Service Area

Sites

Scope of Coverage

Providers

Reimbursement

• Rural Area – defined as a county with a population less than 50,000
• MUA – Medically Underserved Area
• MUP – Medically Underserved Population by the US Dept of Health & Services

HUB– UTMBThe site where the physician or D.O. providing the professional service, is located at the time the service is provided via interactive video communication

Remote– the location of where the service is being furnished via face-to-face interactive video communication.

HUB provider

• Consultations (CPT) codes 99241-99275)

Remote Provider

• CPT office visit codes 99201-99215 or encounter codes in TOS 1 or 5 as applicable (teleradiology/telepathology)

* RHC, FQHC have their own local codes and additional modifiers

HUB site:

• Physician M.D or D.O.

Remote site:

• Physician M.D. or D.O
• APN
• CNM

HUB and Remote:

*Professional services will be reimbursed for both sites based on the current TMRM for CPT evaluation & management codes

*Providers will also be reimbursed for teleradiology and telepathology services

Website

www.tdh.state.tx.us/dpa/01mua-we.htm

Authorized sites:

• Physician Office
• Non Physician Practitioner Office
• Inpatient hospital
• Outpatient hospital§ Emergency Room
• RHC and FQHC
• ICF-MR state school

Billing Requirements

• GT modifier must be appended to the correct CPT code for all services provided.
• The medical record at the remote site must include the physician’s findings.
• All videotaped visits must be kept on file at the hub site.

Note

*No separate payment is made for the cost of telemedicine hardware and/or equipment, videotapes, and transmissions.
*Only one consultation is allowed per 6 month period by the same provider.