Legislative Update

Electronic Visit Verification Update

Outpatient Occupational Therapy (OT), Outpatient Physical Therapy (PT), Outpatient Speech Therapy(ST), and Outpatient Pediatric Behavioral Therapy (PBT) services provided via telehealth (billed as Place of Service 02) do not require EVV. However, those services that are delivered in Places of Service 4, 12, 15, 16, 18, 24, 25, 37, 38, 83, 84, or 99 continue to require EVV.

This exclusion does not apply to EI or EPSDT services.

If you are providing services listed in the EVV Program Manual, EVV is required. You can check this by seeing what procedure or revenue codes you bill with to determine if those services require EVV when delivered via telehealth. For example, procedure code 97155 falls under PBT and so would not require EVV if delivered via telehealth. The only exceptions listed in the notice are if OT, PT, ST, or PBT is delivered via telehealth. Otherwise, EVV is still required.

Community Provider Rate

On January 28, 2021, the Joint Budget Committee (JBC) approved a 2.5% across the board increase in community provider rates. This increase is presented as a restoration of last year’s 1% decrease and a 1.5% increase. The committee noted the 1.5% increase is less than inflation meaning the capacity building goals in the various providers covered by this rate are not fully addressed in this action. Senators Moreno and Rankin also highlighted this increase is contingent upon the revenue forecasts for 2021-22 and beyond.

*Note: This action was approved but will have to make it through the full budget process which ends in April.

R-17 Speech Evaluation Cap – Medicaid

As a cost saving measure, the Department of Health Care Policy and Financing has proposed a cap on speech-language evaluations to two a year. R-17 states: “In order to reduce Medicaid spending in response to the State’s revenue shortfalls, the Department requests to implement targeted benefit reductions in the Medicaid program. These changes include setting a limit on outpatient speech therapy evaluations and implementing an enrollment cap on the Program of All-Inclusive Care for the Elderly.”

CSHA has met with Senator Bob Rankin, Representative Kim Ransom, Representative Julie McCluskie, and Representative Leslie Herod to advocate a cap of three evaluations per year as opposed to two as HCPF proposed.

For more information on this proposal see: FY 2021-22, HCPF, R-17 Medicaid Benefit Adjustments.pdf (colorado.gov)

Interstate Compact

CSHA is leading the effort to pass the Audiology and Speech-Language Interstate Compact in Colorado! The bill “SB21-021 Audiology and Speech-language Pathology Interstate Compact” would allow audiologists and speech-language pathologists licensed in any compact state to provide:

• Audiology or speech-language pathology services in each member state under a privilege to practice;

and;

• Telehealth services in each member state under a privilege to practice.

As of March 16, 2021, this bill passed the Senate on Third Reading 32-0 with three excused. It is on the way to the House and CSHA’s lobbyists have connected with the House sponsors. To follow the process click here: Audiology And Speech-language Interstate Compact | Colorado General Assembly
Click here for further information.