![]() Only the codes identified by CMS as appropriate for telemedicine services will be reimbursed by Highmark for Medicare Advantage members.Īre new patients eligible to utilize virtual visits?Ĭan I continue to use alternate communication channels, such as Skype or FaceTime, for telehealth treatment or diagnosis purposes now that the Public Health Emergency (PHE) has officially ended?Īccess to care is important to our members. *NOTE: Highmark Medicare Advantage plans continue to follow The Centers for Medicaid and Medicare Services (CMS) guidelines for telemedicine visit coverage and reimbursement. Please see Highmark’s Provider Manual, Chapter 2, Unit 5 for more information regarding the services that may be provided through this modality and other guidelines. What services can be offered via virtual visits? These vendors are a separate option and benefit to certain members. *Note: In-network providers do not need to utilize these vendor services to provide virtual services to Highmark members. ![]() These approved vendors provide access to a national network of board-certified physicians with twenty-four hour, seven days a week availability. Telemedicine: Services provided by Highmark-approved telemedicine vendors – American Well (Amwell) ™, Doctor On Demand ™, and Teladoc ™.Virtual Visits: Services provided by Highmark in-network providers within the scope of their license, deemed appropriate using their medical judgment, and delivered within the definition of the code billed.What telehealth options does Highmark offer? More information on Blue Cross NC’s COVID-19-related coverage and policies is available at Blue Cross NC's COVID-19 page.Please see Highmark’s Provider Manual, Chapter 2, Unit 5 for more information regarding the services that may be provided through this modality and other guidelines. For guidance specific to Home Health, please see the Home Health Frequently Asked Questions, otherwise please follow the guidelines below. The extended review period will ensure that telehealth remains a tool that improves health and increases access to affordable health care. The company will continue to use data and insights on telehealth to study its usage and update its telehealth policy in the future to best serve its members. The company saw similar trends for 2021 and will continue to monitor trends going forward.īlue Cross NC has been covering telehealth for more than 20 years and will continue to do so in the future. In 2020, 92% of Blue Cross NC members’ telehealth visits were primary care or behavioral health services, compared to 8% for specialist visits, despite coverage and payment parity. ![]() Providers may continue to use the virtual platform of their choosing for telehealth services. The extended policy does not apply to Blue Cross NC members getting care from out-of-state providers. Members of the Federal Employee Program have telehealth covered at parity with in-person visits until further notice. The policy applies to all Blue Cross NC commercial plans and Medicare Advantage plans offered and administered by Blue Cross NC, including the State Health Plan. The telehealth policy was originally expanded effective March 2020 and covers doctor visits by video or phone the same as face-to-face visits. It will remain in place through September 30, 2022. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is extending its expanded reimbursement telehealth policy.
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