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SOURCE: CO Adopted Rule 8.095.4.A. CO Department of Health Care Policy and Financing. Providers choosing telemedicine can only have one specialty. (D) If an advanced practice nurse with provisional prescriptive authority fails to complete the mentorship required by this subparagraph (I) within three years or otherwise fails to demonstrate competence as determined by the board, the advanced practice nurse's provisional prescriptive authority expires for failure to comply with the statutory requirements. SOURCE: CO Revised Statutes 10-16-123(4)(e). Ensuring a system to routinely track and permanently record such electronic medical information. Disclaimer: These codes may not be the most recent version. (Accessed Jan. 2023). . Home Health Telehealth. SOURCE: CO Revised Statutes 12-230-104(1)(e) (Accessed Jan. 2023). Other codes can be billed, but dont pay the telemedicine transmission fee. Provider Bulletin B2200480. (Accessed Jan. 2023). 2016 Colorado Revised Statutes Title 12 - Professions and Occupations . SOURCE: State Board of Psychologist Examiners Policies, 30-1, page 11. nterstate Medical Licensure Compact. (AccessedJan. (Accessed Jan. 2023). (Accessed Jan. 2023), 7 CCR 1101-3, Rule 18-4(I)(1-4) (Accessed Jan. 2023). Colorado Medicaid provides reimbursement for education-only services provided through telemedicine. (b) Upon satisfaction of the requirements set forth in paragraph (a) of this subsection (4.5), the board may grant provisional prescriptive authority to an advanced practice nurse. This is very dangerous to both the public and to nurses in Colorado. (Accessed Jan. 2023). SOURCE: CO Revised Statutes 10-16-123. :ZJ#xKTtnkY:/XN)DEcP].agYGA]iNO()|)V Rm'S\On>RpL1*&|"j8%c&6UAA;:AFGGH 1 8@D(,1@0B,&0I " Information and Resources for Colorado NPs Practice Information State Policy Fact Sheet A quick, printable look at the details of practicing in Colorado, like CE requirements and authorizations. Telemedicine Billing Manual 10/22. Any registered nurse, as defined in section 12-38-103 (11), may delegate any task included in the practice of professional nursing, as defined in section 12-38-103 (10), subject to the requirements of this section. The member retains the option to refuse the delivery of health care services via telemedicine at any time without affecting the members right to future care or treatment and without risking the loss or withdrawal of any program benefits to which the member would otherwise be entitled. (Accessed Jan. 2023). If the visit occurs via telehealth, a Qualified Provider must follow their existing organizational telehealth policies to ensure identity verification and adequate privacy and confidentiality. (Accessed Jan. 2023). Licensed practical nurse - Perform under the supervision of a registered professional nurse, physician, or other qualified . FQHC/RHCs may bill using modifier GT. SOURCE:CO Department of Health Care Policy and Financing. (Accessed Jan. 2023). Request Cost-Benefit Analysis. The client is unable to perform the health care tasks for him or herself, and no unpaid family/caregiver is able and willing to perform the tasks; and. Implementing consent form(s) and proper disclosure(s) including, but notlimited to the clients knowledge regarding security issues, confidentiality, structure, etc. Telephone shall only be used as necessary because of circumstances related to the disaster or emergency. this site explains what practice standards are and what behaviors are expected of rns. SOURCE:Colorado Adopted Rule 8.700.1. Health care or mental health care services delivered through telemedicine are covered by and reimbursed under the Medicaid per diem payment program; and. CO Revised Statute 12-270-104 (13) & (14). 2. that publication is available for purchase here. CO Department of Health Care Policy and Financing. School nurse services are services provided by a qualified school nurse. 2. (Accessed Jan. 2023). Member of the Interjurisdictional Psychology Compact. The only alternative to Home Health services is hospitalization or emergency room care; or. Pediatric Behavioral Therapists are covered under the telemedicine policy. Section 12-255-120 - Grounds for discipline - definitions (1) "Grounds for discipline", as used in this part 1, means any action by any person who: (a) Has procured or attempted to procure a license by fraud, deceit, misrepresentation, misleading omission, or material misstatement of fact; (b) (I) Has been convicted of a felony or any crime that would constitute a violation of this part 1. Telemedicine may be provided through interactive audio, interactive video, or interactive data communication, including but not limited to telephone, relay calls, interactive audiovisual modalities, and live chat, as long as the technologies are compliant with the federal Health Insurance Portability and Accountability Act of 1996, Pub.L. Phone: Phone Number. The definition of nursing differs from state to state, but you will usually find it near the beginning of the Act. Improve health care equity, access and outcomes for the people we serve while saving Coloradans money on health care and driving value for Colorado. The IMLC. A carrier shall not restrict or deny coverage solely