To help slow the spread of the coronavirus, several new telehealth policies allow injured workers to receive treatment from their medical providers by video or phone in some instances.
We've extended our temporary telehealth policies to March 3, 2022. Our permanent policies will be effective March 4, 2022. You can find these policies on L&I's Medical Aid Rules and Fee Schedules (MARFS) Updates and Corrections page:
Common Questions About Telehealth
This information is meant to answer many of the questions L&I is receiving regarding telehealth (also known as telemedicine).
Is a worker's home considered an originating site for telehealth?
Yes, the worker's home is considered an originating site under L&I's telehealth payment policies.
What services are currently covered using telehealth?
A full list of the covered services can be found on the MARFS Updates and Corrections page. We've added policies for the following services:
- Evaluation and management,
- Mental health,
- Naturopathic physicians,
- Physical medicine,
- Activity coaching,
- Behavioral health interventions,
- Brain injury rehabilitation services, and
- Chronic pain management (SIMP).
What are the requirements for billing a telehealth visit?
Requirements can be found on the MARFS Updates and Corrections page.
Will L&I pay for telehealth visits for new patients referred from an emergency room if the patient has no prior provider and does not require an in-person visit?
No. New patient exams require an in-person visit, unless the exam is for mental health only. More information is available on the MARFS Updates and Corrections page.
Is L&I considering using telehealth to deliver other services?
L&I is continuously evaluating needs and requests, and may modify the existing policies as needed. New information will be available on the MARFS Updates and Corrections page.
What are the confidentiality and release of information requirements when using video applications for appointments?
The provider is required to ensure the privacy and confidentiality of the worker at all times.
Will L&I pay for Activity Prescription Forms (APF) if they are generated during a telehealth or telephone appointment?
APFs generated during a telehealth appointment aren’t covered when the restrictions are changing or if the worker will be taken off work. Additional details are available on the MARFS Updates and Corrections page.
Does the Temporary Interpreter Telehealth Policy allow face-to-face interpreters to provide services through telehealth if the interpreter is face-to-face with either the provider or the patient?
If interpreter services are needed, providers may access a telephonic interpreter using the identified vendor in Chapter 14: Interpretive Services.
Are patient signatures required on L&I forms for COVID-19 telehealth appointments? How should COVID-19 patients submit a claim that needs their signature?
The worker may file a Report of Accident (ROA) with an electronic signature.
Center for Medicaid and Medicare Services (CMS) recently posted an update to pay for telephone calls at the same reimbursement rate as an office visit. Will L&I follow this CMS message?
We are continuing to use our established telephone fees. We will publish our updated fee schedule July 1.
Questions about telehealth payment policies? Contact L&I's Healthcare Policy & Payment Methods team.