Telehealth Services for Orthotists and Prosthetists
The term “telehealth” means a health service delivered by a health professional to a client at a remote location through telecommunications or information technology.
Information technology includes computers, smart phones, and equipment, other than analog telephone, email or facsimile technology and equipment, used or capable of use for purposes of telecommunications.
Services You Can Provide
Orthotic and/or Prosthetic Assistants may not be remotely supervised by a LPO, LO or LP using telecommunications or information technology in the performance of a critical care event.
It is outside the scope of practice of an assistant to perform a critical care event without the supervising orthotist or prosthetist physically in the room, meaning these services cannot be provided by an assistant via telehealth.
Critical care events are defined in the Orthotics and Prosthetics Rules as initial patient assessment, prescription development and recommendation, appropriate patient education and training and final evaluation and assessment of fit and function of the custom-fabricated prosthesis or orthosis.
Follow-Up Care
You must provide the patient (or authorized representative) with information about how to obtain follow-up care, if applicable.
Preventing Fraud
To prevent fraud and abuse when providing a telehealth service, you must take reasonable steps to verify that the identity of the client matches the person who is scheduled to receive the telehealth service.
Out-of-State Providers
If the clients receiving the services are located in Texas, then you must hold an appropriate Texas license.
Billing
It is critical to check with your payor before initiating a new type of service or service delivery model, such as telehealth, as policies frequently change. Licensees who need additional information on billing policies relating to the provision of telehealth services should contact the entity they are billing to verify that telehealth services are reimbursable, and that proper coding is used.
Patient Consent
When providing telehealth services, you must meet each of the following requirements:
- If informed consent would be required for an in-person service, it must also be obtained when the service is provided via telehealth
- You must allow the client (or authorized representative) to refuse delivery of telehealth services at any time
Patient Privacy and Confidentiality
When providing telehealth services, you must take appropriate measures to ensure that client communications, recordings, and records are protected as required by federal and state privacy laws.
You must also ensure that appropriate protocols are in place to prevent unauthorized access to client communications and claim information.
While providing telehealth services, you will be responsible for ensuring all persons acting under your supervision, direction, or delegated authority observe federal and state privacy laws.
Before providing telehealth services, you should verify the applicability of other requirements and obligations, such as HIPAA and other medical and personal privacy requirements.
Record Keeping Requirements
Documentation for a telehealth service must be completed to the same extent as would be required for an in-person service.
Any additional telehealth-related documentation must be maintained in accordance with applicable laws and rules governing your practice.
Relevant Laws and Rules
Telehealth Law for Texas Physicians, Dentists and Other Healthcare Professionals -- Texas Occupations Code, Chapter 111 -- Telemedicine, Teledentistry, and Telehealth.
Telehealth Law for TDLR Health Professions -- Texas Occupations Code 51.501 -- Telehealth
Telehealth Rules for TDLR Health Professions -- Texas Administrative Code, Chapter 100 -- General Provisions for Health-Related Programs in sections 100.61 - 100.65.