Hayley Prosser, Author at LearnTelehealth https://learntelehealth.org/author/hprosserruralmed-net/ Tue, 07 Apr 2026 19:14:50 +0000 en-US hourly 1 https://learntelehealth.org/wp-content/uploads/2026/06/cropped-Favicon-2026-32x32.png Hayley Prosser, Author at LearnTelehealth https://learntelehealth.org/author/hprosserruralmed-net/ 32 32 Billing & Reimbursement Updates Now Available! Q1 2026 https://learntelehealth.org/2026/04/billing-reimbursement-updates-now-available-q1-2026/ Tue, 07 Apr 2026 19:13:46 +0000 https://learntelehealth.org/?p=31310 The post Billing & Reimbursement Updates Now Available! Q1 2026 appeared first on LearnTelehealth.

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Q1 2026 Telehealth Billing & Reimbursement Updates are now available!

The quarterly updates for the Arkansas, Tennessee, and Mississippi Virtual Visit Billing Guides are now available!  These updates reflect key regulatory changes and ongoing efforts to keep providers up to date on virtual care guidelines.

On February 3, 2026, the Consolidated Appropriations Act, 2026, was passed, extending Medicare telehealth flexibilities through December 31, 2027. This ensures continued access to virtual care for Medicare beneficiaries and reinforces the role of telehealth in modern healthcare delivery, particularly for rural and underserved communities.

View South Central Billing & Reimbursement Updates

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]]> View the Latest Billing Updates for the South Central Region – January 2024 https://learntelehealth.org/2024/02/view-the-latest-billing-updates-for-the-south-central-region-january-2024/ Thu, 01 Feb 2024 17:03:48 +0000 https://learntelehealth.org/dev/?p=24557 The South Central Region Virtual...

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]]> 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.

Below are the detailed updates:

The Arkansas, Tennessee, and Mississippi Virtual Visit Billing guides have been updated with the most recent payor changes!  Medicare performed several updates for 2024.  The telehealth code set was updated, direct supervision requirements were clarified, and the list of allowable telehealth providers was expanded.  Furthermore, the Consolidated Appropriations Act of 2023 will continue to allow numerous telehealth flexibilities for Medicare through December 31st, 2024.  For Commercial, several payors completed an end of year telehealth code set update, including Aetna, which had a significant revamp in their telehealth policy for the first time since the PHE ended in May 2023.  Commercial policies should remain relevantly stable in the next couple months, with the exception of possibly BCBS of Mississippi, which still lists numerous codes within their policy that expired in December 2023.   Lastly, Medicaid policies have remained relatively stable, with no significant changes for year end.

AETNA:

  • New policy and updated code set for 2024
  • E-Visit, Virtual Check-Ins, and Telephone no longer allowable

BCBS of TN:

  • Updated quality measure tables
  • Clarified Place of Service Requirements

Mississippi BCBS:

  • Updated code set to remove codes that expired December 31st, 2023

Medicare:

  • Updated Code Set
  • Added in supervision requirements
  • Added in expanded providers allowable to bill Medicare services in 2024 (Mental Health Counselors and Marriage and Family Therapists)
  • Updated payment rates to 2024 allowable rates
  • Updated RHC/FAQHC Section

UHC:

  • Updated code set

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]]> View the Latest Billing Updates for the South Central Region – Q3 2023 https://learntelehealth.org/2023/12/view-the-latest-billing-updates-for-the-south-central-region-q3-2023/ Thu, 14 Dec 2023 18:33:12 +0000 https://learntelehealth.org/dev/?p=24548 The South Central Region Virtual...

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]]> 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.

