Effective March 13, 2020, during the duration of the State of Emergency, Behavioral Health Providers, including qualified practitioners and services Providers, may deliver Covered Services via TeleMental Health, including telephonic services at no cost-share to the Member.
Providers should submit the appropriate E/M or CPT code along with the POS code that would have been reported had the services been furnished in person and use claim modifiers “95” or “GT” on each claim that represents a service delivered via TeleMental Health.
- 95 modifier – Synchronous telemedicine service rendered via real-time interactive audio and video telecommunication system
- GT modifier – Via interactive audio and video telecommunication systems
Providers in OMH/OASAS Licensed Facilities or Designated Programs should work with the NYS Office of Mental Health (OMH) to ensure the required attestation is on file with OMH. Access the Self-Attestation of Compliance to Offer TeleMental Health Services form .
Behavioral Health Providers may bill for Applied Behavioral Analysis (ABA) Covered Services which would otherwise be covered in a Commercial Member’s Subscriber Contract for in-person visits as a TeleMental Health visit at no cost-share to the Member.