because the service is provided through telehealth or based on the communication technology or application used to deliver the telehealth services. Any licensed provider enrolled with Colorado Medicaid is eligible to provide telemedicine services within the scope of the providers practice. A list of bon websites and contact information can be found at: www.ncsbn.org/contactbon.htm. Such relationship need not involve an in-person encounter between the patient and practitioner if otherwise permissible under Colorado law. In this situation, the telemedicine originating site facility fee is billed using procedure code Q3014. A specific list of agencies providing these services via telehealth is listed. Telehealth means a mode of delivery of healthcare services through HIPAA compliant telecommunications systems, including information, electronic, and communication technologies, remote monitoring technologies, and store-and-forward transfers, to facilitate the assessment, diagnosis, consultation, treatment, education, care management, or self-management of a covered persons health care while the covered person is located at an originating site and the provider is located at a distant site. Telemedicine Billing Manual 10/22. (Accessed Jan. 2023). Telemedicine POS 02 and Telehealth POS 10 are allowed place of service codes. Guidelines for the Appropriate Use of Telehealth Technologies in the Practice of Medicine. The essential documents from the profession serve as the foundation for legislation and regulatory policy-making that help assure the public's safety. Note: if you do not agree or understand any or all of the following terms, please do not use this web page. SOURCE: CO Department of Health Care Policy and Financing. CO Medicaid reimburses telehealth remote monitoring services including installation and on-going remote monitoring of clinical data through technologic equipment in order to detect minute changes in the members clinical status that will allow Home Health agencies to intercede before a chronic illness exacerbates requiring emergency intervention or inpatient hospitalization. (Accessed Jan. 2023). (Accessed Jan. 2023), CO Revised Statutes 25.5-5-320. SOURCE: CO Statute 10-16-123 (Accessed Jan. 2023). Certified nurse midwives practice under 12-38 C.R.S., Colorado Nurse Practice Act 1999. Telemedicine Billing Manual 10/22. Home Health Telehealth. A direct visualization by a physician without the member present is not billable as an encounter. (2) Delegated tasks shall be within the area of responsibility of the delegating nurse and shall not require any delegatee to exercise the judgment required of a nurse. They also provide reimbursement for remote patient monitoring for patients with certain chronic conditions. SOURCE: 5 CCR 1006-3, VIII. Telemedicine Billing Manual 10/22. (11) No advanced practice nurse registered pursuant to section 12-38-111.5 shall be required to apply for or obtain prescriptive authority. The Medicaid requirement for face-to-face contact between provider and member may be waived when treating the member through telemedicine. This relationship is established when: A Provider-Patient Relationship has not been established when either the identity of the provider An articulated plan developed pursuant to this subparagraph (II) must include at least the following: (A) A mechanism for consultation and referral for issues regarding prescriptive authority; (D) Documentation of ongoing continuing education in pharmacology and safe prescribing. Aug. 29, 2022. Colorado advanced practice nurses who hold RN licensing in other compact states may be referred to with one of the following designations: C-CNS, C-NP, C-CNM, or C-CRNA. Telemedicine and in-person providers will continue to use the appropriate specialty code for their chosen provider type. Telemedicine only providers are to use Specialty Code 878. Any health benefits provided through interactive audio, interactive video, or interactive data communication must meet the same standard of care as in-person care. SOURCE:CO FQHC & RHC Billing Manual 8/22. CO Medical Assistance Program, Home Health Billing Manual, (10/22), (Accessed Jan. 2023). (d) (I) An advanced practice nurse who has been granted authority to prescribe prescription drugs and controlled substances under this article may advise the nurse's patients of their option to have the symptom or purpose for which a prescription is being issued included on the prescription order. In-person contact between a health care provider and a member is not required for services delivered through telemedicine that are otherwise eligible for reimbursement. The Initial SSP license expires in 3 years; prior to expiration, the school nurse will need to apply for a Professional SSP license. SOURCE: CO Department of Health Care Policy and Financing. Option (2): The General Assembly (Legislature) passes the bill to continue with the Nurse Practice Act. . Telemedicine, (Accessed Jan. 2023). Parity of Professional and Ethical Standards: A providers professional discretion as to the diagnoses, scope of care, ortreatment should not be limited or influenced by non-clinical considerations oftelehealth technologies, and provider remuneration or treatment recommendationsshould