Billing Telehealth Updates for the South Central Region – April 2021

The Arkansas, Tennessee, and Mississippi Virtual Visit Billing Guides have been updated with the most recent payor telehealth policy changes!  The COVID-19 Federal Public Health Emergency (PHE) was renewed for another 90 days, effective April 21^st, 2021.  Due to this renewal, we saw several payors extend their telehealth flexibilities to match the new PHE expiration date of July 20^th, 2021. We also saw commercial payors that closely follow Medicare’s policies, such as Aetna and UHC, update their telehealth allowable code list based on Medicare’s March 31^st, 2021 updates.

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.  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.

Below are more detailed key updates for regional and national payors since the guides were originally published.

AETNA

• Commercial: Effective 5/15/21-Added coverage for 96125, 97129, 97130
• Medicare Advantage: Added coverage consistent with the 1/1/21 Medicare Telehealth Services Temporary Addition for the PHE for the COVID-19 Pandemic services added 3/30/21.

BLUE CROSS BLUE SHIELD

• Arkansas:
  • Extended current telehealth flexibilities and cost share waiver for telehealth visits, for any DX, through June 30^th, 2021.
• Tennessee:
  • Extended cost share waiver for COVID-19 related telehealth visits to June 1^st, 2021. After June 1^st, 2021, will only waive cost share for telehealth visits when related to the administration of a COVID-19 test.

CIGNA

• Extended the cost share waiver for telehealth visits related to the assessment and administration of COVID-19 diagnostic testing, along with virtual screening telephone consults (for any DX) through July 20th, 2021.
• Through end July 20th, 2021, Cigna will continue to allow the following:
  • Facilities to bill on a UB-04 claim form
  • Urgent care centers to offer virtual care
  • Code G2012 to be billed for quick 5-10 minute phone conversations
  • Most synchronous technology to be used (e.g., FaceTime, Skype, Zoom, etc.)
  • eConsult codes (99446-99449, 99451, and 99452)
  • Preventive care codes (99381-99387 and 99391-99397)

UNITED HEALTHCARE

Telehealth Eligible Services Code List updated; G2211 removed due to CMS decision to bundle the code.