Next Event: NCCI Edits & Modifier 59: Version 31.2
Date: June 26,2025
North Carolina Updates on Telehealth
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will end the earlier of the cancellation of the North Carolina state of emergency declaration or when this policy is rescinded.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
South Carolina BCBS Allows Telephone Visits
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
North Carolina Physical Therapy Reimbursement Updates
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.
MPTA Updates BCBS and Telehealth Coverage
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
BCBS of Nebraska Adds Telehealth Coverage for Therapy
Per the Nebraska (NE) Physical Therapy Association, Blue Cross Blue Shield (BCBS) of Nebraska has made the decision to adjust their telehealth policy to cover Physical, Speech and Occupational therapy services . BCBS NE will accept telehealth charges from any credentialed provider with no video component required during this pandemic urgency period. An announcement will be place on our Happening Now section of our webpage later this today. Here is the link to our Happening Now section that will be updated: https://www.nebraskablue.com/Providers/Alerts-and-Updates/Happening-Now A provider may bill using E&M codes, therapy codes or telehealth codes and must use the modifier 95 and
BCBS of North Carolina Expands Telehealth Coverage
Blue Cross Blue Shield (BCBS) of North Carolina has expanded reimbursement for all services delivered through telehealth that meets the criteria outlined in the attached document. To access this document, click HERE.
Regence BCBS Expands Telehealth Services
Regence BCBS is expanding telehealth coverage in the states of Idaho, Oregon, Utah, and select counties of the state of Washington. Click HERE to read all about telehealth. If you have specific questions about telehealth coverage for outpatient physical, occupational and/or speech therapy, you will need to contact your Regence provider.
BCBS of Rhode Island to Pay for Telehealth for Therapy
Blue Cross Blue Shield (BCBS) of Rhode Island has announced they will pay for telehealth services for outpatient therapy services effective March 18, 2020. To read it straight from BCBS of Rhode Island, click HERE.