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California State Agencies Ordered to Cover Telehealth PT and PT as an Essential Healthcare Services


California State Agencies Ordered to Cover Telehealth PT and PT as an Essential Healthcare Services

Things are changing rapidly, but as of this moment the federal government recommendations supported by the CDC include the following: "If you work in a critical infrastructure industry ... such as healthcare services and pharmaceutical and food supply, you have a special responsibility to maintain your normal work schedule. You and your employers should follow CDC guidance to protect your health at work." -Sharon Dunn, APTA President.

As an integral part of the healthcare delivery system in California, physical therapists (PT) and physical therapy assistants (PTA) provide many “essential” healthcare services. CPTA believes that each PT must determine if each patient requires their immediate in-person services and if a delay or postponement in providing these services would produce adverse outcomes. Read CPTA’s Message from the President.

Regarding payment for PT services via telehealth, the California Emergency Services Act (Gov. Code sections 8566, et seq.), states all health plans and Medi-Cal managed care health plans operating under the Department of Managed Health Care and the Department of Health Care Services shall, effective immediately, reimburse providers at the same rate, whether a service is provided in-person or through telehealth, if the service is the same regardless of the modality of delivery, as determined by the provider’s description of the service on the claim. Blue Shield of California has confirmed they plan to adhere to this order. CPTA will share the official Blue Shield notice once it becomes available.

*There is no state order regarding telehealth for California Workers’ Compensation plans and Self-Insured plans, at this time. CPTA is actively seeking clarification of coverage for these insurance systems. Further, any requirements of the California Early Intervention Services Act or Title 17 requiring in-person meetings for determining eligibility or service coordination are hereby waived. This includes infant development programs (805). View California telehealth laws regarding covered services”.

Access a telehealth platform matrix developed by the APTA Health Policy and Administration Technology Special Interest Group.

Read CPTA’s Letter to Governor Newsom.