Telehealth Place of Service 02 and 10 Reimbursement – Non-Facility Rates Continued

Following the April 1, 2024, effective date of Blue Cross and Blue Shield of North Carolina’s (Blue Cross NC) Pricing Policy updates, Blue Cross NC will continue to reimburse properly reported telehealth Covered Services claims at the non-facility rates. Providers must continue to report telehealth Covered Services with a Place of Service (POS) code 02 or 10. Blue Cross NC has reimbursed for telehealth Covered Services at the non-facility rates since March 2020, regardless of Centers for Medicare and Medicaid Services (CMS) or other federal changes.

Blue Cross NC’s updated Pricing Policy will reflect language reflecting the decision to not follow the 2024 CMS reimbursement changes regarding POS 02. Blue Cross NC’s pricing source hierarchy for non-facility telehealth rates published by CMS with POS 02 and 10 will be used to calculate reimbursement for telehealth Covered Services.

This communication applies to State Health Plan (SHP), Administrative Services Only (ASO), Fully Insured, Federal Employee Program^® (FEP), and Blue Cross and Blue Shield Association InterPlan Program (IPP) Host Member claims.

Updated policies:

• Pricing Development and Maintenance Policy BETOS/CCS
• Pricing Development and Maintenance Policy
• Pricing Policy for Procedures/Service Codes (Applicable to all PPO, POS and HMO products)