The Texas Health and Human Services Commission (HHSC) recognizes
that mental health services are expressly excluded from the provisions
of Texas Occupations Code Chapter 111 and further, that the term "mental
health services" is not defined in Texas Occupations Code Chapter
111. Additionally, HHSC recognizes the American Psychiatric Association's
Diagnostic and Statistical Manual of Mental Disorders and the National
Institute of Mental Health recognize substance use disorder as a mental
disorder. Acknowledging the importance of access to substance use
disorder and pursuant to HHSC's broad rulemaking authority in Texas
Government Code §531.0055 and §531.033 and Texas Human Resources
Code §32.021, for the purposes of this rule, HHSC considers the
provision of mental health services, as that term is used in Texas
Occupations Code Chapter 111, to be synonymous with the provision
of behavioral health services. Conditions for reimbursement applicable
to behavioral health services provided through an audio-only platform
are described in this section.
(1) The provider must be enrolled in Texas Medicaid.
(2) The provider must obtain informed consent from
the client, client's parent, or the client's legally authorized representative
prior to rendering a behavioral health service via an audio-only platform;
except when doing so is not feasible or could result in death or injury
to the client. Verbal consent is permissible and must be documented
in the client's medical record.
(3) The covered services must be provided in compliance
with the standards established by the respective licensing or certifying
board of the professional providing the audio-only telemedicine medical
service or audio-only telehealth service.
(4) Behavioral health services provided via audio-only
platform must be designated for reimbursement by HHSC. Behavioral
health services provided via an audio-only platform designated for
reimbursement are those that are clinically effective and cost-effective,
as determined by HHSC and in accordance with §354.1432(3) of
this subchapter (relating to Telemedicine and Telehealth Benefits
and Limitations). Behavioral health services that HHSC has determined
are clinically effective and cost-effective when provided via an audio-only
platform can be found in the Texas Medicaid Provider Procedures Manual
(TMPPM).
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