Below are the detailed updates:

AETNA:

  • Updated code set
  • Audio only connection codes expiring December 1st, 2023
  • Telephone codes expiring December 1st, 2023

Medica:

  • Updated code set
  • Audio Only Codes will expire December 31st, 2024
  • Modifiers updated

BCBS of Mississippi:

  • Added in Remote Patient Monitoring Information
  • Expanded Store and Forward Information

Arkansas Medicaid:

  • G2012 no longer allowed
  • Removed modifier GT information

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]]> Here’s the Latest for the South Central Region – Q2 2023 https://learntelehealth.org/2023/07/billing-telehealth-updates-for-the-south-central-region-q2-2023/ Mon, 10 Jul 2023 16:06:43 +0000 https://learntelehealth.org/?p=22622 The post Here’s the Latest for the South Central Region – Q2 2023 appeared first on LearnTelehealth.

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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.

This Quarter’s Highlights

The Arkansas, Tennessee, and Mississippi Virtual Visit Billing guides have been updated with the most recent payor changes!  The COVID-19 Public Health Emergency expired May 11th, 2023, resulting in the end of several telehealth flexibilities.  Flexibilities that ended include the cost share waiver for COVID-19 testing-related visits, OCR’s HIPAA compliant telehealth platform waiver, and audio only allowable telehealth services for several insurance companies.  For Medicare, the Consolidated Appropriations Act of 2023, continued the allowance of numerous telehealth flexibilities for Medicare through December 31st, 2024.  For commercial payors, most had already transitioned to permanent virtual services policies, however some are still working on finalizing their permanent policies, and therefore are still referring providers to use the interim telehealth guidance that was published during the COVID-19 PHE.  Lastly, Medicaid policies have remained relatively stable, and no significant changes were made with the end of the COVID-19 PHE.

Below are the detailed updates:

AETNA:

  • There are no changes to their permeant telemedicine policy with the end of the PHE
    • An updated telemedicine policy will be shared in Q4 2023.  Providers will receive 90- days’ notice before it goes into effect.

CIGNA:

  • Preventive Care Services for CPT 99381-99387 and CPT 99391-99397 were added
  • Added Remote Patient Monitoring Coverage Policy 0563
  • Removed G2010 and S9100 from allowable telehealth code list
  • Updated UB-04 billing information with May 2023 announcement

BCBS of Arkansas:

  • Removed CS modifier information

BCBS of Tennessee:

  • BCBS of TN announced that with the end of the PHE they will return to some their original policies and procedures
    • However, As of June 30th, 2023, no additional updates have been made to their original policy, and therefore the information within the guide is still utilizing the telehealth guidance that was provided during the COVID-19 PHE

MEDICA:

  • Medica’s emergency telehealth policy was set to end when the federal PHE ended (May 11th, 2023). However, Medica has not updated its standard telehealth policy yet, and therefore, upon inquiry, a Medica representative stated that the emergency policy will be in effective until further notice.

MEDICARE:

  • Removed COVID-19 service flexibilities
  • Updated reimbursement section
  • Updated allowable telehealth list

MEDICAID:

  • Bluecare of Tennessee Medicaid:
    • Cost Share Waiver Updated
  • Amerigroup:
    • Updated allowable code set with Tenn. Code Ann. § 56-7-1002 information
    • Changed E-visits, Virtual Check-Ins, and Telephone Codes to “Conditional” based on provider’s fee schedule
  • UHC Community Plan Tennessee
    • Removed telephone codes as being allowable
    • Updated allowable code set with Tenn. Code Ann. § 56-7-1002 information

UNITED HEALTHCARE:

  • Updated audio only information
  • Added audio only code section

ALL PAYORS/GUIDES:

  • Removed cost share waiver information
    • All cost share waivers have been expired
  • Removed HIPAA Compliant Platform from individual payor sections
  • Updated HIPAA Compliant Platform Information in general section
  • Removed Hospital Outpatient section as that was specific to COVID-19 flexibilities

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]]> Billing Telehealth Updates for the South Central Region – Q4 2022 https://learntelehealth.org/2023/01/billing-telehealth-updates-for-the-south-central-region-q4-2022/ Tue, 03 Jan 2023 16:27:50 +0000 https://learntelehealth.org/?p=21551 The Arkansas, Tennessee, and Mississippi...

