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:
Both TennCare and the Mississippi Division of Medicaid announced significant policy changes effective July 1st, limited details are below, however ensure you check out the guides for full details!
The COVID-19 Federal Public Health Emergency (PHE) has still not yet been renewed past July 20th, 2021, therefore several commercial payors are waiting to update their policies based on the renewal. Below are the detailed highlights:
Aetna
- Added permeant coverage for remote physiologic monitoring to include the following codes: 99453, 99454, 99457, 99458
BCBS of AR
- Extended telehealth flexibilities and cost share waive until September 30th, 2021
Tennessee Medicaid & MCOs
- As of June 30th, 2021 TennCare’s telehealth directives expired, and MCO individual policies will now apply.
- Amerigroup: Has 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: Extended their current telehealth flexibilities and cost share waiver until further notice.
- 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.
Mississippi Medicaid
- The MS Division of Medicaid announced that effective for dates of service on and after July 1, 2021, providers should refer to the Medicaid State Plan for DOM’s coverage of Telehealth Services, except for telephone and virtual check-in codes, which will continue through the end of the Mississippi State of Emergency.
- The MS Division of Medicaid also released the following statement regarding a State Plan Amendment that was being submitted, which will be effective July 1st 2021:
- State Plan Amendment (SPA) 21-0035 is being submitted to allow the Division of Medicaid (DOM) to:
- Set the fees for telehealth services the same as those in effect on July 1, 2020.
- Add Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) as distant site providers.
- Add language that FQHCs, RHCs and Community Mental Health Centers (CMHCs) delivering simultaneous distant and originating site can receive the originating or distant site facility fees when such services are appropriately provided by the same organization.
- Add school which employs a school nurse, inpatient hospital and the beneficiary’s home as an originating site.
- Add telehealth services must be Health Insurance Portability and Accountability Act (HIPAA) compliant.
- State Plan Amendment (SPA) 21-0035 is being submitted to allow the Division of Medicaid (DOM) to:
