Kansas

Disclaimer

PLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction. This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.

At A Glance
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MEDICAID REIMBURSEMENT

  • Live Video: Yes
  • Store-and-Forward: No
  • Remote Patient Monitoring: Yes
  • Audio Only: No

PRIVATE PAYER LAW

  • Law Exists: Yes
  • Payment Parity: No

PROFESSIONAL REQUIREMENTS

  • Licensure Compacts: ASLP-IC, EMS, IMLC, NLC, PSY, PTC
  • Consent Requirements: Yes

FQHCs

  • Originating sites explicitly allowed for Live Video:  Yes
  • Distant sites explicitly allowed for Live Video:  Yes
  • Store and forward explicitly reimbursed:  No
  • Audio-only explicitly reimbursed:  No
  • Allowed to collect PPS rate for telehealth:  No

STATE RESOURCES

  1. Medicaid Program: Kansas Medicaid
  2. Administrator: Kansas Dept. of Health and Environment
  3. Regional Telehealth Resource Center: Heartland Telehealth Resource Center
Disclaimer

PLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction. This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.

Last updated 12/06/2022

Audio Only Delivery

Medicaid:  Guidance for Telephonic Delivery for SUD Providers

STATUS: Active, until further notice

Medicaid: Expands Telemedicine to HCBS Services during COVID-19

STATUS: Active, exceptions granted until rescinded

Medicaid: Telemedicine Updates in Response to COVID-19

STATUS: Active, exceptions granted until rescinded

Medicaid: Expansion of Telemedicine Services Allowed by ECI and LEA Providers

STATUS: Active, exceptions granted until rescinded

Medicaid:  Additional Codes Added to Telemedicine

STATUS: Active, exceptions granted until rescinded

Medicaid: Tobacco Cessation Counseling via Telemedicine

STATUS: Active, exceptions granted until rescinded

Medicaid: Additional Telemedicine Coverage for BI Waiver Services During COVID-19

STATUS: Active, exceptions granted until rescinded

Medicaid: SED Waiver Codes Allowed via Telemedicine

STATUS: Active, exceptions granted until rescinded

Medicaid: Additional E/M Codes Allowed via Telemedicine

STATUS: Active, exceptions granted until rescinded

Medicaid:  Expansion of Telemedicine Services for Therapy Services

STATUS: Active, exceptions granted until rescinded

Medicaid:  I/DD Telemedicine Services During COVID-19

STATUS: Active

Medicaid 1915(c) Waiver: Appendix K – Autism; Brain Injury, Frail Elderly, Intellectual & Developmental Disability; Physical Disability; Serious Emotional Disturbance; Technology Assisted Combined

STATUS: Expired January 26, 2021; extended through Addendum

Medicaid 1915(c) Waiver: Appendix K Extension – Autism; Brain Injury, Frail Elderly, Intellectual & Developmental Disability; Physical Disability; Serious Emotional Disturbance; Technology Assisted Combined

STATUS: Active, expires six months post expiration of the federal Public Health Emergency declaration

Last updated 12/06/2022

Cross State Licensing

Medicaid: MCO Non-Network Provider Participation Requirements

STATUS: Active, exceptions granted until rescinded

Medicaid: Telemedicine Updates in Response to COVID-19

STATUS: Active, exceptions granted until rescinded

KS State Board of Healing Arts:  Emergency Action and Guidance

STATUS: Page still active, temporary licenses will automatically cancel Jan. 20, 2023 according to HB 2477.

Last updated 12/06/2022

Easing Prescribing Requirements

Previous COVID-19 waivers expired.

Last updated 12/06/2022

Miscellaneous

Medicaid:  Telemedicine Billing Guidelines During COVID-19

STATUS: Active

Medicaid 1915(c) Waiver: Appendix K – Autism; Brain Injury, Frail Elderly, Intellectual & Developmental Disability; Physical Disability; Serious Emotional Disturbance; Technology Assisted Combined

STATUS: Expired January 26, 2021; extended through Addendum

Medicaid 1915(c) Waiver: Appendix K Extension – Autism; Brain Injury, Frail Elderly, Intellectual & Developmental Disability; Physical Disability; Serious Emotional Disturbance; Technology Assisted Combined

STATUS: Active, expires six months post expiration of the federal Public Health Emergency declaration

Office of the Governor:  Executive Order on Broadband

STATUS: Active, until rescinded

Last updated 12/06/2022

Originating Site

Medicaid: Telemedicine Updates in Response to COVID-19

STATUS: Active, exceptions granted until rescinded

Medicaid: Telemedicine Response to COVID-10 Emergency

STATUS: Active, exceptions granted until rescinded.

Medicaid:  Expansion with Select Telemedicine Allowed Codes/Home Setting

STATUS: Active, exceptions granted until rescinded

Medicaid:  Additional Codes Added to Telemedicine

STATUS: Active, exceptions granted until rescinded

Medicaid: Additional Telemedicine Coverage for BI Waiver Services During COVID-19

STATUS: Active, exceptions granted until rescinded

Medicaid: SED Waiver Codes Allowed via Telemedicine

STATUS: Active, exceptions granted until rescinded

Medicaid: Additional E/M Codes Allowed via Telemedicine

STATUS: Active, exceptions granted until rescinded

Medicaid:  Expansion of Telemedicine Services for Therapy Services

STATUS: Active, exceptions granted until rescinded

Medicaid:  Wheelchair Seating Assessment Codes Allowed by Telemedicine

STATUS: Active, exceptions granted until rescinded

Medicaid:  Allowance of Additional Mental Health Crisis Intervention Codes

STATUS: Active, exceptions granted until rescinded

Medicaid:  I/DD Telemedicine Services During COVID-19

STATUS: Active

Last updated 12/06/2022

Private Payer

No reference found.

