Since the program’s inception, the Texas state telemonitoring program has only benefited those who have been diagnosed with hypertension and/or diabetes.
In October 2020, TMHP (Texas Medicaid & Healthcare Partnership) announced that they had expanded the benefit under the CHSCN (Children with Special Health Care Needs) program to benefit pediatric Medicaid beneficiaries with three new conditions: required mechanical ventilation; organ transplant; and end-stage solid organ disease. TMHP made no mention of expanding qualified diagnosis for beneficiaries 21 and older.
Since 2018, adoption rates for the Texas Home Telemonitoring program have risen. This is most likely related to the unbundling of Medicare CPT code 99091 that also occurred in 2018, and hence drove exposure to telehealth and remote patient monitoring.
In addition to the October 2020 qualifying diagnosis expansions, TMHP also notified providers that prior authorizations could now be authorized for 180 days vs. the original 60 days, lifting a heavy administrative burden off Home and Community Support Services Agencies or Hospitals.
In the same update, TMHP announced that RN, NP, CNS, or PA’s may sign prior authorization requests on behalf of the client’s physician when the physician delegates this authority. This was another significant update for Home and Community Support Services Agencies or Hospitals that assisted in expediting their orders management process for the program.
Surprisingly, home telemonitoring provider adoption rates remain low. According to a 2020 report from Texas Health and Human Services, 402 providers were rendering telemonitoring services at the end of FY 2019. Clients receiving home telemonitoring services between January and May 2020 was only 13,941. Many factors contribute to the lack of provider adoption. However, it is most likely attributed to the lack of information, education, and provider notification surrounding the home telemonitoring program.