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.
What is telehealth?
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
How does telehealth work?
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 face-to-face.
What types of services are allowed through telehealth when using Wisconsin Medicaid?
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
For a complete list and examples of telehealth services, visit COVID-19: ForwardHealth Program Updates for You and Your Family.
How do I use telehealth?
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.
Where can I get more information about telehealth?
For the latest information about telehealth policy and services, visit the Medicaid Telehealth Expansion webpage.
Can I receive services by phone (audio-only)?
As of March 1, 2020, as part of the temporary telehealth policy, any service that can be delivered over the phone with the same quality and effectiveness as an in-person service can be provided by phone (audio-only).
What options are available for providing my signature or the signature of my representative when required?
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.
Can I receive services from an out-of-state provider through telehealth?
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.
If I am out of state, can I still receive telehealth services?
Yes. As of March 1, 2020, there are no limits on where you can receive telehealth services as long as you are in the United States.
Are in-person services that are not covered allowed through telehealth?
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.
What is “face-to-face equivalence”?
Live services performed through telehealth must be equal to an in-person visit. “Equal to” means you can see and hear your doctor through telehealth as well as you can during an in-person visit. It also means the visit is just as safe and effective as an in-person visit. This is called face-to-face equivalence.
Are telehealth services covered for services supplied by the Birth to 3 Program?
Yes, occupational therapy, physical therapy, speech and language therapy, and targeted case management provided by the Birth to 3 Program are temporarily covered when the services delivered through telehealth are just as safe and effective as those provided during an in-person visit. This is called face-to-face equivalence.
Are therapy (physical, occupational, and speech-language pathology) telehealth services covered?
Yes, therapy services are temporarily covered when the services delivered through telehealth are just as safe and effective as those provided during an in-person visit.
What temporary changes affect narcotic treatment services?
Real-time phone communication is temporarily allowed instead of in-person daily dosing contact by registered nurses or licensed practical nurses working in an opioid treatment program clinic.
What temporary changes affect personal care services?
Nurses are temporarily allowed to supervise personal care workers using remote technology like a smartphone or tablet with sound and video to limit the number of people entering your home.
What temporary changes affect targeted case management services?
Telehealth visits are temporarily 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
What temporary changes affect behavioral treatment services?
Phone calls are temporarily 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.
What temporary changes affect Community Recovery Services?
Phone calls or telehealth visits are temporarily 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.
Can school-based services be provided through telehealth?
Reimbursement for telehealth services is temporarily allowed if the service is covered and is included on the Individualized Education Program (IEP).
Can I receive group treatment services through telehealth?
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.
Which substance use disorder services are covered through telehealth?
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.
Changes to Requirements
Have the requirements for in-person initial assessments or other in-person visits changed?
Yes, fee-for-service initial assessments (or other visits that were previously required to be in-person) can be done through telehealth if the services are just as safe and effective as those delivered in an in-person visit. If you are enrolled in a managed care organization, you should check to see their requirements.