The South Central Region Virtual Visit Billing Guides have been updated with the most recent payor changes. Below is this quarter’s most recent updates, or click on any state to go directly to that state’s guide.
This Quarter’s Highlights
The Arkansas, Tennessee, and Mississippi Virtual Visit Billing guides have been updated with the most recent payor changes! The COVID-19 Public Health Emergency expired May 11th, 2023, resulting in the end of several telehealth flexibilities. Flexibilities that ended include the cost share waiver for COVID-19 testing-related visits, OCR’s HIPAA compliant telehealth platform waiver, and audio only allowable telehealth services for several insurance companies. For Medicare, the Consolidated Appropriations Act of 2023, continued the allowance of numerous telehealth flexibilities for Medicare through December 31st, 2024. For commercial payors, most had already transitioned to permanent virtual services policies, however some are still working on finalizing their permanent policies, and therefore are still referring providers to use the interim telehealth guidance that was published during the COVID-19 PHE. Lastly, Medicaid policies have remained relatively stable, and no significant changes were made with the end of the COVID-19 PHE.
Below are the detailed updates:
AETNA:
- There are no changes to their permeant telemedicine policy with the end of the PHE
- An updated telemedicine policy will be shared in Q4 2023. Providers will receive 90- days’ notice before it goes into effect.
CIGNA:
- Preventive Care Services for CPT 99381-99387 and CPT 99391-99397 were added
- Added Remote Patient Monitoring Coverage Policy 0563
- Removed G2010 and S9100 from allowable telehealth code list
- Updated UB-04 billing information with May 2023 announcement
BCBS of Arkansas:
- Removed CS modifier information
BCBS of Tennessee:
- BCBS of TN announced that with the end of the PHE they will return to some their original policies and procedures
- However, As of June 30th, 2023, no additional updates have been made to their original policy, and therefore the information within the guide is still utilizing the telehealth guidance that was provided during the COVID-19 PHE
MEDICA:
- Medica’s emergency telehealth policy was set to end when the federal PHE ended (May 11th, 2023). However, Medica has not updated its standard telehealth policy yet, and therefore, upon inquiry, a Medica representative stated that the emergency policy will be in effective until further notice.
MEDICARE:
- Removed COVID-19 service flexibilities
- Updated reimbursement section
- Updated allowable telehealth list
MEDICAID:
- Bluecare of Tennessee Medicaid:
- Cost Share Waiver Updated
- Amerigroup:
- Updated allowable code set with Tenn. Code Ann. § 56-7-1002 information
- Changed E-visits, Virtual Check-Ins, and Telephone Codes to “Conditional” based on provider’s fee schedule
- UHC Community Plan Tennessee
- Removed telephone codes as being allowable
- Updated allowable code set with Tenn. Code Ann. § 56-7-1002 information
UNITED HEALTHCARE:
- Updated audio only information
- Added audio only code section
ALL PAYORS/GUIDES:
- Removed cost share waiver information
- All cost share waivers have been expired
- Removed HIPAA Compliant Platform from individual payor sections
- Updated HIPAA Compliant Platform Information in general section
- Removed Hospital Outpatient section as that was specific to COVID-19 flexibilities
