> ## Documentation Index
> Fetch the complete documentation index at: https://docs.encoreos.io/llms.txt
> Use this file to discover all available pages before exploring further.

# Telehealth Documentation & Compliance — Integration

> Feature ID: CL-24 Status: 📝 Planned Spec Reference: CL-24-telehealth-documentation-compliance.md Last Updated: 2026-02-24

**Feature ID:** CL-24\
**Status:** 📝 Planned\
**Spec Reference:** [CL-24-telehealth-documentation-compliance.md](../../../specs/cl/specs/CL-24-telehealth-documentation-compliance.md)\
**Last Updated:** 2026-02-24

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## Overview

CL-24 provides telehealth consent tracking, session-level technology and location metadata, GT/95 modifier logic for billing, and telehealth-specific safety and group documentation. It integrates with CL-04 (progress notes), CL-07 (safety planning), CL-11 (consent), CL-14 (group therapy), and PM-07 (charge capture / fee schedules) for modality and modifier logic.

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## Integration Points (from Spec)

| Dependency   | Pattern         | Purpose                                                                                       |
| ------------ | --------------- | --------------------------------------------------------------------------------------------- |
| PF-01, PF-02 | Direct          | Encounter and RBAC context for consent check at encounter (US-2)                              |
| CL-04        | Data            | Progress notes — `cl_telehealth_sessions.progress_note_id`; service\_modality remains on note |
| CL-07        | Data / API      | Remote safety planning protocols                                                              |
| CL-11        | Data / Boundary | Telehealth consent separate from TPO/SUD consent                                              |
| CL-14        | Data            | Group telehealth attendance and consent                                                       |
| PM-07        | Data            | GT/95 modifier logic reads session modality from CL-24 session data                           |

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## API / Data Contracts

### Data Provided by CL-24

* **Consent:** `cl_telehealth_consents` — per-patient telehealth consent with expiration (status derived from `expires_at`, `revoked_at`).
* **Sessions:** `cl_telehealth_sessions` — session-level modality, patient location, state jurisdiction, technology verified, connectivity issues; linked to `cl_progress_notes` via `progress_note_id`.

### Consumed by PM-07

* **Modifier logic:** PM-07 (charge capture / fee schedules) reads session modality (e.g. synchronous\_video, synchronous\_audio\_only) from `cl_telehealth_sessions` to apply GT/95 or payer-specific modifiers. Contract: modality + org/payer rules → modifier selection; feed into charge/claim workflow.

### Consent Check at Encounter (PF-01 / PF-02)

* **Contract:** At encounter start, registration/workflow checks valid telehealth consent for chart (e.g. `deriveTelehealthConsentStatus` (planned — not yet implemented): active when `revoked_at IS NULL AND expires_at > now()`). Block or warn if expired/missing; renewal workflow available.

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## Event Contracts (Planned)

*No events currently specified.* Modality data is read synchronously by PM-07 from `cl_telehealth_sessions` when building charges. If event-based flow is adopted later, document here.

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## Security and RLS

* All CL-24 tables: RLS enabled; policies use SECURITY DEFINER helpers (e.g. `cl_has_org_access`); UPDATE policies include WITH CHECK (§5.2.4).
* Consent and session data are PHI; permission-gated UI; no RLS policies query RLS-protected tables directly (§5.7).

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## Related Docs

* [CL-04 Progress Notes & Session Documentation](./progress-notes-session-documentation-integration.md)
* [CL-PM Encounter-to-Billing](./CL-PM-ENCOUNTER-TO-BILLING.md) — PM-07 charge capture consumes note/session data
* [CL-PM Telehealth](./CL-PM-TELEHEALTH.md)
* [CROSS\_CORE\_INTEGRATIONS.md](./CROSS_CORE_INTEGRATIONS.md)