Expanding Patient Care Through Telehealth During COVID-19
We know the recent novel coronavirus (COVID-19) outbreak has caused a disruption to many provider offices in our region. BlueCross BlueShield is continuing to monitor the COVID-19 outbreak and support our providers.
During the COVID-19 outbreak, the expansion of telehealth policies allows you to continue providing care for your patients. Patients who take advantage of any telehealth service during the COVID-19 pandemic will have a $0 cost-share even if the reason for the service is not related to COVID-19.
Under federal regulations from CMS and HHS, use of HIPAA and non-HIPAA compliant, non-public platforms are allowed to be used to conduct telehealth visits during the COVID-19 outbreak until further guidance is provided or these temporary regulations are lifted.
Electronic medical record (EMR) systems, such as, but not limited to, Medent, offer telehealth capabilities without the use of a third party administrator. You can check with your EMR provider to see if telehealth capabilities are available.
Telehealth for Annual Wellness Visits (AWV)
As previously announced, AWVs for Medicare Advantage patients can be conducted through telehealth and will receive the same rate of reimbursement. Please note: use of video and audio components should be used when conducting an AWV via telehealth.
Pediatric Well Visits
Pediatric offices are also able to conduct telehealth well visits for patients 2 years old up to and including 19 years old. We will reimburse at the same rate for any telehealth pediatric well visit for these patients.
Claims submitted for a telehealth AWV or pediatric well visit must include 02 place of service code to receive correct reimbursement.
Pediatric well visits must also document that a physical was not conducted due to COVID-19.
To bill for a telehealth AWV, the following codes must be submitted:
- G0438 = Initial AWV OR
- G0439 = Every year after the initial AWV
- GT modifier
- If using Vatica, you must also include a CG modifier
Telemedicine Hosted by Doctor On Demand
You can also advise your BlueCross BlueShield patients that they can use their Telemedicine Hosted by Doctor On Demand benefit to receive telehealth services.
Patients can seek behavioral health telehealth services directly from their behavioral health specialist or be referred to a behavioral health specialist from their PCP.
Your patients can also seek behavioral health services through Doctor On Demand. Access to licensed psychologists and psychiatrists is provided 24/7 and patients seeking behavioral health through telemedicine will not be subject to prolonged wait times so they can get quick support when they need it.
Your patients can get treatment and screenings for conditions such as:
- Trauma such as:
- Post-traumatic stress disorder (PTSD)
- Physical abuse
- Postpartum depression
- Anger management
- Behavioral disorders
Doctor On Demand will update you with a report after each visit so you can stay informed when your patients seek care.
You can find more information on COVID-19 or telemedicine by visiting the sites listed below.
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