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MedicaidCoverageHigh impact

Oregon Health Plan coverage of telemedicine services

Oregon Health Plan·OR · Family Medicine, Internal Medicine, Pediatrics +1 more·Plan
Effective date
Mar 13, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Oregon Health Plan has significantly expanded telemedicine/telehealth coverage in response to COVID-19, adding new billing codes for telephone services, online portal communications, and provider consultations. Behavioral health providers can now bill telephone assessment codes (98966-98968, 99441-99443) retroactive to January 1, 2020, and audio/video services can use relaxed HIPAA platforms if necessary.

Action Required

Action needed
Immediately: Update billing system to include new telephone service codes (98966-98968 for non-physician providers, 99441-99443 for physicians) with time-based documentation requirements. Ensure telemedicine visits use GT modifier for behavioral health services. Train staff on telephone billing restrictions: patient must initiate call, cannot be related to service within 7 days prior or 24 hours after. Allow up to one week for MMIS system configuration to process new fee-for-service Medicaid claims.

Affected Billing Codes

99201
99202
99203
99204
99205
99211
99212
99213
99214
99215
99421
99422
99423
98970
98971
98972
G2061
G2062
G2063
99451
99452
99446
99447
99448
99449
99441
99442
99443
98966
98967
98968