The Arkansas, Tennessee, and Mississippi Virtual Visit Billing Guides have been updated with recent January payor changes! Payors continue to make permanent telehealth policy changes that incorporate greater telehealth flexibilities. Permanent telehealth changes seen from payors such as Cigna and UHC include the removal of the originating site restriction and expanded telehealth code sets.
These guides were created to save you time and intended to provide overall information and education about virtual visits, however due to the volume of information in these guides, it can be difficult for healthcare providers to decipher the best workflow for their particular situation. We are finding in our work with organizations that there is no “one size fits all” solution. Each unique set-up and situation must be considered in formulating the best plan for your organization. If you would like some support in a plan, please reach out to us and we would be glad to discuss how we can help.
Providing a quick high-level overview of the recent updates, all payors have extended their telehealth flexibilities to at least the end of the federal Public Health Emergency (PHE), which is currently set to end on April 21st, 2021. UHC has followed suit with Cigna and Medicare and rolled out significant permanent telehealth changes.
Below are more detailed key updates for regional and national payors since the guides were originally published.
AETNA
- No Changes
CIGNA
- Extended the current cost share waiver through April 20th, 2021, including the cost share waiver for virtual check ins (G2012).
- Clarified that while the Virtual Care Reimbursement Policy that went into effect on January 1st, 2021 only applies to claims submitted on a 1500 claim form, Cigna will continue to reimburse Services billed when the service is:
- Reasonable to be provided in a virtual setting; and
- Reimbursable per a provider’s contract; and
- Synchronous audiovisual technology is utilized (except for CPTs 99441-99443)
- Extended coverage for the virtual check-in code, G2012, through April 20th, 2021.
- Clarified that non-HIPAA complaint technology can still be used during the PHE, such as FaceTime, Skype, Zoom, etc.
- Urgent care centers may continue to offer virtual care through April 20th, 2021.
UNITED HEALTHCARE
- UHC implemented a permanent Telehealth/Telemedicine policy effective 01/01/2021, which includes the following changes:
- E-Visits, Interprofessional Consultations, Remote Patient Monitoring, and Virtual Check-Ins are now permanently allowable.
- Telehealth is now permanently allowable from the patient’s home with no telepresenter present.
- HIPAA compliant platform is required after PHE ends.
- Audiovisual technology is required for telehealth services.
- Published a revised telehealth allowable code set list.
MEDICA
- Extended cost share waiver for visits related to COVID-19 testing through April 30th, 2021.
ARKANSAS
Blue Cross Blue Shield
- Extended current telehealth flexibilities until April 21st, 2021.
- Extended cost share waiver for telehealth services, for any DX, as indicated by the highlighted codes in the telehealth code matrix in the guide until April 21st, 2021.
Medicaid
- Extended current telehealth flexibilities until April 21st, 2021.
- Extended cost share waiver for telehealth services, for any DX, as indicated by the highlighted codes in the telehealth code matrix in the guide until April 21st, 2021.
MISSISSIPPI
Blue Cross Blue Shield
- No Changes.
Medicaid
- No Changes.
TENNESSEE
Blue Cross Blue Shield
- No Changes.
Medicaid
- No Changes.
