The South Central Region Virtual Visit Billing Guides have been updated with the most recent payor changes. Below is this announcement's most recent updates, or click on any state to go directly to that state's guide.
Recent Updates
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
- Will no longer waive cost shares for specialty telehealth visits for Medicare Advantage members effective January 31st, 2021. However, through March 31st, 2021, Aetna will waive member cost sharing for in-network telehealth visits for primary care and behavioral health.
CIGNA
- Preventive care codes (99381-99387 and 99391-99397) will be temporarily allowed through April 20th, 2021.
- As of February 16th, 2021 Cigna will apply member cost sharing to all COVID-19 related treatment. Cigna will continue to cover visits related to assessment or administration of a COVID-19 test.
UHC
- No Changes
Medicare
- Medicare updated their 2021 telehealth allowable code list. They removed CPT 99201, as it is no longer a valid code.
BCBS of AR
- No Changes
Arkansas Medicaid
- No Changes
BCBS of MS
- No Changes
Mississippi Medicaid
- No Changes
BCBS of TN
- No Changes
Tennessee Medicaid & MCOs
- All Medicaid Managed Care Organizations (Amerigroup, Bluecare, and UHC Community Plan) have extended their current telehealth flexibilities and cost share waiver for COVID-19 related telehealth visits until June 30th, 2021.
