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Texas SLP Telehealth

Definitions Relating to Telehealth

Client - A consumer or proposed consumer of speech-language pathology or audiology services.

Client site - The physical location of the client at the time the services are being furnished via telecommunications.

Consultant - Any professional who collaborates with a provider of telehealth services to provide services to clients.

Facilitator - The individual at the client site who assists with the delivery of the telehealth services at the direction of the audiologist or speech-language pathologist.

Provider - An individual who holds a current, renewable, unrestricted speech-language pathology or audiology license or an individual who holds an audiology intern license.

Provider site - The physical location at which the speech-language pathologist or audiologist delivering the services is located at the time the services are provided via telecommunications which is distant or remote from the client site.

Telecommunications - Interactive communication at a distance by concurrent two-way transmission, using telecommunications technology, of information, including, without limitation, sound, visual images, and/or computer data, between the client site and the provider site, and required to occur without a change in the form or content of the information, as sent and received, other than through encoding or encryption of the transmission itself for purposes of and to protect the transmission.

Telecommunications technology - Computers and equipment, other than telephone, email or facsimile technology and equipment, used or capable of use for purposes of telecommunications. For purposes of this subchapter, the term includes, without limitation:

    • Compressed digital interactive video, audio, or data transmission;
    • Clinical data transmission using computer imaging by way of still-image capture and storage and forward; and
    • Other technology that facilitates the delivery of telepractice services.

Telehealth - The use of telecommunications and information technologies for the exchange of information from one site to another for the provision of speech-language pathology or audiology services to a client from a provider.

Telehealth services - The application of telecommunication technology to deliver speech-language pathology and/or audiology services at a distance for assessment, intervention, and/or consultation.

Telepractice - The use of telecommunications technology by a license holder for an assessment, intervention, or consultation regarding a speech-language pathology or audiology client.

Telepractice services - The rendering of audiology and/or speech-language pathology services through telepractice to a client who is physically located at a site other than the site where the provider is located.

Service Delivery Models of Speech-Language Pathologists

Telehealth may be delivered in a variety of ways, including, but not limited to those set out in this section.

    • Store-and-forward model/electronic transmission is an asynchronous electronic transmission of stored clinical data from one location to another.
    • Clinician interactive model is a synchronous, real time interaction between the provider and client or consultant that may occur via telecommunication links.

Self-monitoring/testing model refers to when the client or consultant receiving the services provides data to the provider without a facilitator present at the site of the client or consultant.

Live versus stored data refers to the actual data transmitted during the telepractice. Both live, real-time and stored clinical data may be included during the telepractice.

Requirements for the Use of Telehealth by Speech-Language Pathologists

A provider of telehealth services who practices in the State of Texas shall be licensed by the department.

A provider shall comply with the commission's Code of Ethics and Scope of Practice requirements when providing telehealth services.

The scope, nature, and quality of services provided via telehealth are the same as that provided during in-person sessions by the provider.

The quality of electronic transmissions shall be equally appropriate for the provision of telehealth services as if those services were provided in person.

A provider shall only utilize technology that the provider is competent to use as part of the provider's telehealth services.

Equipment used for telehealth services at the clinician site shall be maintained in appropriate operational status to provide appropriate quality of services.

Equipment used at the client/patient site at which the client or consultant is present shall be in appropriate working condition and deemed appropriate by the provider.

The initial contact between a licensed speech-language pathologist and client may be at the same physical location or through telehealth/telepractice, as determined appropriate by the licensed speech-language pathologist.

A provider shall consider relevant factors including the client's behavioral, physical, and cognitive abilities in determining the appropriateness of providing services via telehealth/telepractice.

A provider shall be aware of the client's or consultant's level of comfort with the technology being used as part of the telehealth services. The provider shall adjust the provider's practice to maximize the client's or consultant's level of comfort.

When a provider collaborates with a consultant from another state in which the telepractice services are delivered, the consultant in the state in which the client receives services shall be the primary care provider for the client.

As pertaining to liability and malpractice issues, a provider shall be held to the same standards of practice as if the telehealth services were provided in person.

A provider shall be sensitive to cultural and linguistic variables that affect the identification, assessment, treatment, and management of the clients.

Upon request, a provider shall submit to the department data which evaluates effectiveness of services provided via telehealth including, but not limited to, outcome measures.

Telehealth providers shall comply with all laws, rules, and regulations governing the maintenance of client records, including client confidentiality requirements, regardless of the state where the records of any client within this state are maintained.

Notification of telehealth services shall be provided to the client, the guardian, the caregiver, and the multi-disciplinary team, if appropriate. The notification shall include, but not be limited to: the right to refuse telehealth services, options for service delivery, and instructions on filing and resolving complaints.

Limitations on the Use of Telecommunications Technology by Speech-Language Pathologists

The limitations of this section apply to the use of telecommunications technology by speech-language pathologists.

Supervision of a licensed assistant in speech-language pathology may be undertaken through the use of telecommunications technology and as follows:

    • No more than two (2) hours of direct supervision per month shall be undertaken through the use of telecommunications technology; and
    • No more than six (6) total hours of supervision per month shall be undertaken through the use of telecommunications technology.

Direct supervision of a licensed intern in speech-language pathology shall not be undertaken through the use of telecommunications technology.

Telehealth services may not be provided by correspondence only, e.g., mail, email, faxes, although they may be adjuncts to telepractice.

Reference

16 Tex. Admin. Code §111.210

16 Tex. Admin. Code §111.211

16 Tex. Admin. Code §111.212

16 Tex. Admin. Code §111.213

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