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Telehealth services
Aetna Better Health® of New Jersey allows reimbursement for telehealth (also known as telemedicine) within the provider’s scope of practice.
What is telehealth?
What is telehealth?
Under NJ Family Care, telehealth is an approved way to deliver service. Telehealth is the use of electronic info and telecommunications technologies to support:
- Long-distance clinical health care
- Patient and professional health-related education
- Public health
- Health administration
Telehealth services include telephone calls and interactive visits using a computer, tablet or cell phone with two-way immediate communication. This is with or without a camera.
Documentation requirements for telehealth services are the same as in-office visits. You’ll want to document any info you use to make medical decisions about patients. Since some codes are time based, you’ll also want to document the telehealth encounter start and end times. Include this info in your documentation:
- A statement that the service was provided through telehealth
- The location of the patient and provider
- The names and roles of anyone else taking part in the telehealth service
We offer accessibility solutions for members who are deaf or hard of hearing through Akorbi, which:
- Offers a full range of interpretation services for telehealth visits that meet the needs of both members and providers
- Provides an adaptive platform that includes over-the-phone interpretation and video interpretation services
- Doesn’t require prior authorization for services
Schedule an interpreter
Call Member Services at 1-855-232-3596 (TTY: 711) to schedule Akorbi interpreter services for people who are deaf or hard of hearing. We request at least a three-day notice. Although we may accommodate same-day appointments, we can’t guarantee them due to increased demand.
More resources
- Get tips for treating members during COVID-19 from the Division of the Deaf and Hard of Hearing.
We’ll authorize and reimburse for any service from a health care provider who has a valid license. They must also be certified or registered with the Department of Health (annually) to provide such services in New Jersey. Either the provider or patient must also be in New Jersey at the time services were provided. Services must be provided in compliance with existing requirements under law or regulation.
Health care providers may bill for any Medicaid billable service using the same billing codes and rates provided for face-to-face services. There is no need to use any additional procedure codes or modifiers. The Centers for Medicare and Medicaid Services (CMS) has discontinued the use of “GT” suggested in the original pilot and it isn’t necessary for billing.
You’ll want to use place of service code POS 02 to indicate telehealth. For telephone services only, codes are time based.
Service codes
- Physicians: use service codes 99441–99443
- Non-physicians: use 98966–98968
We’re waiving copays for telehealth visits for behavioral and mental health counseling for members eligible for managed long-term services and supports (MLTSS) and Division of Developmental Disabilities (DDD). This is for the duration of the COVID-19 public health emergency.
CPT codes
- 98966
- 98967
- 98968
- 99441
- 99442
- 99443
Well-visit codes
- 99391 - PER PM REEVAL EST PAT INFANT
- 99392 - PREV VISIT EST AGE 1–4
- 99393 - PREV VISIT EST AGE 5–11
- 99394 - PREV VISIT EST AGE 12–17
- 99395 - PREV VISIT EST AGE 18–39
- 99443