Professional Services Manual. (Nov. 2025), Pg. 5-6. (Accessed Jan. 2026).

Dental Services

For teledentistry services or benefits delivered via asynchronous store and forward, providers must also meet the requirements in state statute (Welfare and Institutions Code [WIC] Section 14132.725[b]).

A member receiving teledentistry services by store and forward may also request to have real-time communication with the distant dentist at the time of the consultation or within 30 days of the original consultation.

Specific teledentistry codes via store-and-forward (see manual) are reimbursed.

Limited Medi-Cal dental services may be rendered via asynchronous store-and-forward using Current Dental Terminology (CDT) code D9996 (Teledentistry – Asynchronous; Information stored and forwarded to dentist for subsequent review), which identifies the services as teledentistry. CDT code D9996 is not reimbursable; instead, the billing dental provider would be reimbursed based upon the applicable CDT procedure code to be paid according to the Schedule of Maximum Allowance (SMA).

SOURCE: CA Department of Health Care Services (DHCS). Medi-Cal Dental Provider Handbook. 2025. Pg. 4-29 – 4-31. (Accessed Jan. 2026).

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GEOGRAPHIC LIMITS

No Reference Found

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TRANSMISSION FEE

SOURCE: CA Department of Health Care Services. Medi-Cal Part 2 General Medicine Manual. Telehealth. (Nov. 2025), Pg. 16. (Accessed Jan. 2026).

FQHC & RHC/Tribal FQHCs/IHS-MOA

These sites are not eligible for the facility or transmission fee.

SOURCE: CA Department of Health Care Services (DHCS).  Indian Health Services, Memorandum of Agreement (MOA) 638, Clinics Manual. Nov. 2025. Pg. 8 & Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHC) Outpatient Services Manual. Mar. 2024. Pg. 13, Tribal FQHC Nov. 2025, p. 13. (Accessed Jan. 2026).

Vision Care

The facility fee is reimbursable to the originating site when billed with HCPCS code Q3014. Transmission costs incurred from providing telehealth services via audio/video communication is also reimbursable for the original site and the consulting provider when billed with HCPCS code T1014. Expenses involving telehealth equipment and telecommunications and transmission costs by Internet service providers will not be reimbursed by Medi-Cal.

SOURCE: CA Department of Health Care Services, Vision Care: Professional Services Manual. (Nov. 2025), Pg. 5. (Accessed Jan. 2026).

Dental Care

Transmission costs associated with store and forward are not payable.

SOURCE: CA Department of Health Care Services (DHCS). Denti-Cal Manual. 2025. Pg. 4-30. (Accessed Jan. 2026).