not be materially based on the delivery of patient-desired outcomes (i.e. CO Department of Health Care Policy and Financing. Telemedicine, (Accessed Jan. 2023). National Council of State Boards of Nursing, Inc. All Rights Reserved. SOURCE: The Colorado Medical Board Policies, 40-03, page 57. authority to certify nurse aides to practice in the state of Colorado, and the board shall implement Telemedicine Billing Manual 10/22. Exemptions from Policy 40-27 Guidelines for the Appropriate Use of Telehealth Technologies inthe Practice of Medicine: The Colorado Medical Board recognizes the challenges during a public health emergency. (Accessed Jan. 2023). (Accessed Jan. 2023). The service must be submitted on a professional service claim form (the 1500). HB20-1216 Sunset Continue Nurse Practice Act. The Board of Nursing will dissolve and there will be no regulation of nursing in the State of Colorado. You already receive all suggested Justia Opinion Summary Newsletters. The Colorado Medical Board Policies, 40-03, page 57. The delegating nurse shall be solely responsible for . SOURCE: CO Department of Health Care Policy and Financing. Primary Care Medical Provider (PCMP) means an individual physician, advanced practice nurse or physician assistant, who contracts with a Regional Accountable Entity (RAE) in the Accountable Care Collaborative (ACC), with a focus on primary care, general practice, internal medicine, pediatrics, geriatrics, or obstetrics and gynecology, Member must receive Home Health services from provider who has opted to provide telehealth services, Member must require frequent and on-going monitoring/management of their disease or condition, Members home environment must be compatible with the use of the equipment, Member or caregiver must be willing and able to comply with vital sign self-monitoring. Board rules must follow the laws enacted by the legislature and adopted in the Nurse Practice Act. SOURCE: The Colorado Medical Board Policies, 40-09, page 63. It is the position of the Colorado Medical Board that it is unprofessional conduct for aprovider to provide treatment and consultation recommendations, including issuing a prescription, via anymeans, unless a provider-patient relationship, as defined in Board Policy 40-3, has been established. The Department of Health Care Policy & Financing is committed to providing service-delivery options that empower Health First Colorado (Colorado's Medicaid program) members and their families to direct and manage the long-term care services and supports they need to live at home. Using modifier GT with specific codes adds $5.00 to the fee listed for the service. CO Department of Health Care Policy and Financing. In some cases, the originating provider site will not be providing clinical services, but only providing a site and telecommunications equipment. The indication, appropriateness, andsafety considerations for each telehealth visit prescription must be evaluated by theprovider in accordance with current standards of practice and consequently carrythe same professional accountability as prescriptions delivered during anencounter in person. (Accessed Jan. 2023). SOURCE:CO Statute, Sec. Telemedicine enables the remote evaluation and diagnosis of injured workers in addition to the ability to detect fluctuations in their medical condition(s) at a remote site in such a way as to confirm or alter the treatment plan, including medications and/or specialized therapy. 8/20/15. both the general and the specialty standards of practice may be introduced in court as a part of the expectations a client or a community may have for a nurse. hb```,+@Y8.0 CO Department of Health Care Policy and Financing. Consult with an attorney if you are seeking a legal opinion. In this arrangement the provider who is present with the member is called the originating provider, and the provider located at a different site, acting as a consultant, is called the distant provider. Provider Bulletin B1900434. Rule 1011-1. The following are listed under the covered services heading in the Telemedicine Manual: SOURCE: CO Department of Health Care Policy and Financing. (Accessed Jan. 2023). CO Medicaid Live Video Facility/Transmission Fee, Colorado Professional Requirements Online Prescribing, Colorado Adopted Rule 8.700.6.D. SOURCE: Colorado Adopted Rule 8.095.1.A. 8/19/21. %%EOF 8/19/21. Background Ch. Teletherapy Policy Guidance regarding Psychotherapy through Electronic Means. All nurses have a duty to understand their nurse practice act and regulations and to keep up with ongoing changes. If the originating provider also provides clinical services to the member, the provider bills the rendering providers appropriate procedure code and bills Q3014. CO Revised Statutes 25.5-5-320(3). Electronic Health Entity (eHealth Entity) means a group practice that delivers services exclusively through telemedicine and is enrolled in a provider type that has an eHealth specialty. Performed within the scope of the persons license or certification; Do not exceed twenty days per year in this state; Are not otherwise in violation of this article 245; and, Disclosed to the public that the person is not licensed or certified in this state. In no event may a registered nurse delegate