• Telehealth is a term that covers all of the ways you and your doctor or other health care providers can use technology to communicate without being in the same room. You can now call a nurse 24 hours a day, 7 days a week (even on holidays) with no copay for advice on your health. Members can access. Arkansas Blue Cross and Blue Shield is.
• Blue Cross Blue Shield of Massachusetts follows federal and state-mandated requirements for COVID-19 treatment coverage. For our commercial products (managed care HMO and POS, PPO, and Indemnity), we will accept the following CPT codes for COVID vaccines and COVID vaccine administration.
• First two visits free, then $10 copay per visit Nutritional counseling sessions are covered in full for all members.

CareFirst is encouraging members to call their doctor’s office if they have symptoms of the flu, COVID-19 or other contagious conditions. During this public health event, we understand the use of telemedicine is a practical option for members who wish to or should stay home. Therefore, we have temporarily expanded our telemedicine policy. Refer to our coding guidance for all existing and temporarily covered services.

Blue Cross Blue Shield of Massachusetts continues our commitment to our members. Additional Telehealth Access Blue Cross plans will waive member cost share (co-pays, co-insurance. How will waiving cost share (copay, coinsurance, deductible) for non-COVID-19 telehealth. The copay amount for a telehealth visit is listed on your Summary of Benefit and Coverage (SBC). An independent licensee of the Blue Cross and Blue Shield Association. Download Adobe Reader Site Map Follow us; Facebook LinkedIn Twitter YouTube.

Telemedicine Capability

If your practice has its own telemedicine capability (audio/video), proceed with visits and bill CareFirst as normal with a place of service “02” and refer to this guidance for accepted telemedicine procedure codes and modifiers. Services for diagnosis, consultation or treatment provided through telemedicine must meet all the requirements of a face-to-face consultation or contact between a licensed health care provider and a patient consistent with the provider's scope of practice for services appropriately provided through telemedicine services.

If the claim is to evaluate a member for coronavirus, use diagnosis code Z20.828 (Exposure to viral disease). If you are treating a member with confirmed coronavirus use diagnosis code B97.29 for dates of service prior to 4/1/20 and diagnosis code U07.1 for dates of service on and after 4/1/20. Utilization review may be performed. Documentation in the medical record must support the services rendered.

If you are currently not set up to conduct telemedicine, you can use a commercially available platform to conduct telemedicine visits. The Office for Civil Rights (OCR) at the HHS has stated that providers may use commercially available video chat services to provide telehealth without risk that OCR might seek to impose a penalty for noncompliance with the HIPAA Rules during the COVID-19 nationwide public health emergency. Guidance and frequently asked questions can be found on their website.

Please note, CareFirst is waiving cost sharing for in-network or out-of-network visits to a provider’s office, including telemedicine, related to diagnosis and treatment of COVID-19. Providers are encouraged not to collect member cost sharing for these services. If a member does owe a copay or coinsurance after the claim is processed, you can bill the member as you do for all other claims. For these purposes we’ve defined telemedicine as a combination of interactive audio and video.

Member-Initiated Phone Consultations

Bcbs Telehealth Visits

CareFirst is paying for phone consultations provided by physicians and nurse practitioners credentialed in CareFirst’s network for the following specialties: primary care provider, internal medicine, OB/GYN, family practice and pediatrics. CareFirst will pay a $20 flat fee for CPT 99441.* We selected this code for all phone visits, regardless of the amount of time..

Blue Cross Blue Shield Telehealth Copay Program

* These benefits are covered for our fully insured members. We are also partnering closely with our self-insured customers to implement similar measures. Due to a change in D.C. law for members covered by a D.C. insured product, member-initiated phone calls are covered at $20, regardless of a provider’s specialty. Physicians and Nurse Practitioners should use CPT Codes 99441, 99442 or 99443. Non-physician providers should use CPT codes 98966, 98967 or 98968.