Medicaid Telehealth Expansion: Frequently Asked Questions
The Wisconsin Department of Health Services, which administers Wisconsin’s Medicaid programs, has answered a number of questions from members about telehealth policy changes in response to the COVID-19 outbreak. These questions and their answers are included below. The FAQs will be updated to provide helpful answers to member questions.
General
Telehealth is audio and video contact with your doctor or health care provider using your phone, computer, or tablet. It includes:
- Health care services
- Getting a diagnosis
- Consultations to discuss your treatment
- Treatment for your medical condition
Normally, you need to meet with your doctor or other health care provider in person for many health care services. Now you can get many services through telehealth if it can be securely delivered through your smartphone, computer, or tablet with the same quality and effectiveness.
Your doctor or health care provider, using guidance from the Wisconsin Department of Health Services, will decide if you can receive a service through telehealth. If you do not want to receive a service through telehealth or do not have the right technology—such as a phone, computer, or tablet—for it to be effective, you can still see your doctor in-person.
Services allowed through telehealth include:
- General health services, like seeing your provider or getting prescriptions for supplies or equipment
- Behavioral health services, like mental health screenings or treatment
- Dental consultations, like diagnosing an infected tooth and prescribing antibiotics until you can be seen in person
- Case management services
- Therapy services, like physical therapy, speech and language therapy, and occupational therapy
When you contact your provider to set up an appointment or talk to your care manager or health plan, they may ask if you want a telehealth appointment. They may also refer to it as a virtual visit or e-visit.
You can choose whether you want to use telehealth or see your provider in person. If you want to use telehealth, the provider will let you know how to use your phone, computer, or tablet to join the appointment.
Your provider will let you know which type of technology is right for your appointment.
For the latest information about telehealth policy and services, visit the Medicaid Telehealth Expansion webpage.
Some services can be delivered over the phone with the same quality and effectiveness as an in-person service. These services can be provided by phone (audio-only). Your provider will let you know which type of technology is right for your appointment.
When your signature or the signature of your representative is required, handwritten or electronic signatures are acceptable. If a handwritten signature is specified, an electronic signature will not be accepted.
The following types of signatures are accepted:
- Handwritten signature—This includes:
- Signing a paper document and handing it to your provider or returning it to your provider through the mail or fax.
- Signing a touchpad signature device.
- Sending a statement by email giving your approval.
- Taking a picture of a signed document and electronically forwarding it to your provider using methods such as text or email.
- Electronic signature—The provider handles setting up a way to accept your signature electronically.
Yes, you can receive services from an out-of-state provider if they are enrolled in Wisconsin Medicaid and follow Medicaid policy for prior authorizations (getting permission before the service occurs). Check with your provider to see if they qualify. If you are enrolled in a managed care program, you should check with them to determine who you can see.
Maybe. Providers may be required to have a license to practice in the state where you are located. Check with your provider to see if they are able to provide telehealth services in the state where you are located.
No. Services that are not currently covered will not be paid when supplied through telehealth.
Families should review the HealthCheck “Other Services” benefit for services available for children under the age of 21.
Providers need to follow federal laws to ensure your privacy and security. This might include making sure you have a private space for your visit. This will help keep your health information confidential.
Covered services
Yes, occupational therapy, physical therapy, speech and language therapy, and targeted case management provided by the Birth to 3 Program are covered when the services delivered through telehealth are just as safe and effective as those provided during an in-person visit.
Yes, therapy services are covered when the services delivered through telehealth are just as safe and effective as those provided during an in-person visit.
Telehealth visits are allowed for targeted case management services when the services delivered through telehealth are just as safe and effective as those provided during an in-person visit. Targeted case management services allowed through telehealth include services that help coordinate care for the following:
- High-risk children in Milwaukee and Racine
- Children with complex medical needs
- Members diagnosed with HIV infection or AIDS
- Members using HealthCheck services
- Members requiring prenatal care
- Members with specific health care conditions, such as dementia
- Members enrolled in the Birth to 3 program
Phone calls are allowed for behavioral treatment services when the services delivered through audio only are just as safe and effective as those provided during an in-person visit.
Phone calls or telehealth visits are allowed for Community Recovery Services when the services delivered through telehealth are just as safe and effective as those provided during an in-person visit.
Reimbursement for telehealth services is allowed if the service is covered and is included on the Individualized Education Program (IEP).
Yes, group treatment services are temporarily allowed when the services delivered through telehealth are just as safe and effective as those provided during an in-person visit. Providers must be sure privacy requirements of the participants are met.
All substance use disorder services that can be delivered through telehealth with the same safety and effectiveness as an in-person visit may be provided through telehealth. Examples include outpatient and day treatment substance use disorder services including group counseling.