Update to Additional Coverage to Support Virtual Health

February 08, 2023
group-label
Button Group
size
md
orientation
horizontal
alignment
center
button-type
lh-button
variant
text
text
Medical Policy & Clinical Guidelines
media-label
label
link
Medical Policy & Clinical Guidelines
icon-position
right
full-width
false
full-width-mobile
false
button-type
lh-button
variant
text
text
Claims & Coding
media-label
label
link
Claims & Coding
icon-position
right
full-width
false
full-width-mobile
false
button-type
lh-button
variant
text
text
Physicians & Specialists
media-label
label
link
Physicians & Specialists
icon-position
right
full-width
false
full-width-mobile
false

Effective 4/18/2023, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has updated our Reimbursement Policy "Telehealth" to allow reimbursement for Remote Physiologic and Remote Therapeutic Monitoring codes (98975, 98976, 98977, 98980, 98981, 99453, 99454, 99457, 99458).

Remote Monitoring Services do not have a face-to-face equivalent and therefore are  not  to be submitted with a Telehealth “Place of Service” or Modifier(s).

The addition of these Remote Physiologic and Remote Therapeutic Monitoring codes increases our level of coverage provided under virtual care and provides physicians with additional resources to provide care to members. This change was made with consideration to access to care and improved affordability, and as a direct result of collaboration with provider requests and the Blue Cross NC’s policy review process.

For further information, review the full Telehealth policy.

This communication applies to State Health Plan (SHP), Federal Employee Program (FEP), Administrative Services Only (ASO), Fully Insured, and IPP Host. It does not apply to IPP Home claims.