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]]> The Arkansas, Tennessee, and Mississippi Virtual Visit Billing guides have been updated with the most recent payor changes! The 2023 Medicare Physician final rule brought new allowable Medicare telehealth services, but also confirmed the future termination of multiple waivers currently in place for the federal public health emergency (PHE).  The Consolidated Appropriations Act, signed into law earlier this year, extended certain telehealth flexibilities for Medicare patients for 151 days after the official end of the PHE.  CMS confirmed that on day 152, the waivers listed below would be terminated.  One of the most significant waivers is the termination of the originating site waiver, which will require Medicare patients to once again to visit a qualified originating site (not patient’s home) to receive telehealth services unless it is for tele-mental health.  CMS did add several new services to the allowable telehealth list, including 5 new permanent telehealth codes for prolonged E/M services and chronic pain management and 54 codes to the category 3 telehealth list that be available for use through the end of 2023.  The COVID-19 Public Health Emergency is set to expire January 11th, 2023, however it is expected to be renewed for another 90-day period, as DHHS has stated that they will provide a 60-day notice before termination.  Due to the probable extension, commercial payors continue to allow their COVID flexibilities.  However, most payors have reverted to permanent policies with only a few expectations for the COVID PHE.

BCBS of Mississippi

  • Added store and forward information

UHC Community Plan of TN

  • Added additional services considered for telehealth reimbursement
  • Updated UHC telehealth allowable code list

Mississippi Medicaid

  • Added documentation information

Medicare

  • The below waivers will expire on day 152 post PHE:
    • Originating site restriction waiver
    • Expanded list of allowable telehealth practitioners
    • Audio only telehealth services
      • However, audio only mental telehealth services will still be allowed on a permanent basis if certain criteria are met
    • In person requirement for mental health services via telehealth
    • Extension of FQHC/RHC to serve as originating site
  • Updated allowable modifiers and POS for during PHE and post PHE

UHC

  • Add interprofessional code information
  • Updated eligible telehealth code list

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]]> Billing Telehealth Updates for the South Central Region – Q3 https://learntelehealth.org/2022/10/billing-telehealth-updates-for-the-south-central-region-q3/ Tue, 04 Oct 2022 14:18:35 +0000 https://learntelehealth.org/?p=21373 The Arkansas, Tennessee, and Mississippi...

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]]> The Arkansas, Tennessee, and Mississippi Virtual Visit Billing guides have been updated with the most recent payor changes!  The COVID-19 Public Health Emergency is set to expire October 13th, 2022, however it is expected to be renewed for another 90-day period, as DHHS has stated that they will provide a 60-day notice before termination.  Due to the probable extension, we have only seen minor payor updates this quarter.  However, we do anticipate significant payor updates at the end of 2022 due to the Medicare 2023 proposed Medicare Final rule and routine yearly payor policy reviews.

AETNA

  • Added audiovisual coverage for 90901 and 97763

BCBS of Arkansas

  • The cost share waiver for visits in which COVID-19 is the primary diagnosis, has expired.  Cost share waiver will continue only for visits that result in an evaluation or administration for a COVID-19 test.

United Healthcare

  • Updated telehealth code list table

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]]> Billing Telehealth Updates for the South Central Region – June 2022 https://learntelehealth.org/2022/07/billing-telehealth-updates-for-the-south-central-region-june-2022/ Wed, 06 Jul 2022 14:01:15 +0000 https://learntelehealth.org/?p=21053 Check out the most recent...

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]]> Check out the most recent updates to the Arkansas, Tennessee, and Mississippi Virtual Visit Billing guides! As the COVID-19 Federal Public Health Emergency (PHE) remains in place, payors continue to comply with federal and state mandated flexibilities.  However, we are seeing most payors shift from temporary policies, that had numerous telehealth flexibilities, to permanent policies, that are slightly more restrictive.  Payors also continue to implement the 2022 released modifiers 93, FQ, and FR and place of service code 10.   Furthermore, almost all payors have eliminated elective cost share waivers, and only continue to offer the federally mandated cost share waiver for COVID-19 testing-related services.

