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.
The quarterly updates for the Arkansas, Tennessee, and Mississippi Virtual Visit Billing Guides are now available! Following the wave of 2025 policy changes, most payors have remained relatively quiet this quarter, with few new updates as their telehealth and virtual care policies appear to have stabilized a bit more.
One notable change comes from Medicare regarding RHCs and FQHCs. The original July 1st, 2025 deadline for transitioning from HCPCS G0511 to individual CPT care management codes has now been extended. CMS has announced an updated deadline of September 30, 2025. Providers may continue billing G0511 through this extended period if system updates are still underway.
Below are additional other updates:
CIGNA
- Removed CPT code 96040, Medical genetics and genetic counseling services, each 30 minutes face-to-face with patient/family as the AMA deleted the code effective 12/31/2024
- Added CPT code 96041, Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter, which replaced code 96040 effective 01/01/2025
Medicare
- Effective January 1, 2025, CMS began requiring RHC and FQHC providers to report individual CPT and HCPCS base/add-on codes for care coordination services in place of HCPCS code G0511. A transition period was initially established, allowing continued use of G0511 through July 1st, 2025. CMS has since extended the transition period to September 30, 2025. After this date, G0511 will no longer be valid for billing.
UHC
- Effective January 1, 2025, CMS began requiring RHC and FQHC providers to report individual CPT and HCPCS base/add-on codes for care coordination services in place of HCPCS code G0511. A transition period was initially established, allowing continued use of G0511 through July 1st, 2025. CMS has since extended the transition period to September 30, 2025. After this date, G0511 will no longer be valid for billing.
