| Physical Presence required (Telehealth Capacity = 1) | ||||
|---|---|---|---|---|
| Examination/Screening | Lab Tests | Imaging | Treatments | Health Education/Counseling |
| Alcohol misuse screening | Basic Metabolic Panel | Any Image | ||
| Depression screening | CBC | Bone Mineral density | Alcohol abuse counseling | |
| Domestic violence screening | Chlamydia Test | CT Scan | Asthma education | |
| Substance abuse screening | Comprehensive metabolic panel (CBP) | Echocardiogram | Asthma action plan given to patient | |
| Skin | Creatinine/Renal Function Panel | Other Ultrasound | Mental health counseling, excluding psychotherapy | Diabetes education |
| Culture, blood | Mammography | Diet/Nutrition | ||
| Culture, throat | MRI | Exercise | ||
| Culture, urine | Radiograph | Psychotherapy | Family planning/Contraception | |
| Culture, other | Other Imaging | Growth/development | ||
| Glucose, serum | Injury prevention | |||
| Gonorrhea test | STD prevention | |||
| HbA1c (Glycohemoglobin) | Stress management | |||
| Hepatitis testing/panel | Substance abuse counseling | |||
| HIV test | Tobacco use/Exposure | |||
| HPV DNA test | Weight reduction | |||
| Lipid profile/panel | Other services | |||
| Liver enzymes/Hepatic function panel | ||||
| Pregnancy/HCG test | ||||
| PSA | ||||
| Rapid Strep test | ||||
| TSH/Thyroid | ||||
| Urine analysis/Urine dip stick | ||||
| Vitamin D test | ||||
| Cholesterol | ||||
| Triglycerides | ||||
| Fasting blood glucose | ||||
| Physical Presence required (Telehealth Capacity = 0) | ||||
|---|---|---|---|---|
| Examination/Screening | Procedures | Lab Tests | Treatments | |
| Breast Exam | Audiometry | Pap test | Cast/splint/wrap | |
| Foot Exam | Biopsy provided | Complementary and alternative medicine (CAM) | ||
| Neurologic | Cardiac stress test | Durable medical equipment | ||
| Pelvic | Colonoscopy | Home health care | ||
| Rectal | Cryosurgery(cryotherapy)/destruction of tissue | |||
| Retinal | EKG/ECG | Occupational therapy | ||
| Electroencephalogram (EEG) | Physical therapy | |||
| Electromyogram (EMG) | ||||
| Excision of tissue provided | Radiation therapy | |||
| Fetal monitoring | Wound care | |||
| Peak flow | ||||
| Sigmoidoscopy provided | ||||
| Spirometry | ||||
| Tonometry | ||||
| Tuberculosis skin testing (PPD) | ||||
| Upper gastrointestinal endoscopy/EGD provided | ||||
CBC, Complete blood count; HPV, human papillomavirus; HCG, human chorionic gonadotrophin; HIV, human immunodeficiency virus; TSH, thyroid-stimulating hormone; MRI, magnetic resonance imaging; STD, sexually transmitted disease; EKG/ECG, electrocardiogram; PPD, purified protein derivative (TB test); EGD, esophagogastroduodenoscopy.