March 25, 2020

Expanded Provider Telehealth Access, No Cost Share and Reduced Prior AUthorization Requirements

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• Reduced prior authorization requirements: The changes affect transfers to a post-acute care setting and when members transfer to a new provider. In addition to what we announced in the press release, we are suspending review for site of service for the surgical codes listed here until April 30, 2020.  LEARN MORE >>

• No cost share for COVID-19 testing and testing related visits: In addition to covering the test itself for our members, we’re waiving their copays, coinsurance and deductibles for COVID-19 testing related visits, whether the care is received in a physician’s office, an urgent care center, a telehealth visit or an emergency department. LEARN MORE >>

• Expanded provider telehealth access: Through June 18, 2020, eligible medical care providers who have the ability and want to connect with their patient through synchronous virtual care (live video-conferencing) can do so. Benefits will be processed in accordance with the member’s plan. LEARN MORE >>

• Updated diagnosis and laboratory codes: CMS and CDC guidance as well as input from the American Medical Association has helped inform all of our new coding requirements. LEARN MORE >>

March 23, 2020

New Telehealth for medical providers and Telehealth for behavioral health providers guides are now available for providers seeking more information on this benefit. Telehealth allows members to consult with physicians from home using their computers, smartphones, tablets and telephones. This applies to all Blue Cross Blue Shield of Michigan and Blue Care Network members with an existing telehealth benefit.

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The guides help define the differences between telemedicine services and online visits, how to use telehealth, billing requirements and more. Any exceptions related to COVID-19 will be published in separate communications. They can be found on the Coronavirus information updates for providers link on the BCN Provider Publications and Resources or BCBSM Newsletters and Resources web-DENIS pages.

March 23, 2020

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March 20, 2020

HAP is waiving all member cost share for virtual visits and telehealth from March 15 through April 30. HAP will continue to evaluate the effective date of this change as the pandemic response continues to evolve.

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Click below for HAPs Expanded Coverage and Reimbursement for Virtual Visits and Telehealth 

March 20, 2020

The CDC announced the new ICD-10 code for COVID-19 will be effective 4/1/20 instead of 10/01/2020, making an unprecedented off cycle addition to the code set.

ICD-10 Code

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U07.1- COVID-19

March 19, 2020

Please Note: We are actively working to update our Telehealth policies based on CMS guidance from 3/17.

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Effective immediately, UnitedHealthcare is expanding our policies around telehealth services for our Medicare Advantage, Medicaid and commercial membership, making it even easier for patients to connect with their health care provider.

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• Designated Telehealth Partners - Members can access their existing telehealth benefit offered through one of UnitedHealthcare’s designated partners for free.

• Expanded Provider Telehealth Access - Effective immediately, for the next 90 days (through June 18, 2020), all eligible in-network medical providers who have the ability and want to connect with their patient through synchronous virtual care (live video-conferencing) can do so. Member cost sharing will be waived for COVID-19 related testing through June 18, 2020.

March 18, 2020

Today, the Centers for Medicare & Medicaid Services (CMS) is posting an update to its Frequently Asked Questions (FAQs) on the Medicaid.gov website to aid state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their response to the 2019 Novel Coronavirus (COVID-19) outbreak. CMS is taking this action to continue its efforts to protect the health and safety of providers and patients, including those who are covered by Medicaid and CHIP.out? What makes it interesting? Write a catchy description to grab your audience's attention...

Question: Will CMS enforce an established relationship requirement?

Answer: No. It is imperative during this public health emergency that patients avoid travel, when possible, to physicians’ offices, clinics, hospitals, or other health care facilities where they could risk their own or others’ exposure to further illness. Accordingly, the Department of Health and Human Services (HHS) is announcing a policy of enforcement discretion for Medicare telehealth services furnished pursuant to the waiver under section 1135(b)(8) of the Act. To the extent the waiver (section 1135(g)(3)) requires that the patient have a prior established relationship with a particular practitioner, HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during this public health emergency.

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Question: How does a qualified provider bill for telehealth services?

Answer: Medicare telehealth services are generally billed as if the service had been furnished in-person. For Medicare telehealth services, the claim should reflect the designated Place of Service (POS) code 02-Telehealth, to

March 17, 2020

The Trump Administration today announced expanded Medicare telehealth coverage that will enable beneficiaries to receive a wider range of healthcare services from their doctors without having to travel to a healthcare facility. Beginning on March 6, 2020, Medicare—administered by the Centers for Medicare & Medicaid Services (CMS)—will temporarily pay clinicians to provide telehealth services for beneficiaries residing across the entire country.

February 20, 2020

An emergency ICD-10 code has been created by the World Health Organization that will be implemented into ICD-10 effective October 1, 2020.

Until then, providers must use available ICD-10 codes and guidance when reporting.

U07.1 - 2019-nCoV acute respiratory disease (not effective until October 1, 2020)