Aetna

  • Implemented use of FR, 93 and FQ modifiers.

BCBS of Arkansas

  • Removed their temporary COVID-19 telehealth guidance and referred providers to utilize an updated version of their permanent policy.  The policy shift resulted in several significant updates, including an established patient relationship and a video component requirement for telehealth codes.

Cigna

  • Cigna stated effective 07/01/2022, Place of Service (POS) 02 should be billed for virtual care services and not to bill POS 10 or the new virtual modifiers (93, FQ, and FR) until further notice.  Previously, they had instructed providers to begin utilizing modifiers 93 and FQ.  However, during the PHE, providers must continue to bill the POS that would have been used if the visit took place in person, and again, do not use the newly released modifiers.  This ensures proper reimbursement during the COVID PHE.

Medica

  • Implemented use of modifier 93 and FQ

Medicare

  • Added CPT 90901, 97537, 97763, 98960, 98961, 98962 to Temporary Addition for the PHE for the COVID-19 Pandemic
  • Clarified use of the FQ modifier, as most MACs are instructing providers to not utilize until after the PHE ends.

State of Tennessee Law

  • On April 8th, 2022, the State of Tennessee Public Chapter No 807, house bill no 1843, was enacted into law Tennessee which authorizes that all healthcare services, along with behavioral health services, can be provided by HIPAA compliant audio only conversation when real-time interactive video is not available.  Providers should confirm and maintain documentation that the patient:
    • Does not own the video technology necessary to complete an audio-video provider-based telemedicine encounter
    • Is at a location where an audio-video encounter cannot take place due to lack of service
    • Has a physical disability that inhibits the use of video technology

    Providers should also notify the patient that the financial responsibility for the audio-only encounter will be consistent with the financial responsibility for other in-person or video encounters, prior to the audio-only telemedicine encounter

Tennessee Medicaid

  • TennCare announced in June 21st, 2022 that the MCOs will comply with the following:
    • Continue to allow payment for services originating at a site other than an office on a permanent
    • Continue to reimburse telehealth services at parity.
    • Comply with public Chapter 4 of the 111th General Assembly 2nd Extraordinary Session authorizes the terms and conditions for the electronic delivery of health care.
    • Comply with public Chapter 191 of the 112th General Assembly authorizes payment for behavioral health services provided via audio only telehealth when broadband is not accessible.
    • Comply with public Chapter 807 of the 112th General Assembly authorizes that all healthcare services along with behavioral health services can be provided by HIPAA compliant audio only conversation when real-time interactive video is not available.

United Healthcare

  • Clarified telephone code usage

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]]> Billing Telehealth Updates for the South Central Region – March 2022 https://learntelehealth.org/2022/04/billing-telehealth-updates-for-the-south-central-region-march-2022/ Mon, 11 Apr 2022 17:23:19 +0000 https://learntelehealth.org/?p=20832 Check out the most recent...

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]]> Check out the most recent updates to the Arkansas, Tennessee, and Mississippi Virtual Visit Billing guides!  The updates not only include recent payor telehealth policy changes, but also a new payor matrix format!  Payors have continued their current telehealth flexibilities as the COVID-19 Federal Public Health Emergency (PHE) remains in place.  However, we are continuing to see these flexibilities becoming permanent instead of temporary policies. We are also seeing more payors implement the use of POS 10, which is “Telehealth Provided in Patient’s Home”.

