July 2020 Telehealth Updates
With the Secretary of the Department of Health and Human Services extending the Public Health Emergency (PHE) due to the COVID-19 pandemic, many private practices as well as facilities and organizations want to know what does this mean for the extension of providing outpatient therapy services via telehealth. In this article, I will provide updates on outpatient therapy services delivered via telehealth for the traditional Medicare Part B program and some of the larger national insurance carriers.
Medicare (Traditional)
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Aetna
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Anthem BCBS of Colorado
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Anthem BCBS of Connecticut
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Anthem BCBS of Georgia
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Anthem BCBS of Indiana
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Anthem BCBS of Kentucky
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Anthem BCBS of Maine
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Anthem BCBS of Missouri
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Anthem BCBS of Nevada
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Anthem BCBS of New Hampshire
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Anthem BCBS of Ohio
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Anthem BCBS of Virginia
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Anthem BCBS of Wisconsin
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BCBS of North Carolina
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Cigna
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CareFirst BCBS
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Florida BCBS
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HighMark BCBS for OH, PA and WV
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Horizon BCBS
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Humana
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Premera BCBS for Alaska
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Premera BCBS for Washington
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Regence BCBS
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UnitedHealthcare Telehealth for Individual and Fully Insured Group Market
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UnitedHealth Medicare Advantage
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Wellmark BCBS
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Thank you Rick for continuing to research, pull, and publish this information for us, we really appreciate it. It helps us tremendously in being able to keep up with this ever changing part of our practice.
The link for Anthem BC of California is not working (not highlighted). I am curious about Anthem BC Medi-Cal as the governor’s state order was that telemed physical and occupational therapy was to be covered by all state managed plans. Did that expire?
Anthem BCBS for California has been corrected. Regarding specific questions about state Medicaid programs, I would recommend you contact your state association. The California Emergency Services Act (Gov. Code sections 8566, et seq.), states all Medi-Cal managed care health plans shall, effective immediately, reimburse providers at the same rate, whether a service is provided in-person or through telehealth, if the service is the same regardless of the modality of delivery, as determined by the provider’s description of the service on the claim.
SO HELPFUL, makes my membership more than worth it!
You are welcome!
great info! Thanks Rick.
Sam Dalal
Have they made any changes regarding supervision and the use of telehealth? Specifically, for outpatient, a therapist is required onsite during assistant treatments. Can telehealth be used as a means for this supervision?
In the private practice setting, CMS has eased the direct supervision requirements of a PTA by a PT and an OTA by an OT to general supervision if allowed by the therapists’ state law and practice act.
Hi Rick- United originally (in March) had language that talked about using revenue code 780, instead of normal revenue codes. I don’t see that listed anywhere, any longer. Can you confirm that for United we would bill using normal therapy revenue codes? Thanks!
Per the UHC website: During this expansion time frame, we will temporarily reimburse providers for telehealth services at their contracted rate for in-person services. UnitedHealthcare will reimburse claims including one of the CPT codes from the telehealth code list, as long as claims are submitted on a CMS 1500 form using the place of service that would have been reported had the services been furnished in person along with a 95 modifier, or on a UB04 form with applicable revenue code and a CPT code with a 95 modifier.
For Medicare in Hospital based settings, does this include evaluations, or do they still have to be established patients?
You can do evaluations. Please refer to the list of CPT codes the Medicare program covers if delivered via telehealth.
Hi Rick. Are there updates on your website with end dates to cover telehealth by insurance? The dates on this page are 2020. Thanks!
Under current news, there are articles for Aetna, UHC and Cigna.