March 2025
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.
The quarterly updates for the Arkansas, Tennessee, and Mississippi Virtual Visit Billing Guides are now available!
Good news! Current Medicare telehealth flexibilities were extended through September 30th, 2025, via recently passed legislation.
Several changes within the Commercial and Medicaid space also occurred this past quarter, as payors continue to evaluate the newly released 2025 telehealth E/M codes.
See the detailed updates below and stay tuned for additional updates as payors continue to evaluate their policies regarding the 2025 telehealth code changes!
Aetna
- Added CPT code 96041 covered with modifiers FR, GT and 95
- Removed reference to deleted CPT code 96040
BCBS of AR
- Updated allowable code list to include new telehealth CPT codes 98000-98015
- Noted that CPT 98016 is considered an integral part of the evaluation and management service and is not separately reimbursable
- Expanded Q3014 claim information/requirements
CIGNA
- Removed deleted telephone CPT codes 99441 – 99444
- Added new telehealth CPT codes 98000-98015 to the medical section of the policy only
- Removed language around CMS 97 guidelines and replaced with language to support the current E/M guidelines
Medicare
The Full Year Continuing Appropriations and Extensions Act, 2025 extended current telehealth flexibilities for Medicare patients through September 30th, 2025:
- Originating Site & Geographic Restriction waived
- Allows any health care provider who is eligible to bill Medicare for covered services to continue to provide and bill for telehealth services
- In person requirement for mental health services via telehealth waived
- Extension of FQHC/RHC to serve as originating site for non-behavioral/mental telehealth services
BlueCare of Tennessee
Updated allowable code list to include new telehealth CPT codes 98000-98015
- Online assessments and e-visits are no longer allowable
- Reduced allowable for audio-only telehealth services
- Provided direction for RHCs and FQHCs to utilize POS 50 or 72
UHC Community Plan of Tennessee
- School-based services need to billed using POS 03 with appropriate modifier for telehealth
- RHC/FQHC to utilize standard POS 50/72 with appropriate procedure and modifier combination for telehealth and only utilize POS 02/10 if no other option is available
- Audio only services identified by modifier 93 will be reduced by 15% for reimbursement
