Telehealth and Form 5A

We offer a number of services via telehealth.  Can you please tell me where we should place these on Form 5A? 

Telehealth is simply a mechanism for service delivery using telecommunications technology or equipment and is not a service in itself; therefore, services provided via telehealth should be documented on Form 5A like all other services.  For example:

  • If Mental Health Services are provided via telehealth by a W-2 health center provider or volunteer, these services would be reflected in Column I under Mental Health Services.
  • If General Primary Medical Care Services are provided via telehealth by a 1099 contracted provider, these services would be reflected in Column II under General Primary Medical Care.
  • If Gynecological Services are provided through a formal, written contract that the health center pays for, these services would be reflected in Column II under Gynecological Services. 

Resources for telehealth include the following:

Policy Information Notice 2008-01 – Defining Scope of Project and Policy for Requesting Changes (PIN 2008-01):  This Policy Information Notice helps to define what constitutes the scope of project for health centers.

Program Assistance Letter 2020-01 – Telehealth and Health Center Scope of Project (PAL 2020-01): This Program Assistance Letter provides information on the utilization and documentation of telehealth within the health center’s scope of project.

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