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COVID-19 Temporary payment policy

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We are here to support you as you care for your patients—our members. The information on this page will remain in effect for the duration of the Massachusetts state of emergency.

 News & updates

Telehealth (telephone calls and video visits)

Are telehealth services covered?

Yes, we cover medically necessary telehealth services (COVID-19 and non-COVID-19-related) for in-network providers. We are removing member cost share (copayments, co-insurance, and deductibles) for all telehealth services, including behavioral health.

We’ll reimburse providers at the same rate as we would reimburse a face-to-face visit, as long as it meets clinical standards, for the duration of the Massachusetts public health emergency.

Please refer to the COVID-19 Temporary payment policy for telehealth billing guidelines.

For Federal Employee Program (FEP) members:
Effective March 10, 2020, we’ve removed the member cost share for all telehealth services (COVID-19 and non-COVID-19-related) received through the Teladoc network. Members can register for Teladoc by visiting fepblue.org/coronavirus. For providers not in the Teladoc network, the applicable cost share will apply (unless COVID-19 related).

What platforms can I use to offer telehealth? Can I deliver care by phone?

All Blue Cross Blue Shield of Massachusetts contracted doctors and health care providers can provide care remotely, using any technology, for medically necessary covered services (COVID-19 AND non-COVID-19 related) to our members. This includes visits by phone and your communication platform of choice. You don’t need to be part of a telehealth network of providers to offer this.

We will reimburse all providers, including ancillary, behavioral health, and applied behavioral analysis providers at the same rate they would receive for an in-person visit. This is in place for the duration of the Massachusetts state of emergency.

The U.S. Department of Health and Human Services and the Office of Civil Rights have relaxed HIPAA requirements related to the use of telehealth services during the COVID-19 nationwide public health emergency. See the Notification of Enforcement Discretion for telehealth.

How should I bill for telehealth services?

To bill for telehealth and telephonic services, follow the same telehealth billing guidelines as you would for an in-person visit and include the following modifiers with the applicable place of service as outlined in the COVID-19 Temporary payment policy

  • Practitioners must use modifier GT, 95, G0, or GQ to designate that that they are providing services via synchronous/asynchronous telehealth audio and/or video telecommunications systems rather than an in-person encounter.
  • Your claim represents your attestation that you provided the service to the patient via telehealth.
  • When reporting modifier GT, 95, G0, or GQ, the practitioner is attesting that services were provided via synchronous/asynchronous telehealth audio and/or video telecommunications systems.
  • If you are submitting 1500 claims using Direct Data Entry in Online Services, please do not use separate fields for each character of the modifier. The screenshot below shows the correct way to enter modifiers.

Bill for telephonic services using the additional billing guidelines and applicable place of service codes in our COVID-19 Temporary payment policy.

For ancillary and a subset of behavioral health providers

Important note: This information only applies to the ancillary and behavioral health specialties on this list.

When you provide any telephonic services, do not bill the specific telephonic CPT codes. Bill all covered services that you render either by telehealth/video or telephone as if you are performing an in-person service using the codes that are currently on your fee schedule.

You must use one of the following telehealth modifiers listed above (GT, 95, G0, and GQ) and the applicable place of service code. We’ll allow the use of these modifiers for any service on your fee schedule. This will enable us to pay you the same rate we pay you for in-person visits.

For acute care hospitals

When you provide telehealth or telephonic services, bill on a facility claim using a professional revenue code with the telehealth services outlined in our COVID-19 Temporary payment policy. Use one of the following telehealth modifiers on all lines billed: GT, 95, G0, or GQ. Bill as if you are performing an in-person service, using the revenue and HCPCS/CPT code combinations that you would normally bill on a facility claim.

Note: Telephonic codes (98966-98968, 99441-99443) do not require the use of any telehealth modifier.

Medicare Advantage facilities should follow CMS guidelines for telehealth services.

I bill on a UB-04. There is no place to enter a place of service.

UB-04 billers do not need to enter a place of service when billing for telephonic services.

Please see our COVID-19 Temporary payment policy for more information.

Do I need to meet any other criteria with Blue Cross before providing telehealth services?

You can offer telehealth services as long as you are contracted and credentialed by Blue Cross Blue Shield of Massachusetts. There are no additional credentialing or contracting processes you need to follow to offer telehealth services.

The U.S. Department of Health and Human Services and the Office of Civil Rights have relaxed HIPAA requirements related to the use of telehealth services during the COVID-19 nationwide public health emergency. See the Notification of Enforcement Discretion for telehealth.

Can I have telehealth video or phone visits with a child or adolescent patient? Is there an age limit?

Yes, you can. There are no age limits for members who need care through telehealth or phone services.

I am an out-of-state provider. Am I able to bill for telehealth services?

The local Blue plan that you are contracted with will have their own payment policy for telehealth services. Please consult your local Blue plan. Blue Cross Blue Shield of Massachusetts will reimburse telehealth covered claims that received though the BlueCard program.

COVID-19 testing and care

Have you updated APR-DRG Grouper ICD-10 codes to support COVID-19 related claims?

Effective for claims with discharge dates or dates of service on or after April 1, 2020, for all commercial products, we have updated our APR-DRG grouper with the ICD-10 diagnosis codes below. This update also includes the recently released ICD-10 vaping-related disorder code.

Diagnosis code Description
U07.1 COVID-19 virus identified
U07.0 Vaping-related disorder

How do I bill for drive-through COVID-19 testing?

When testing patients in a drive-through or other temporary setting (such as a tent), please use the following codes for claims with dates of service on or after March 1, 2020. These codes apply to all commercial, Medicare Advantage, and Federal Employee Program (FEP) members.

