Illinois Governor Mandates Telehealth Coverage

March 26, 2020
Rick Gawenda

Governor Pritzker of Illinois, On March 19, 2020, mandated that all insurance carriers regulated by the Department of Insurance are hereby required to cover the cost of Telehealth Services rendered by in-network providers to deliver any clinically appropriate, medically necessary covered services and treatments to insureds, enrollees and members under each policy, contract, or certificate of health insurance coverage.

Click HERE to read the order. Click HERE to access the Illinois PT Association website regarding any updates.

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  1. Rick, with the mandated telehealth coverage for Illinois, can we bill for PT services using our normal CPT codes, 97110 etc, or will we have to use codes 98970, 98971, and 98972 for non-CMS insurance providers?

  2. we continue to struggle with clarity around if we can bill on the UB04 for commercial payors in IL. Seems like we cannot get a straight answer when we call or we get “ill have to look into and call you back”. i did see your other article about cigna and how to bill on the UB04. any other insight?

    1. I have many articles on my website. If you need consulting, I can provide that service to you.

  3. How are parity payments-in this case meaning, paid at the same rate as an office visit going to be done using evisit codes for therapy providers. It seems that the differences with fee schedule allowances and units would make this challenging at best?