Last updated 12/06/2022

Provider Type

Medicaid: Telemedicine Updates in Response to COVID-19

STATUS: Active, exceptions granted until rescinded

Medicaid: Expansion of Telemedicine Services Allowed by ECI and LEA Providers

STATUS: Active, exceptions granted until rescinded

Medicaid: Additional Telemedicine Coverage for BI Waiver Services During COVID-19

STATUS: Active, exceptions granted until rescinded

Last updated 12/06/2022

Service Expansion

Medicaid: Telemedicine Updates in Response to COVID-19

STATUS: Active, exceptions granted until rescinded

Medicaid: Expands Telemedicine to HCBS Services during COVID-19

STATUS: Active, exceptions granted until rescinded

Medicaid:  Telemedicine Billing Guidelines During COVID-19

STATUS: Active

Medicaid: Allowance of T2011 for Tele-Video

STATUS: Active, until rescinded

Medicaid:  Expansion with Select Telemedicine Allowed Codes/Home Setting

STATUS: Active, exceptions granted until rescinded

Medicaid: Expansion of Telemedicine Services Allowed by ECI and LEA Providers

STATUS: Active, exceptions granted until rescinded

Medicaid:  Additional Codes Added to Telemedicine

STATUS: Active, exceptions granted until rescinded

Medicaid: Tobacco Cessation Counseling via Telemedicine

STATUS: Active, exceptions granted until rescinded

Medicaid: Additional Telemedicine Coverage for BI Waiver Services During COVID-19

STATUS: Active, exceptions granted until rescinded

Medicaid: SED Waiver Codes Allowed via Telemedicine

STATUS: Active, exceptions granted until rescinded

Medicaid: Additional E/M Codes Allowed via Telemedicine

STATUS: Active, exceptions granted until rescinded

Medicaid:  Expansion of Telemedicine Services for Therapy Services

STATUS: Active, exceptions granted until rescinded

Medicaid:  Wheelchair Seating Assessment Codes Allowed by Telemedicine

STATUS: Active, exceptions granted until rescinded

Medicaid:  Allowance of Additional Mental Health Crisis Intervention Codes

STATUS: Active, exceptions granted until rescinded

Medicaid:  Revisions to April 2020 NCCI PTP and MUE Files – Telemedicine and COVID-19

STATUS: Active

Medicaid:  I/DD Telemedicine Services During COVID-19

STATUS: Active

Medicaid 1915(c) Waiver: Appendix K – Autism; Brain Injury, Frail Elderly, Intellectual & Developmental Disability; Physical Disability; Serious Emotional Disturbance; Technology Assisted Combined

STATUS: Expired January 26, 2021; extended through Addendum

Medicaid 1915(c) Waiver: Appendix K Extension – Autism; Brain Injury, Frail Elderly, Intellectual & Developmental Disability; Physical Disability; Serious Emotional Disturbance; Technology Assisted Combined

STATUS: Active, expires six months post expiration of the federal Public Health Emergency declaration

Last updated 12/06/2022

Definitions

‘‘Telemedicine,’’ including ‘‘telehealth,’’ means the delivery of healthcare services or consultations while the patient is at an originating site and the healthcare provider is at a distant site. Telemedicine shall be provided by means of real-time two-way interactive audio, visual, or audio-visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support healthcare delivery, that facilitate the assessment, diagnosis, consultation, treatment, education and care management of a patient’s healthcare. ‘‘Telemedicine’’ does not include communication between:

    1. Healthcare providers that consist solely of a telephone voice-only conversation, email or facsimile transmission; or
    2. a physician and a patient that consists solely of an email or facsimile transmission.

SOURCE:  KS Statute Ann. § 40-2,211(5).  (Accessed Dec. 2022).

Last updated 12/06/2022

Parity

SERVICE PARITY

Payment can be limited to only services that are medically necessary, subject to the terms and conditions of the covered individual’s health benefits plan.

SOURCE:  KS Statute Ann. § 40-2,213.  (Accessed Dec. 2022).


PAYMENT PARITY

Payment or reimbursement for covered services delivered through telemedicine may be established by an insurance company, nonprofit health service corporation, nonprofit medical and hospital service corporation or health maintenance organization in the same manner as payment or reimbursement for covered services that are delivered via in-person contact are established.

SOURCE:  KS Statute Ann. § 40-2,213. (Accessed Dec. 2022).

Last updated 12/06/2022

Requirements

Insurers cannot exclude an otherwise covered healthcare service from coverage solely because such service is provided through telemedicine, rather than in-person contact, or based upon the lack of a commercial office for the practice of medicine, when such service is delivered by a healthcare provider.