to another person the authority to select medications if such person is not, independent of such delegation, authorized by law to select medications. Select a Colorado Advanced Practice Nurse Topic: . Safe, competent nursing practice is grounded in the law as written in the state nurse practice act (NPA) and its rules. The mentor must be practicing in Colorado and have education, training, experience, and an active practice that corresponds with the role and population focus of the advanced practice nurse. See our Privacy Policy. (Accessed Jan. 2023). (b) and (c) (Deleted by amendment, L. 2009, (SB 09-239), ch. Failure to comply may constitute grounds for disciplinary action as set forth in section 12-36-117, C.R.S. (Accessed Jan. 2023), O Revised Statutes 10-16-123. Any health benefits provided through telemedicine shall meet the same standard of care as in-person care. through technologies that are used in a manner that is compliant with HIPAA, including information, electronic, and communication technologies, remote monitoring technologies, and store-and-forward transfers, to facilitate the assessment, diagnosis, consultation, or treatment of a patient while the patient is located at an originating site and the person who provides the services is located at a distant site. All distant site rendering providers bill the appropriate procedure code using Place of Service code 02 or 10 and the appropriate modifiers FQ or FR on the CMS 1500 paper claim form or as an 837P transaction. Compare the language to the AHNA definition of holistic nursing: A holistic nurse is a legally licensed nurse who takes a holistic (mind-body-spirit-emotion) approach to the practice of traditional nursing. Services are provided under a plan of care as defined at Section 8.520.1 DEFINITIONS. See: CO Medicaid Live Video Facility/Transmission Fee. (Accessed Jan. 2023). Guidelines for the Appropriate Use of Telehealth Technologies in the Practice of Medicine. The CO Medical Assistance Program will reimburse for home health care or home and community-based services through telemedicine at a flat fee set by the state board. Holistic nursing is based on a body of knowledge, evidence-based research, sophisticated skill sets, defined standards of practice, and a philosophy of living and being that is grounded in caring, relationship, and interconnectedness.. (Accessed Jan. 2023). agencies in its sunset review and report on the "Nurse Practice Act" (act), HOUSE SPONSORSHIP Mullica, Buckner, Caraveo, Lontine, Titone SENATE SPONSORSHIP (None), . Services may be rendered via telemedicine when the service is: All services provided through telemedicine shall meet the same standard of care as in-person care. Covered service types are those listed in Service Types, Section 8.520.5. Client is receiving services from a home health provider for at least one of the following: congestive heart failure, chronic obstructive pulmonary disease, asthma, or diabetes, pneumonia; or other diagnosis or medical condition deemed eligible by the Department or its Designee. CO Department of Health Care Policy and Financing. The first arrangement is when a member receives services via a live audio/visual connection from a single provider. The FQHC section of CCHPs Policy Finder Tool is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $1,656,250 with zero percentage financed with non-governmental sources. NCSBN partnered with each participating state board of nursing to develop the online nurse practice acts course program. Telehealth, telerehabilitation, and teletherapy are included within the practice of occupational therapy. A health care provider may provide these services through telehealth, including store-and-forward, and is entitled to reimbursement for the delivery of those services via telehealth to the extent the services are otherwise eligible for reimbursement under the program when provided in person. Nurses and Nurse Aide Practice Act. (III) The advanced practice nurse shall maintain national certification, as specified in subparagraph (III) of paragraph (a) of this subsection (4.5), unless: (A) The advanced practice nurse was included on the advanced practice registry prior to July 1, 2010, and has not obtained national certification; (B) The advanced practice nurse was included on the advanced practice registry prior to July 1, 2008, and has not completed a graduate degree as specified in section 12-38-111.5 (4) (c); or. State Board of Psychologist Examiners Policies, 30-1, page 10. Colorado Adopted Rule 8.095.2, 8.095.4, 8.095.7. Pediatric Behavioral Therapies Billing Manual, 1/23 (Accessed Jan. 2023). FQHC are eligible for the originating site facility fee and may bill procedure code Q3014 (telemedicine originating site facility fee). (B) The physician or advanced practice nurse serving as a mentor shall not require payment or employment as a condition of entering into the mentorship relationship, but the mentor may request reimbursement of reasonable expenses and time spent as a result of the mentorship relationship. Transmissions must be performed on dedicated secure lines or must utilize an acceptable method of encryption adequate to protect the confidentiality and integrity of the transmission. is unknown to the