Magellan Healthcare
Provider Focus Newsletter
News & information for Magellan network providers

columns : Network Notes

Video-based counseling network continues to expand

Did you know that as a Magellan provider, you can deliver care via telehealth if it is a covered benefit under the member’s benefit plan? Telehealth offers a convenient and simple solution to increase access to members, while earning extra income.

In this issue, we share some common provider questions about telehealth.

What is telehealth?

Magellan defines telehealth as a method of delivering behavioral health services using interactive telecommunications when the patient and the behavioral health provider are not in the same physical location. Telecommunications must be the combination of audio and live, interactive video.

I am a telehealth provider. How can I add telehealth to my practice for Magellan members?

Complete Magellan’s online telehealth attestation. Note that this form requires your Magellan MIS number; if you do not know your MIS number, call us at 1-800-788-4005 to request it.

I am not a telehealth provider but would like to be. What do I need to get started?

You will need a broadband internet connection and a computer with a microphone and a built-in or external web camera. You must use a HIPAA-compliant telehealth software/platform.

How do I select a telehealth platform?

Identify a telehealth platform that meets your needs and ensure that it is HIPAA-compliant. The American Telemedicine Association is a great source for telehealth guidance.

Are there different rates for delivering services via telehealth?

Your contracted rates for services remain the same whether delivered via telehealth or face-to-face. For telehealth, you must submit your claim with a “GT” or "95" modifier added (to indicate telehealth). Telehealth services must be a covered benefit under the member’s benefit plan to be reimbursed.

How are claims and billing handled?

As a Magellan provider, you will continue to verify benefits and eligibility, as well as submit claims, exactly as you do now (billing using the “GT” or "95" modifier to signify telehealth services).

Again, in order to be reimbursed, telehealth services must be a covered benefit under the member’s benefit plan.

To learn more, view our complete list of Telehealth FAQs on our Telehealth webpage.

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About Provider Focus

Welcome to Provider Focus, our award-winning e-newsletter for network providers! Here you’ll find articles and information to keep you up-to-date on news and topics relevant to serving Magellan members, including a section for regional- and plan-specific news. Check back as a new issue is released each quarter.

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