The insured’s medical record shall serve to satisfy all documentation for the reimbursement of all telemedicine healthcare services, and no additional documentation for telemedicine is required.

SOURCE:  KS Statute Ann. § 40-2,213.  (Accessed Dec. 2022).

The same requirements for patient privacy and confidentiality under the health insurance portability and accountability act of 1996 and 42 C.F.R. § 2.13, as applicable, that apply to healthcare services delivered via in-person contact shall also apply to healthcare services delivered via telemedicine. Nothing in this section shall supersede the provisions of any state law relating to the confidentiality, privacy, security or privileged status of protected health information.

Telemedicine may be used to establish a valid provider-patient relationship.

The same standards of practice and conduct that apply to health-care services delivered via in-person contact shall also apply to healthcare services delivered via telemedicine.

A person authorized by law to provide and who provides telemedicine services to a patient shall provide the patient with guidance on appropriate follow-up care.

SOURCE:  KS Statute Ann. § 40-2,212.  (Accessed Dec. 2022).

 

Last updated 12/06/2022

Definitions

“Telemedicine is the use of communication equipment to link health care practitioners and patients in different locations. This technology is used by health care providers for many reasons, including increased cost efficiency, reduced transportation expenses, improved patient access to specialists and mental health providers, improved quality of care, and better communication among providers.”

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-30 (Aug. 2022). (Accessed Dec. 2022).

‘‘Telemedicine,’’ including ‘‘telehealth,’’ means the delivery of healthcare services or consultations while the patient is at an originating site and the healthcare provider is at a distant site. Telemedicine shall be provided by means of real-time two-way interactive audio, visual, or audio-visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support healthcare delivery, that facilitate the assessment, diagnosis, consultation, treatment, education and care management of a patient’s healthcare.

‘‘Telemedicine’’ does not include communication between:

    1. Healthcare providers that consist solely of a telephone voice-only conversation, email or facsimile transmission; or
    2. A physician and a patient that consists solely of an email or facsimile transmission.

SOURCE:  KS Statute Ann. § 40-2,211(5). & KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-31 (Aug. 2022). (Accessed Dec. 2022).

Telemedicine is the use of communication equipment to link health care practitioners and patients in different locations. This technology is used by health care providers for many reasons, including increased cost efficiency, reduced transportation expenses, improved patient access to specialists and mental health providers, improved quality of care, and better communication among providers.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, p. 8-13 (Aug. 2022). (Accessed Dec. 2022).

Telemedicine is the use of communication equipment to link health care practitioners and individuals in different locations.

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Certified Community Behavioral Health Clinic (CCBHC), p. 8-5 (Oct. 2022). (Accessed Dec. 2022).

Last updated 12/06/2022

Email, Phone & Fax

Telemedicine does not include communication between:

  • A healthcare provider that consists solely of a telephone voice-only conversation, email, or facsimile transmission.
  • A physician and a patient that consists solely of an email or facsimile transmission.

Email, telephone, and facsimile transmissions are not covered as telemedicine services.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-31 & 2-32 (Aug. 2022). (Accessed Dec. 2022).

Email, telephone, and facsimile transmissions are not covered as telemedicine services.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-13, (Aug. 2022). (Accessed Dec. 2022).

Hospital E&M

A “comprehensive exam” is considered a “hands on” specialist examination. Telephone consultation with a specialist is not the equivalent of comprehensive exam.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, FFS Provider Manual, Hospital, p. 8-4 (Aug 2022). (Accessed Dec. 2022).

Last updated 12/06/2022

Live Video

POLICY

Insurers (including Medicaid) cannot exclude from coverage a service solely because the service is provided through telemedicine, rather than in-person contact or based upon the lack of a commercial office for the practice of medicine, when such service is delivered by a healthcare provider.

SOURCE: KS Statute Ann. § 40-2,213(b).  (Accessed Dec. 2022). 

Services provided through telemedicine must be medically necessary and are subject to the terms and conditions of the individual’s health benefits plan.

Payment or reimbursement of covered healthcare services delivered through telemedicine is the payment or reimbursement for covered services that are delivered through personal contact.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p.  2-31-2 (Aug. 2022). (Accessed Dec. 2022).


ELIGIBLE SERVICES/SPECIALTIES

Eligible services:

  • Office visits;
  • Individual psychotherapy;
  • Pharmacological management services.

The consulting or expert provider at the distant site must bill with the 02 place of service code. The GT modifier is not required when billing for telemedicine services.

See manual for list of acceptable CPT codes.  Telemedicine will be reimbursed at the same rate as face-to-face services.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-30 (Aug. 2022) & FQHC/RHC, 8-13 (Aug. 2022), (Accessed Dec. 2022)

Mental health assessment can be delivered by a non-physician at a professional level and delivered either face-to-face or through telemedicine. Some specialized community-based rehabilitation services can be provided face-to-face or via telemedicine.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Mental Health, p. 8-15, 8-22 (Mar. 2022). (Accessed Dec. 2022).

The speech-language pathologist and audiologist may furnish appropriate and medically necessary services within their scope of practice via telemedicine. See manual for list of codes that are deemed appropriate to be furnished via telemedicine by the American Speech-Language and Hearing Association. Codes not appearing on the tables below are not covered via telemedicine.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-29 (Aug 2022), & Rehabilitative Therapy Services, p. 8-5, (Apr. 2022). (Accessed Dec. 2022).

