October 2020
Telehealth Visits – Medicare Advantage
Telehealth can help provide our members access to the care they need, including routine care, while helping to protect against the spread of viruses. Due to the COVID-19 Public Health Emergency, Blue Cross and Blue Shield of Illinois (BCBSIL) has expanded access to telehealth at no cost-share* for our Blue Cross Medicare Advantage (PPO)SM and Blue Cross Medicare Advantage (HMO)SM members through Dec. 31, 2020. See our COVID-19 Provider FAQs for more information.
The Centers for Medicare & Medicaid Services (CMS) is allowing providers to engage in telehealth services with new and established Medicare patients. Visit the CMS website for telehealth guidance and a complete list of telehealth codes.
| Telehealth Visits | Procedure Codes1 | Modifier/Place of Service (POS) |
Telehealth visits offer the same services that would be provided during an in-person visit. They are conducted with an interactive audio and video telecommunications system** that permits two-way, real-time communication,2 including:
Telehealth visits for in-network, medically necessary covered health care services are reimbursed at the same rate as in-person visits. |
Common services include:
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Report the POS code that would have been reported had the service been provided in person.
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*BCBSIL Medicare (not Part D) and Medicare Supplement members can access in-network telehealth services at no cost-share for medically necessary, covered services and treatments consistent with the terms of the member’s benefit plan. Services available for telehealth may vary. Providers may call the number on the member ID card with questions.
**Providers can find the latest guidance on acceptable HIPAA-compliant remote technologies issued by the U.S. Department of Health and Human Services’ Office for Civil Rights in Action.
1CMS interim final rule and comment period (IFC), 136, https://www.cms.gov/files/document/covid-final-ifc.pdf
2CMS interim final rule and comment period (IFC), 49, https://www.cms.gov/files/document/covid-final-ifc.pdf
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The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. References to third party sources or organizations are not a representation, warranty or endorsement of such organizations. Any questions regarding those organizations should be addressed to them directly. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.