patient, or the identity of the patient is not known to the provider. (Accessed Jan. 2023). Providers who evaluate, treat or prescribe through telehealth technologies arepracticing medicine. The patient may refuse telemedicine services at any time without affecting the patients right to future care or treatment and without risking the loss or withdrawal of any program benefits to which the patient would otherwise be entitled; All applicable confidentiality protections shall apply to the services; The patient shall have access to all medical information resulting from the services, under state law. The location where health services and health related services are provided or received through telecommunication technology. Counseling Compact. The Colorado Nurse Practice Act, Section 12-13-128, (amended language in italics) now reads . Originating site must bill with the appropriate facility POS code. Telemedicine services are limited to the procedure codes identified on theTelemedicine Provider Informationweb page at theProvider Telemedicine web page. Nurse Practice Act; AANP in Colorado AANP Region. 6 CO Regs. (d) Whether the delegated task has a predictable outcome. 8/20/15. You can explore additional available newsletters here. Any health benefits provided through interactive audio (including but not limited to telephone and relay calls), interactive video (including but not limited to interactive audiovisual modalities), or interactive data communication (including but not limited to live chat and excluding text messaging, electronic mail, and facsimile transmission) must meet the same standard of care as in-person care. The child or youth must be physically in the same room as the professional person during the Face-to-Face clinical assessment. (Accessed Jan. 2023). Teletherapy may be defined differently in different statutory contexts, including but notlimited to, insurance requirements or reimbursement. This information establishes justification for services and Children and Youth Mental Health Treatment Act funding. Health First Colorado will not pay for the equipment. Provider News, Issue 48. aprescription or referral) or the utilization of telehealth technologies. 201 East Colfax Ave. 2/2/18. Referrals for Emergency Services:An emergency plan should be provided by the provider to the patient when the care providedusing teletherapy technologies indicates that a referral to an Emergency Department fortreatment is necessary for the safety of the patient. Legislative Updates. Telehealth remote monitoring services include the installation and on-going remote monitoring of clinical data through technologic equipment in order to detect minute changes in the clients clinical status that will allow Home Health agencies to intercede before a chronic illness exacerbates requiring emergency intervention or inpatient hospitalization. CO Department of Health Care Policy and Financing. The agreed upon therapeutic means of communication between the client andthe licensee, certificate, or registrant. SOURCE: CO Medicaid Provider News & Resources. Unfortunately, state government Websites can be confusing. The mentor must be practicing in Colorado and have education, training, experience, and an active practice that corresponds with the role and population focus of the advanced practice nurse. Generally, FQHCs get PPS from CO Medicaid: The Department will perform an annual reconciliation to ensure each FQHC has been paid at least their per visit Prospective Payment System (PPS) rate. Telemedicine is not a unique service, but a means of providing services approved by Health First Colorado through live interactive audio and video telecommunications equipment. Individual psychotherapy services shall be face-to-face, or interactive audio (including but not limited to telephone and relay calls), interactive video (including but not limited to interactive audiovisual modalities), or interactive data communication (including but not limited to live chat and excluding text messaging, electronic mail, and facsimile transmission) services that are tailored to address the individual needs of the client. Individual psychotherapy services are limited to thirty-five visits per State fiscal year. Section 12-38-111.5 C.R.S., "Requirements for advanced practice nurse registration - legislative declaration - definition - advanced practice registry," specifically addresses nurse-midwifery. questionnaire, does not constitute an acceptable standard of care. Failure to advise a patient pursuant to subparagraph (I) of this paragraph (d) shall not be grounds for any civil action against a nurse in a negligence or tort action, nor shall such failure be evidence in any civil action against a nurse. (Accessed Jan. 2023). Member Contact Center1-800-221-3943/State Relay: 711. (Accessed Jan. 2023). (Accessed Jan. 2023). An appropriate medical evaluation and review of relevant clinical history,commensurate with the presentation of the patient to establish diagnoses andidentify underlying conditions and/or contra-indications to the treatmentrecommended/provided, should be performed prior to providing treatment,including issuing prescriptions, electronically or otherwise.
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