Kansas Medicaid does not authorize the use of telemedicine in the delivery of any abortion procedure.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-32 (Aug 2022). (Accessed Dec. 2022). 

Autism Service

Parent support and training as well as Family Adjustment Counseling can be provided via telemedicine, telehealth, or other modes of video distance monitoring methods that adhere to all required HIPPA guidelines and meet the state standards for telemedicine delivery methods.  This service delivery model is subject to state program manager approval. A request submitted for this exception must include, at a minimum, three written statements from service providers in at least a 50-mile radius declining to provide services because the participant resides in a location that is so remote or far away that the provider does not have the staff to meet with the child on a continual and/or intermittent basis as needed.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Autism Services, p. 8-5 & 8-8 (Nov. 2021). (Accessed Dec. 2022). 

Intellectual/Developmentally Disabled Services

All functional assessments must be conducted in-person at a location of the individual’s choosing, or, if available, through the use of real-time interactive telecommunications equipment that includes, at a minimum, audio and video equipment. Those responsible for conducting the assessment will be flexible in accommodating the individual’s preference for the meeting location and time of assessment.

SOURCE: KS Dept. of Health and Environment, Provider Manual, HCBS Intellectual/Developmentally Disabled, p. I-1 (Jan. 2022). (Accessed Dec. 2022). 

Substance Use Disorder directs providers to General Benefits manual telemedicine section.

SOURCE: KS Dept. of Health and Environment, Provider Manual, Substance Use Disorder, p. 8-10, (Mar. 2022), (Accessed Dec. 2022).

Telehealth and transportation codes are covered codes for OTP services. Please refer to the Kansas Medicaid Telehealth and Non-Emergency Medical Transportation (NEMT) policies.

SOURCE: KS Dept. of Health and Environment, Provider Manual, Professional, p. 8-38, (Oct. 2022), (Accessed Dec. 2022).


ELIGIBLE PROVIDERS

Telemedicine and telehealth services may be delivered by a healthcare provider, which includes:

  • Physicians
  • Licensed Physician Assistants
  • Licensed Advanced Practice Registered Nurses
  • Other persons licensed, registered, certified, or otherwise authorized to practice by the behavioral sciences regulatory board.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-30 (Aug. 2022). (Accessed Dec. 2022). 

The speech-language pathologist and audiologist may furnish appropriate and medically necessary  services within their scope of practice via telemedicine. As documented in related telemedicine policies, telemedicine claims at the distant site must contain place of service 02 (Telehealth distant site).

  • Distant site means a site at which the healthcare provider is located while providing healthcare services by means of telemedicine.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-29 (Aug 2022); Early Childhood Intervention Fee-for-Service Provider Manual, p. 8-5 (Aug. 2022) ; Local Education Agency Services, p. 8-7 (Jan. 2020); & Rehabilitative Therapy Services, p. 8-4, (Apr. 2022). (Accessed Dec. 2022).

Providers who are not RHC or FQHC providers and are acting as the distant site will be reimbursed in accordance with a percentage of the Physician Fee Schedule and not an encounter rate.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-13, (Aug. 2022), (Accessed Dec. 2022).


ELIGIBLE SITES

The speech-language pathologist and audiologist may furnish appropriate and medically necessary services within their scope of practice via telemedicine.  Providers at the originating site may submit claims using code Q3014 (Telehealth originating site facility fee).

  • Originating site means a site at which a patient is located at the time healthcare services are provided by means of telemedicine. The facilitator at the originating site must have the appropriate skill set to safely assist the speech-language pathologist or audiologist to provide safe, effective, and medically necessary services via telemedicine.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-29 (Aug. 2022), & Rehabilitative Therapy Services, p. 8-5, (Apr. 2022). (Accessed Dec. 2022).


GEOGRAPHIC LIMITS

No Reference Found


FACILITY/TRANSMISSION FEE

The originating site, with the member present, may bill code Q3014 with the appropriate POS code.  Providers at the originating site are required to submit claims using code Q3014 (Telehealth originating site facility fee).

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-30 & 32 (Aug. 2022), (Accessed Dec. 2022).

The originating site, with the member present, may bill code Q3014 with POS code 50 or 72 under the originating site provider ID and location number.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, RHC/FQHC Fee-for-Service Provider Manual, Benefits & Limitations, p. 8-13 (Aug. 2022), (Accessed Dec. 2022).

Providers at the originating site may submit claims using code Q3014 (Telehealth originating site facility fee).  Originating site means a site at which a patient is located at the time healthcare services are provided by means of telemedicine. The facilitator at the originating site must have the appropriate skill set to safely assist the speech-language pathologist or audiologist to provide safe, effective, and medically necessary services via telemedicine.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-29 (Aug 2022), (Accessed Dec. 2022).

 

 

Last updated 12/06/2022

Miscellaneous

Home Health Agencies

The face-to-face encounter may occur through telehealth, as implemented by the State.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, FFS Provider Manual, Home Health Agency, p. 8-7 (Nov. 2022). (Accessed Dec. 2022).

