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.
Highlights:
The COVID-19 Federal Public Health Emergency (PHE) was renewed for another 90 days, effective July 21st, 2021. Due to this renewal, we saw several payors extend their telehealth flexibilities to match the new PHE expiration date of October 17th, 2021. Furthermore, there were some significant changes in Tennessee’s Medicaid policies due to TennCare not renewing their state mandated telehealth polices. Below are more detailed updates for all three states.
CIGNA
- Extended the member cost share waiver for telehealth visits related to assessment and administration of diagnostic testing through October 17th, 2021.
- Extended the member cost share waiver for virtual screening telephone consults (for any DX) until further notice.
- Until further notice, 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)
Medica
- Extended current telehealth flexibilities and cost share waiver for in-network telehealth visits when related to administration of a COVID-19 test through October 31st, 2021.
Tennessee Medicaid & MCOs
As of June 30th, 2021 TennCare’s telehealth directives expired. Throughout the month of July we closely monitored TennCare for any updated policies, but there has been none published, therefore MCO individual policies will now apply.
- Amerigroup: Has still not issued updated telehealth guidance since the expiration of the TennCare’s telehealth directives on June 30th. We are seeking clarification from Amerigroup about an updated policy.
- BlueCare: Published a permanent telehealth policy, which does still include some temporary COVID-19 waivers. See guide for full detailed changes.
- United Healthcare Community Plan: With the expiration of TennCare’s directives on June 30th, UHC Community Plan coverage policies now apply. See guide for list of accepted telehealth codes.
