BCBS of North Carolina is implementing a new policy that will have a financial impact on outpatient therapy services. In this article, I will answer the following questions:

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) Aetna Anthem BCBS of Colorado Anthem BCBS of Connecticut Anthem BCBS of Georgia Anthem BCBS of Indiana Anthem BCBS of Kentucky

I have been receiving a significant number of questions regarding telehealth services covered by the various Blue Cross Blue Shield (BCBS) plans around the country. The expansion of telehealth services to include outpatient physical, occupational and speech therapy services by BCBS in each state will have different billing rules and regulations (place of service codes, CPT codes payable via telehealth), different start and end dates as well as different practice settings that can be reimbursed for providing telehealth services. In this article, I have provided the link to each states BCBS webpage where you can obtain the latest information on

On April 13, 2020, Arkansas Blue Cross Blue Shield (BCBS) announced they have expanded telehealth services to include outpatient physical, occupational and speech therapy services. The temporary changes are retroactive to April 1 and will be in effect through at least May 15, 2020, and could beextended after that, if circumstances warrant. There will be no waiver of cost share (e.g. copays, deductibles, and coinsurance) for these services and all contractual limitations, conditions, policies, and procedures will apply. Codes must be submitted with place of service 02 and modifier 95 or GT to indicate billing of a telehealth service. Appropriate

Here are 2 updates regarding telehealth services being expanded to outpatient therapy services. Effective March 30, 2020, NC Medicaid is temporarily modifying its Telemedicine and Telepsychiatry Clinical Coverage Policy to better enable the delivery of remote care to Medicaid and NC Health Choice beneficiaries. These temporary changes will be retroactive to March 10, 2020, and will end the earlier of the cancellation of the North Carolina state of emergency declaration or when this policy is rescinded. Click HERE to read the special bulletin and its application to outpatient physical, occupational and speech therapy services. Blue Cross Blue Shield (BCBS) of North Carolina

On March 26, 2020, South Carolina Blue Cross Blue Shield (BCBS) posted Frequently Asked Questions (FAQs) regarding COVID-19. You will want to read question #14 as this pertains to physical therapists, occupational therapists, and speech-language pathologists. Here is the Question and Answer: Can physical therapists, occupational therapists, and speech therapists file for telephone visits?Yes, we will accept claims for physical therapy, occupational therapy, and speech therapy, using the following codes: • 98966: Telephonic Assessment and Management services provided by a qualified non-physician health care professional to an established patient; 5-10 minutes of medical discussion • 98967: Telephonic Assessment and Management

The North Carolina Physical Therapy Association has provided updated Reimbursement and Practice Updates Related to the Covid-19 Pandemic. To access the update, click HERE.

The Michigan Physical Therapy Association (MPTA) has provided updated information regarding Blue Cross Blue Shield (BCBS) of Michigan covering telehealth services for outpatient physical therapy. Per the MPTA website, it now states “BCBSM has informed MPTA that it will cover CPT Codes 97110, 97112, 97116, 97530 and 97535 via telehealth effective for both commercial and MA population until June 30. Unfortunately, this policy decision has not been finalized or implemented and we have not been given any further information. Until official notification is provided, providers should not bill for telehealth services. MPTA continues to advocate for coverage of telehealth services. We will