Except when otherwise prohibited by any other provision of law, when the patient consents and has a primary care or other treating physician, the person providing telemedicine services will send within three business days a report to such primary care or other treating physician of the treatment and services rendered to the patient in the telemedicine encounter.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-31 (Aug. 2022). (Accessed Dec. 2022).

Hospice

Service Intensity Add-on (SIA) Payment for hospice care is not covered if provided by a social worker via telephone.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, FFS Provider Manual, Hospice, p. 8-11 (Oct. 2022). (Accessed Dec. 2022).

Last updated 12/06/2022

Out of State Providers

No reference found. See Cross-State Licensing Section under Professional Requirements.

Last updated 12/06/2022

Overview

Kansas Medicaid covers live video telemedicine for certain services.  Additionally, they also cover remote patient monitoring that is in real-time through home health agencies and with prior authorization.

All insurers (including Medicaid) must cover medically necessary services, subject to the terms and conditions of the contract. Medicaid specifically must provide reimbursement for speech language pathology services and audiology services.

Last updated 12/06/2022

Remote Patient Monitoring

POLICY

Kansas Medicaid will reimburse for home telehealth. The policy states:

“Home telehealth uses real-time, interactive, audio/video telecommunication equipment to monitor patients in the home setting, as opposed to a nurse visiting the home. This technology may be used to monitor the beneficiary for significant changes in health status, provide timely assessment of chronic conditions and provide other skilled nursing services.”

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Home Health, p. 8-29 (Nov. 2022) (Accessed Dec. 2022).

Home and Community Based Services for the Frail Elderly

“Home Telehealth is a remote monitoring system that enables the participant to effectively manage one or more diseases and catch early signs of trouble so intervention can occur before the participant’s health declines. The provision of Home Telehealth involves participant education specific to one or more diseases (e.g. COPD, CHF, hypertension, and diabetes), counseling, and nursing supervision.

SOURCE:  Kansas Medical Assistance Program, Provider Manual, HCBS Frail Elderly, p. 8-17. (Nov. 2021) (Accessed Dec. 2022).


CONDITIONS

Providers use codes T1030 and T1031 for the provision of telehealth visits under the Long-Term Care Home Health Service Plan and to assist members in managing their diabetes. See specific provider requirements for the provision of telehealth services.

Place of service 02 is used for home telehealth skilled nursing visits.  These codes are per visit.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Home Health, p. AIII-4-AIII-6 AIII-8. (Nov. 2022). (Accessed Dec. 2022).

Home and Community Based Services for the Frail Elderly

Telehealth services (including remote patient monitoring) are provided on an individualized basis for participants who have an identified need in their ISPOC. Participant options and information are provided and discussed during the development of the Integrated Service Plan of Care (ISPOC).  The participant can qualify if either of the following apply:

  • The participant is in need of disease management consultation and education AND has had two or more hospitalizations, including emergency room (ER) visits, within the previous year related to one or more diseases.
  • The participant is using MFP to move from a nursing facility back into the community.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, HCBS Frail Elderly, p. 8-17 & 8-18, (Nov. 2021). (Accessed Dec. 2022).  


PROVIDER LIMITATIONS

Home Telehealth services must be provided by a registered nurse or licensed practical nurse. Agencies may bill skilled nursing services on the same date of service as telehealth services.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Home Health, p. 8-29 (Nov. 2022). (Accessed Dec. 2022). 

 Home and Community Based Services for the Frail Elderly

Must be delivered by a registered nurse or licensed practical nurse with RN supervision.  Providers can include home health agencies or county health departments with system equipment capable of monitoring participant vital signs daily.  This includes (at a minimum) heart rate, blood pressure, mean arterial pressure, weight, oxygen saturation, and temperature. Also, the provider must have the capability to ask the participant questions which are tailored to his or her diagnosis. The provider and equipment must have needed language options such as English, Spanish, Russian, and Vietnamese.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, HCBS Frail Elderly, p. 8-18-19, (Nov. 2021), (Accessed Dec. 2022).


OTHER RESTRICTIONS

Providers must submit literature to the fiscal agent’s Provider Enrollment team pertaining to the telecommunication equipment the agency has chosen that will allow thorough physical assessments such as: assessment of edema, rashes, bruising, skin conditions, and other significant changes in health status.

Providers must satisfy all the enrollment/demonstration requirements. See manual for specific demonstration criteria.

Providers are eligible for reimbursement of home telehealth services that meet the following criteria:

  • Prescribed by a physician or allowed nonphysician practitioner;
  • Considered medically necessary;
  • Signed beneficiary consent for telehealth services;
  • Skilled nursing service;
  • Does not exceed program limitations (two visits per week for non-Home and Community Based Services beneficiaries)

Providers must obtain prior authorization (PA) for member participation in the demonstration process, as PA is required for all fee-for-service home health visits.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Home Health, p. AIII-18-19. (Nov. 2022). (Accessed Dec. 2022).

