Telemedicine

Applies to:

Group commercial HMO, EPO, POS and PPO plans

Individual commercial MyPriority® plans

Medical policy

Refer to the medical policy for medical necessity criteria, services not covered as telemedicine services, and coding information.

Use of telemedicine visits for behavioral health services

Please note: Effective Jul. 1, 2020, all audio-only visits must be billed using audio-only visit codes (99441 - 99443, 98966 - 98968). No other codes can be billed for audio-only visits. You should bill for these visits using the place of service you normally would, based on your office location.

From the medical policy, page 5:

Telemedicine visits for acute life-threatening medical conditions or psychotherapy may be restricted to hosted sites where the patient can be monitored or assisted by an onsite provider. Behavioral health services in settings other than hosted sites should be limited to stable patients with straightforward needs. Patients with acute psychiatric needs or patients requiring ongoing psychotherapy beyond crisis stabilization may not be candidates for telemedicine. 

Telemedicine billing

Refer to the medical policy for most coding information. These links will take you to service-specific pages.