BCBS

  • Tennessee: Added POS 10 as recognized POS

CIGNA

  • Effective 04/10/2022: CPT 96112 and 96113 added to code list as eligible for reimbursement.
  • Effective 03/13/2022: Added CPT 99091, 99446-99454, 99457-99458, 99473-99474 and HCPCS G0151-G0153, G0155, G0157-G0158, G0299-G0300, G0493, G2010. G2012, S9110, S9123 and S9128-S9131 code lists as eligible for reimbursement Added 98966-98972, 99421-99423, G0406-G0408, G0425-G0427, G0508-G0509, and S0320 to Non-Reimbursable code list.
  • Effective 07/01/2022 virtual care services must be submitted with POS 02; modifiers 93 or FQ will be added to the list of required modifiers

MEDICAID

  • Arkansas: Added POS 10 as recognized POS
  • Bluecare of Tennessee: Added POS 10 as recognized POS
  • UHC Community Plan of Tennessee: Added POS 10 as recognized POS

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]]> Billing Telehealth Updates for the South Central Region – February 2022 https://learntelehealth.org/2022/03/billing-telehealth-updates-for-the-south-central-region-february-2022/ Mon, 07 Mar 2022 20:50:27 +0000 https://learntelehealth.org/?p=20746 The Arkansas, Tennessee, and Mississippi...

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]]> The Arkansas, Tennessee, and Mississippi Virtual Visit Billing Guides have been updated with the most recent payor telehealth policy changes!  Payors have continued to keep in place their current telehealth flexibilities as the COVID-19 Federal Public Health Emergency (PHE) continues on.

We are seeing payors begin to implement the use of POS 10, which is the new POS code that CMS added effective January 1st, 2022.  POS 10  is now known as “Telehealth Provided in Patient’s Home”, while the original telehealth place of service (02),  was renamed to “Telehealth Provided Other than in Patient’s Home”.

Below are the detailed updates:

View or Download Guides

 

ANTHEM WISCONSIN

  • Extended telephone allowable code and cost share waiver through April 16th, 2022

CIGNA

  • Ended coverage for urgent care virtual care services effective March 13th, 2022
  • Announcement to hold off billing POS 02 until further notice

UHC Community Plan of Tennessee

  • Code list recognized with a modifier 95 updated

UHC

  • Added use of POS 10

WELLMARK

  • Revised section based on provider manual that was received.

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]]> Billing Telehealth Updates for the South Central Region – January 2022 https://learntelehealth.org/2022/02/billing-telehealth-updates-for-the-south-central-region-january-2022/ Wed, 02 Feb 2022 19:04:26 +0000 https://learntelehealth.org/?p=20476 The Arkansas, Tennessee, and Mississippi...

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]]> The Arkansas, Tennessee, and Mississippi Virtual Visit Billing Guides have been updated with the most recent payor telehealth policy changes!  The COVID-19 Federal Public Health Emergency (PHE) was renewed for another 90 days, effective January 16th, 2022.  Due to this renewal, we saw several payors extend their telehealth flexibilities to match the new PHE expiration date of April 15th, 2022. 

Medicaid Arkansas’ COVID-19 telehealth flexibilities, per policy, ended December 31st, 2021.  They still have not published updated guidance, however upon e-mailing an Arkansas Medicaid Representative they stated they have not heard that the flexibilities will end.  We have requested an updated policy and will continue to monitor for updates.

Below are the detailed updates:

AETNA

  • Added audiovisual coverage for 94625 and 94626

CIGNA

  • Extended cost share waiver through the end of the PHE

BCBS of Arkansas

  • Extended current COVID telehealth flexibilities through the end of the PHE

Medicare

  • Added CPT 94625 and 94626 available through December 31st, 2023.
  • Removed G0424 from the list of code available through December 31st, 2023

Call us to talk more about how the South Central Telehealth Resource Center can support your organization’s telehealth program. Call 1.888.664.3450 or email us at info@learntelehealth.org.

About the author(s)

Our guest contributor is Hayley Prosser, Director of Revenue Cycle Services, ruralMED Revenue Cycle Resources. Ms. Prosser, along with Ms. Shelly Cassidy, Vice President of Revenue Cycle Services, are trusted advisors to the SCTRC and our service region, and have developed the three state-focused Virtual Visit Billing Guides and webinars now available in the “Regional Resources” section of LearnTelehealth.org.

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