Home Telehealth Limitations

  • Providers must bill T1030 and T1031 with place of service 02 for home telehealth skilled nursing visits. These codes are per visit.
  • PAs are entered for no more than 60 days. Home telehealth services cannot be approved for durations of more than 60 days. Additional documentation may be required to support continuation of home telehealth service requests that exceed 60 days.
  • Telehealth visits must be provided by a registered nurse or licensed practical nurse.
  • Telehealth visits must use face-to-face, real-time, interactive video contact to monitor beneficiaries in the home setting as opposed to a nurse visiting the home. This technology can be used to monitor a beneficiary’s health status and to provide timely assessments of chronic conditions and other skilled nursing services.
  • HCBS beneficiaries eligible for face-to-face skilled nursing visits provided by a home health agency may receive home telehealth visits with documentation of medical necessity and prior authorization (PA).  The PA must include units to cover the duration and frequency of home telehealth visits. Oral medication administration or monitoring is not considered skilled care.
  • Oral medication administration or monitoring is not considered skilled care.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Home Health, p. AIII-8. (Nov. 2022). (Accessed Dec 2022).

 Home and Community Based Services for the Frail Elderly

See HCBS Frail Elderly provider manual for documentation requirements.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, HCBS Frail Elderly, p. 8-19 & 8-20 (Nov. 2021), (Accessed Dec. 2022).

Last updated 12/06/2022

Store and Forward

POLICY

Kansas Medicaid requires the patient to be present at the originating site indicating store-and-forward will not be reimbursed, despite including store-and-forward in their definition of telemedicine.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-32 (Aug. 2022). (Accessed Dec. 2022).


ELIGIBLE SERVICES/SPECIALTIES

No Reference Found


GEOGRAPHIC LIMITS

No Reference Found


TRANSMISSION FEE

No Reference Found

Last updated 12/06/2022

Cross State Licensing

Notwithstanding any other provision of law, a physician holding a license issued by the applicable licensing agency of another state or who otherwise meets the requirements of this section may practice telemedicine to treat patients located in the state of Kansas, if such physician receives a telemedicine waiver issued by the state board of healing arts. The state board of healing arts shall issue such a waiver within 15 days from receipt of a complete application, if the physician:

  • Submits a complete application that may include evidence in the form of an affidavit from an authorized third party that the applicant meets the requirements of this section in a manner determined by the state board of healing arts and pays a fee not to exceed $100; and
  • holds an unrestricted license to practice medicine and surgery in another state or meets the qualifications required under Kansas law for a license to practice medicine and surgery and is not the subject of any investigation or disciplinary action by the applicable licensing agency.

A physician practicing telemedicine in accordance with this subsection shall conduct an appropriate assessment and evaluation of the patient’s current condition and document the appropriate medical indication for any prescription issued.

Nothing in this section shall supersede or otherwise affect the provisions of K.S.A. 65-4a10, and amendments thereto, or K.S.A. 2020 Supp. 40-2,210 et seq., and amendments thereto.

Any person who receives a telemedicine waiver under the provisions of this section shall be subject to all rules and regulations pertaining to the practice of the licensed profession in this state and shall be considered a licensee for the purposes of the professional practice acts administered by the state board of healing arts.

A waiver issued under this section shall expire on the date of expiration established by the state board of healing arts unless renewed in the manner established by the state board of healing arts, including payment of an annual renewal fee not to exceed $100 and evidence that the applicant continues to meet the qualifications described in this section.

Notwithstanding any other provision of law to the contrary, a physician holding a license issued by the applicable licensing agency of another state may provide, without limitation, consultation through remote technology to a physician licensed in the state of Kansas.

An applicable healthcare licensing agency of this state may adopt procedures consistent with this section to allow other healthcare professionals licensed and regulated by such licensing agency to practice telemedicine within the scope of practice defined by Kansas law for such healthcare profession as deemed by such licensing agency to be consistent with ensuring patient safety.

Nothing in this section shall be construed to prohibit a licensing agency from denying an application for a waiver under this section if the licensing body determines that granting the application may endanger the health and safety of the public.

As used in this subsection, “telemedicine” means the delivery of healthcare services by a healthcare provider while the patient is at a different physical location.

SOURCE: KS Statute Sec. 65-28-135, (Accessed Dec. 2022).

A physician holding a license issued by the applicable licensing agency of another state may practice telemedicine to treat patients located in the state of Kansas, if such out-of-state physician holds a temporary emergency license granted pursuant to K.S.A. 2021 Supp. 48-965, and amendments thereto.

SOURCE: KS Statute Sec. 48-9-63, (Accessed Dec. 2022).

Last updated 12/06/2022

Definitions

‘‘Telemedicine,’’ including ‘‘telehealth,’’ means the delivery of healthcare services or consultations while the patient is at an originating site and the healthcare provider is at a distant site. Telemedicine shall be provided by means of real-time two-way interactive audio, visual, or audio-visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support healthcare delivery, that facilitate the assessment, diagnosis, consultation, treatment, education and care management of a patient’s healthcare. ‘‘Telemedicine’’ does not include communication between:

    1. Healthcare providers that consist solely of a telephone voice-only conversation, email or facsimile transmission; or
    2. a physician and a patient that consists solely of an email or facsimile transmission.

SOURCE:  KS Statute Ann. § 40-2,211(5). (Accessed Dec. 2022).

Home Health Agency Licensure

“Telehealth” means the use of information and communication technology while a patient is at one site and a qualified health professional is at another site so that clinical parameters and other clinical data can be sent to qualified health professionals overseeing the health care provided to the patient. This term is also known as “telemedicine,” “telemonitoring,” or “remote monitoring.”

