This month, CMS released an updated State Medicaid and CHIP Telehealth Toolkit consolidating information from previous toolkits and providing additional guidance – as required by the Bipartisan Safer Communities Act – on issues from billing best practices to strategies for using telehealth in schools.

In addition to FAQs on issues such as benefit flexibility, financing, workforce, managed care, and quality reporting, the comprehensive updated toolkit also includes information on strategies for delivering specific services via telehealth to different populations. This includes employing telehealth to improve health equity, delivering services to specific populations, including children and youth, and using telehealth to deliver maternal and behavioral health services.

Highlighted state best practices from the toolkit related to telehealth and behavioral health include:

• Colorado, which has a dedicated website for school-based services that includes procedure codes for telehealth, and allows for the telehealth delivery of certain services including behavioral health.
• Iowa, which has employed targeted promotion of telehealth to members and providers in counties with lower utilization of behavioral health care, including utilization by geography and race/ethnicity to identify and address barriers.
• North Carolina, which during the COVID-19 public health emergency temporarily permitted Medicaid providers to provide perinatal care, maternal support services, and postpartum depression screening via telehealth and in 2023 permanently permitted the use of telehealth for prenatal and postpartum visits.
• Oregon, which leveraged the State Directed Payments Option under managed care to create an enhanced payment rate increase for behavioral health services delivered by culturally- and/or linguistically-specific behavioral health providers, including services delivered via telehealth.

The toolkit also includes strategies for delivering services via telehealth to address behavioral health provider shortages including leveraging Certified Community Behavioral Health Clinics, community-based mobile crisis units, and the Collaborative Care Model with telepsychiatry. For example, the toolkit notes that states may submit a request for a 90/10 enhanced Medicaid match for a number of IT initiatives to support mobile crisis units, including the provision of cell phones or iPads to state-staffed mobile crisis teams to facilitate telehealth with a clinic at another location during a crisis intervention.

The updated toolkit including additional state best practices and strategies as well as other information such as a state checklist, a state Medicaid telehealth assessment/action plan, and telehealth communication strategies can be found here.