2. Tele-Psychiatry In Oneida

3. Steps to Implementation
Analysis to determine if this approach would be accepted by your Tribal community
Access to care was a major issue and determining factor
Analysis of vendors available to provide the service
We utilized ReGroup because they had the technology readily available and the types of providers we needed
Impact to existing Licensure to provide the service
Our existing State License DHS 35 as an Outpatient Mental Health Facility had to be modified to approve our facility to provide the services via Tele-Psychiatry
This process took us 9 months

4. On-site Preparation for State Licensure
All of our Policies for Tele-Health had to be completed
Securing technology within our infrastructure
Developing a back-up plan if technology failed
Employee Orientation Plan

5. Tele-Health Orientation
Historical Uses of Telehealth
History of Telehealth
Clinical Application in Telehealth
Telecommunications Technology
Technology
Codes
Cameras
Consumer Peripherals
Transmission Equipment
Audio Equipment
Presenting Techniques

6. Tele-Health Orientation
Clinical Services
Safety and security during the service provision
Privacy and Confidentiality
Documentation
Consumer Rights
Back up Procedures
Patient Preparation for Tele-health
Market the Program to the Community!!

7. Tele-Psychiatry Scheduling and Billing for Services
Define Appointment Types
BH-TEL Medication Check Follow-up
BH-TEL RX refill
BH-TEL Adult Eval
BH-TEL Medication Check
Billing for Telepsychiatry (Medicaid Update No )
The service is a service that is covered under one of the Medicaid mental health or substance abuse benefits:
Outpatient Mental Health
Outpatient Substance Abuse
Pharmacologic Management
Mental Health Substance Abuse Day treatment
Crisis Intervention
Community Support Program
Comprehensive Community Services
Child/Adolescent Day treatment services

8. Barriers We Experienced
Internal system security for the Doctor to be able to work remotely with all of our systems.
System speed SLOWNESS!
Time Delay for Credentialing of the Provider for WI
Department of Safety and Professional Services (DSPS)
3-6 months for final approval
Provider needed to be licensed in the State they are providing services
Getting Staff on Board
Some were hesitant about using the technology
Change!

9. Procedure Codes
The Provider indicates the “GT” Modifier on the claim detail for the specific procedure code
“GT” Modifier is defined: Via interactive audio and video telecommunication systems
This table shows the services for which tele-health and the “GT” modifier are allowed and are not allowed
Service
Procedure Code
Telehealth
Services
Covered?
Outpatient Mental Health and Substance Abuse
90801, 90802, 90804, 90805, 90806, 90807,
90808, 90809, 90810, 90811, 90812, 90813,
90814, 90815, 90816, 90817, 90818, 90819,
90821, 90822, 90823, 90824, 90826, 90827,
90828, 90829, 90845, 90846, 90847, 90849,
90862, 90875, 90876, 90887, H0022, H0046,
H0047, T1006
Yes
90853, 90857, 90865, 90870, 90871, 90880,
90899, H0005 NO