SOURCE:  KS Administrative Regulation, Sec. 28-51-100, (Accessed Dec. 2022).

 

Last updated 12/06/2022

Licensure Compacts

Member of the Interstate Medical Licensure Compact.

SOURCE: Interstate Medical Licensure Compact. The IMLC. (Accessed Dec. 2022).

Member of Nurses Licensure Compact.

SOURCE:  Current NLC States and Status.  NCSBN. (Accessed Dec. 2022).

Member of the Psychology Interjurisdictional Compact

SOURCE: PSYPACT Compact, (Accessed Dec. 2022).

Member of the Audiology and Speech-Language Therapy Compact.

SOURCE: ASLP Compact Map, (Accessed Dec. 2022).

Member of Physical Therapy Compact.

SOURCE: PT Compact, Compact Map, (Accessed Dec. 2022).

Member of EMS Compact

SOURCE: Interstate Commission of EMS Personnel Practice, EMS Member States, (Accessed Dec. 2022).

* See Compact websites for implementation and license issuing status and other related requirements.

Last updated 12/06/2022

Miscellaneous

Within the limits of appropriations therefor, the university of Kansas medical center is hereby authorized to establish, maintain and operate a telemedicine communications system, subject to the approval by the executive chief information technology officer under K.S.A. 75-4709, and amendments thereto. The telemedicine communications system shall apply telecommunications technology to the practice of medicine through compressed, full-motion, high-resolution, two-way interactive video communication and information transfer over long distances within a medical setting.

STATUS: KS Statute Annotated Sec. 76-389, (Accessed Dec. 2022).

Last updated 12/06/2022

Online Prescribing

The same laws and regulations that apply to the prescribing of drugs, including controlled substances, by means of in-person contact shall apply to the prescribing of drugs, including controlled substances, by means of telemedicine.

SOURCE: KS Admin. Regs., Sec. 100-77-3. (Accessed Dec. 2022). 

Physicians must have a pre-existing patient-prescriber relationship.  Physicians are prohibited from prescribing drugs on the basis of an internet-based questionnaire, internet-based consult, or telephonic consultation.

SOURCE: KS Admin. Regs., Sec. 68-2-20(2). (Accessed Dec. 2022).

Telemedicine may be used to establish a valid provider-patient relationship.

SOURCE:  KS Statute Ann. § 40-2,212(b). (Accessed Dec. 2022).

“Telepharmacy” means the practice of pharmacy by a pharmacist located in Kansas using telecommunications or other automations and technologies to deliver personalized, electronically documented, real-time pharmaceutical care to patients or their agents, who are located at sites other than where the pharmacist is located, including prescription dispensing and counseling and to oversee and supervise telepharmacy outlet operations.

A pharmacist shall be in attendance at the telepharmacy outlet by connecting to the telepharmacy outlet via computer link, video link and audio link or other functionally equivalent telecommunications equipment and shall be available to consult with and assist the pharmacy technician in performing activities.

Not later than January 1, 2023, the board shall adopt rules and regulations necessary to specify additional criteria for a managing pharmacy and telepharmacy outlet under this section, including, but not limited to:

Application requirements;

  • structural, security, technology and equipment requirements;
  • staffing, training and electronic supervision requirements;
  • inventory record keeping and storage requirements;
  • labeling requirements;
  • establishment of policies and procedures;
  • the number of telepharmacy outlets that may be operated by a supervising pharmacy;
  • use of automated dispensing machines; and
  • criteria for requesting exemptions or waivers from the requirements set forth in rules and regulations adopted under this subsection.

SOURCE: KS Statute Sec. 65-16, 130, (Accessed Dec. 2022).

A physician may issue a prescription for or order the administration of medication, including a controlled substance, for a patient without conducting an in-person examination of such patient.

A physician practicing telemedicine in accordance with this section shall conduct an appropriate assessment and evaluation of the patient’s current condition and document the appropriate medical indication for any prescription issued.

SOURCE: KS Statute Ann. Sec. 48-963, (Accessed Dec. 2022).

Last updated 12/06/2022

Professional Boards Standards

Board of Healing Arts

SOURCE: KS Admin. Regulations Sec. 100-77-1 to 3, (Accessed Dec. 2022).

Last updated 12/06/2022

Definition of Visit

A covered RHC or FQHC “visit” means a face-to-face encounter between a clinic/center patient and a clinic/center health care professional or practitioner (listed below) during which a covered RHC/FQHC service or dental service is rendered:

  • Physician
  • Physician assistant (PA)
  • Advanced practice registered nurse (APRN)
  • Nurse midwife
  • Dentist (for FQHCs only)
  • Clinical psychologist
  • Clinical social worker
  • Registered nurse (RN), for KBH-EPSDT nursing screen only, bill with modifier TD
  • Visiting nurse (if the conditions listed under “visiting nurse services” are fulfilled)
  • Registered dental hygienist, extended care permit (RDH ECP)

Encounters with more than one health professional, or multiple encounters with the same professional, on the same day constitute a single visit.

Just because a service is covered does not automatically mean it is a billable/covered visit.

If an encounter does not involve one of the above listed practitioners, it is not a covered RHC/FQHC visit and should not be billed.

