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Telehealth Coverage Guidelines
Updated June 19, 2020
Due to COVID-19, Blue Cross and Blue Shield of Alabama expanded telehealth services effective March 1, 2020. This expansion of services will expire on July 31, 2020. We will continue to evaluate to determine whether a further extension is needed.
For complete information, refer to our Telehealth Billing Guide. This guide details the eligible providers and services included in the telehealth coverage expansion for each of these categories:
- Blue Advantage®
- Blue Cross
- Federal Employee Program (FEP)
Only the codes listed in the Telehealth Billing Guide should be submitted for these expanded telehealth services.
Always check eligibility and benefits through ProviderAccess or your practice management system to confirm coverage and cost-sharing details for your patients.
Blue Advantage® Telehealth Updates
Effective April 21, 2020, Blue Advantage telehealth services require providers to use audio AND video capability for the visits.
We do understand that some patients may not have access to video equipment. The patient's medical record encounter documentation should note that services were rendered via audio telecommunications only due to the patient not having access to video capabilities.
CMS is allowing the expansion of telehealth services to include Annual Wellness Visits for Blue Advantage patients.
If you have questions, call Provider Networks at 1-866-904-4130.
Telehealth Billing Reminder: Use Approved Codes to Avoid Rejected Claims
We have noticed that some claims for telehealth services were filed with CPT codes 98966-98968 or 99441-99443. Although these are valid CPT codes, they are not included in our COVID-19 expanded Telehealth Coverage Guidelines.
If you notice a rejected claim that was originally submitted with one of the above codes, file a new claim with one of the approved codes from our Telehealth Billing Guide and place of service 02 (telehealth).
Helpful Telehealth Resources:
- Explained: Telehealth vs. Telemedicine
- "COVID-19 Telehealth Coding & Documentation Tips," April 9 Timely Topics Webinar
- Take the Exam (1 CEU)
- For information about prescribing controlled substances via telehealth, see the joint statement on the Alabama State Board of Medical Examiners website and the additional statement from the Alabama Board of Pharmacy.