This guidance describes Alaska Medicaid’s temporary expansion of telehealth coverage for the duration of the U.S. HHS Secretary’s public health emergency. The expansion authorizes additional provider types (including Autism services providers, Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), home health and hospice providers, and others listed in the policy) to deliver services via telehealth modes. Effective November 1, 2021, direct-entry midwife, ESRD, and vision services (including services performed by optometrists and ophthalmologists) are excluded from telehealth delivery. For dual-eligible members, Medicare crossover codes G2012 and G0071 are covered and applicable copays/deductibles will be reimbursed to the provider.

Permissible modes of delivery include live interactive synchronous audio-video technologies (examples provided: Zoom, Skype, FaceTime), telephone/audio-only services, and online digital patient-initiated communications (such as EHR portal messages or email). Member and provider locations are unrestricted for live interactive, telephone, and online digital modes, allowing services to be provided from home or facility settings. FQHCs and RHCs may be reimbursed at their encounter rate for telehealth services provided by rendering providers included in the policy.

Telephone (audio-only) services are described as evaluation/assessment and management services for an established patient lasting in the 5–30 minute range and are represented by CPT codes 99441–99443 (physician-level) and the alternate non-physician codes 98966–98968. Telephone services are not reimbursable if a related E/M was provided in the previous 7 days or if the telephone service leads to or results in an E/M within 24 hours or the soonest available appointment. Effective for dates of service on or after 2022-03-01, providers must append modifier FQ when billing the specified audio-only CPT codes (99441–99443 and 98966–98968) or claims for audio-only services will be denied.

Online digital evaluation and management services are patient-initiated digital communications with an established patient and may be billed for up to 7 days cumulative per episode using CPT codes 99421–99423 (physician-level) or the non-physician online digital codes 98970–98972. These services are subject to the same timing exclusions as telephone services: not reimbursable if related E/M occurred in the prior 7 days or if the digital service leads to an E/M within 24 hours or the next available appointment.

Service-specific guidance: case management services may be performed via telephone, online digital, or live interactive modes — bill using the applicable case management procedure codes with place of service 02 or 10 and an applicable telehealth modifier (GT, GQ, FQ, or 95). Physical, occupational, and speech therapy are permitted via live interactive modes using standard therapy procedure codes with a GT or 95 modifier. Federally Qualified Health Centers may bill audio-only behavioral health services (e.g., psychiatric diagnostic interviews, individual psychotherapy) using the telephone CPT codes when other modalities are unavailable; documentation must explain the rationale for audio-only delivery.

Billing and modifier notes: use the specified CPT codes for telephone, online digital, vision (temporary window), and other telehealth services per the temporary fee schedule. For audio-only services billed on or after 2022-03-01, failure to include modifier FQ will result in denial of payment. Live interactive services may use common telehealth modifiers and the guidance above for place-of-service and encounter-rate billing for FQHCs/RHCs.

Behavioral health: Alaska Medicaid indicates behavioral health guidance will be published separately by the Division of Behavioral Health; providers should consult the DBH materials and the Telehealth Services Temporary Fee Schedule for rates and additional behavioral-health-specific telehealth details.