If an examination of the patient is not performed during a face-to-face encounter, it does not constitute a covered RHC/FQHC visit and should not be billed. For example, a visit for the sole purpose of obtaining or renewing a prescription (need for which was determined previously) without a medical examination of the patient is not a covered encounter.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-3 to 4 (Aug. 2022), (Accessed Dec. 2022).

Visit. A “visit” shall mean face-to-face encounter between a center patient and a center health care professional as defined in K.A.R. 129-5-118. Encounters with more than one health professional or multiple encounters with the same health professional that take place on the same day shall constitute a single visit, except under either of the following circumstances:

  • The patient suffers an illness or injury requiring additional diagnosis or treatment after the first encounter.
  • The patient has a different type of visit on the same day, which may consist of a dental, medical, or mental health visit.

SOURCE: KS Admin. Regulation Sec. 129-5-118a, (Accessed Dec. 2022).

Last updated 12/06/2022

Eligible Distant Site

The consulting or expert provider at the distant site must bill an appropriate code from the list below with place of service (POS) 02 – Telemedicine and will be reimbursed at the same rate as face-to-face services.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-13 (Aug. 2022), (Accessed Dec. 2022).

See: KS Medicaid Live Video Eligible Providers

Last updated 12/06/2022

Eligible Originating Site

The originating site, with the member present, may bill code Q3014 with POS code 50 or 72 under the originating site provider ID and location number.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-13 (Aug. 2022), (Accessed Dec. 2022). 

See: KS Medicaid Live Video Eligible Sites

Last updated 12/06/2022

Facility Fee

The originating site, with the member present, may bill code Q3014 with POS code 50 or 72 under the originating site provider ID and location number.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-13 (Aug. 2022), (Accessed Dec. 2022).

See: KS Medicaid Live Video Facility/Transmission Fee

Last updated 12/06/2022

Home Eligible

If the RHC or FQHC services are in a setting outside of the clinic, the appropriate POS code must be used. For example, if an RHC or FQHC service is provided in a skilled nursing facility (SNF), POS code 31 is applicable. If an RHC or FQHC service is provided in the home, POS code 12 is applicable. Code 13 is the billable POS code for assisted living facilities.

If the service is furnished at a location other than the facility (such as the patient’s place of residence, the scene of an accident), the coverage as an RHC/FQHC encounter depends on whether there is an agreement that the clinic/center would compensate the practitioner for furnishing services in a location away from the clinic/center. The following criteria apply for billing for these services:

  • Practitioner Compensated: The service is covered as an RHC/FQHC visit and should only be billed under the RHC/FQHC provider number. It may not be billed under any other Medicaid provider number.
  • Practitioner Not Compensated: The service is not covered as an RHC/FQHC visit. It can be billed under the performing provider’s individual Medicaid provider number.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-4 to 5 (Aug. 2022), (Accessed Dec. 2022).

Federally qualified health center services provided at a location other than a federally qualified health center shall meet the following conditions:

  • No services are provided at an inpatient hospital, outpatient hospital, or hospital emergency room.
  • The services provided are listed in subsection (b).
  • The services are provided to a patient of a federally qualified health center.
  • The health professional providing the services is an employee of a federally qualified health center or under contract with a federally qualified health center and is required to seek compensation for that person’s services from the federally qualified health center.

SOURCE: KS Admin. Regulation Sec. 129-5-118, (Accessed Dec. 2022).

Last updated 12/06/2022

Modalities Allowed

Live Video

Office visits, individual psychotherapy, and pharmacological management services may be reimbursed when provided through telecommunication technology. The consulting or expert provider at the distant site must bill an appropriate code from the list below with place of service (POS) 02 – Telemedicine and will be reimbursed at the same rate as face-to-face services.  See manual for eligible codes.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-13 (Aug. 2022), (Accessed Dec. 2022).

See: KS Medicaid Live Video


Store and Forward

The member must be present at the originating site, excluding store-and-forward modality.  See: KS Medicaid Store and Forward


Remote Patient Monitoring

Not mentioned in FQHC manual, although reimbursed in other KS Medicaid programs.  See: KS Medicaid Remote Patient Monitoring


Audio-Only

Email, telephone, and facsimile transmissions are not covered as telemedicine services.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-13 (Aug. 2022), (Accessed Dec. 2022).

See: KS Medicaid Email, Phone and Fax

Last updated 12/06/2022

Patient-Provider Relationship

No reference found.

Last updated 12/06/2022

PPS Rate

Providers who are not RHC or FQHC providers and are acting as the distant site will be reimbursed in accordance with a percentage of the Physician Fee Schedule and not an encounter rate.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-13 (Aug. 2022), (Accessed Dec. 2022). 

Last updated 12/06/2022

Same Day Encounters

Encounters with more than one health professional, or multiple encounters with the same professional, on the same day constitute a single visit.

Just because a service is covered does not automatically mean it is a billable/covered visit.

If the patient suffers illness or injury subsequent to the first visit on the same day requiring additional diagnosis and treatment which are different from the first visit, the second encounter qualifies as an additional visit.

Subsequent visit on the same day must be medically necessary and include documentation of why the subsequent service could not have been provided during the initial encounter.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-4 (Aug. 2022), (Accessed Dec. 2022).