Code Comments
99001
(CPT)
Blue Cross Blue Shield of Massachusetts is temporarily allowing reimbursement for this code for drive-through testing specimen collection*
G2023
(HCPCS)
Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), any specimen source*

*Reimbursement for these codes is included in the payment for an evaluation or management (E/M) service if reported by the same provider on the same day, for the same member.

Please also use one of the following applicable place of service codes that describes the location of the drive-through or temporary testing site.

Place of service code Location
POS 11 Office
POS 15 Mobile unit
POS 20 Urgent care facility
POS 22/19 On/off campus outpatient hospital
POS 23 Emergency room hospital

Is there a limit to the number of COVID-19 tests per patient?

Blue Cross covers medically necessary COVID-19 testing in accordance with CDC and DPH guidelines.

What codes should I use for COVID-19 testing?

New codes were recently announced for providers and laboratories to test patients for COVID-19. The codes apply to commercial, Federal Employee Program and Medicare Advantage members.

Code Description Reimbursement date
U0001
(HCPCS)
CDC 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel Effective April 1, 2020 for dates of service on or after February 4, 2020
U0002
(HCPCS)
2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC
U0003
(HCPCS)
Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique, making use of high throughput technologies as described by CMS-2020-01-R. Reimbursable for dates of service on or after April 14, 2020

Only to be reported with use of high-throughput technologies. See our COVID-19 Temporary payment policy

U0004
(HCPCS)
2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC, making use of high throughput technologies as described by CMS-2020-01-R.
87635
(CPT)
Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique Effective March 13, 2020

Do not bill 87635 and U0002 on the same day for the same patient

We have added these codes to our COVID-19 Temporary payment policy.

What diagnosis codes should be used to bill for treatment or care provided for COVID-19?

Use the diagnosis codes below for patients presenting for evaluation of suspected COVID-19.

We expect providers to code for COVID-19 testing and treatment using guidelines provided by the CDC. Blue Cross will identify patients presenting for evaluation of possible COVID-19 using the below codes*:

Diagnosis code Service description
Z20.828 Contact with and (suspected) exposure to other viral communicable diseases
Z03.818 Encounter for observation for suspected exposure to other biological agents ruled out
Z11.59 Encounter for screening for other viral diseases**

If your patient has previously confirmed COVID-19 illness or tests positive for COVID-19, use the code below.

Diagnosis code Service description
B97.29 Other coronavirus as the cause of diseases classified elsewhere
B97.21 SARS-associated coronavirus as the cause of diseases classified elsewhere
U07.1 2019-nCOV acute respiratory disease (Effective April 1, 2020)
B342 Coronavirus infection, unspecified

*The CDC has created an interim set of ICD-10 CM official coding guidelines, effective February 20, 2020.
**Does not apply for Federal Employee Program member claims.

Referrals and authorizations

Will you be extending authorizations for any services members may not have been able to receive due to the COVID-19 emergency?

We’re extending time-limited authorizations for specific outpatient procedures our members may not have been able to receive due to the COVID-19 emergency. All other administrative requirements related to these services continue to apply.

For the duration of the Massachusetts public state of emergency, we are granting extensions for the services listed below.

Assisted reproductive technology services
For assisted reproductive technology services listed in our medical policy that require prior authorization:

  • We will extend existing authorizations for the period of January 1, 2020-April 1, 2020 to September 30, 2020.
  • We will give new authorization requests 180 days for the service to be completed. After that time, an authorization extension would be required.

Chiropractic services
For chiropractic services that require prior authorization through WholeHealth Networks, Inc. (WHN):

  • We extended all finalized authorizations with a start date on or after February 1, 2020 by 120 days.
  • As of March 31, 2020, the end dates have been extended 120 days for auto approved authorizations in the system.
  • WHN’s clinical reviewers will manually adjust any authorizations that pend for clinical review and the clinical reviewer will extend the end dates by 120 days once the final determination is made.

Durable medical equipment

  • We have extended existing authorizations through December 31, 2020.

High-technology radiology and obstructive sleep apnea testing and treatment
For the high-technology radiology and sleep testing and treatment services that require prior authorization with AIM Specialty Health:

  • As of March 27, 2020, we have authorized new requests for 180 days to allow time to have the service performed.

Do I still need pre-authorization for non-emergency ground ambulance transport?

For the duration of the Massachusetts health emergency, we will waive pre-authorization requirements for ground ambulance transport by a contracted provider. In addition, ground ambulance transport to and from the locations listed below will be covered to help our healthcare delivery system optimize inpatient capacity.

  • Applies to in-network, ground ambulance providers for HMO, PPO, Indemnity, Medicare Advantage, and Federal Employee Program* members
  • Excludes air ambulance transport
  • Notification is not required
  • Cost share is waived for members with a COVID-19 diagnosis
  • Cost share will apply to members without a COVID-19 diagnosis

How to bill for ambulance transport
Be sure to bill using CPT A0426, A0428, A0433, or A0434 (non-emergent transports) and the appropriate modifier shown below to represent the direction of the transfer.

Modifier Description
DH Diagnostic site (including COVID-19 testing) or therapeutic site (including dialysis; excluding physician office or hospital) to hospital
EH Residential, domiciliary, custodial facility (other than skilled nursing facility) if the facility is the beneficiary’s home to hospital
HD Hospital to diagnostic site (including COVID-19 testing) or therapeutic site (including dialysis; excluding physician office or hospital)
HE Hospital to residential, domiciliary, custodial facility (other than skilled nursing facility) if the facility is the beneficiary’s home
HH Hospital to hospital (includes ASCs approved to provide hospital level of care)
HN Hospital to alternative site for skilled nursing facility (SNF)
HR Hospital to residence
NH Alternative site for SNF to hospital
NN SNF to SNF
NR* SNF to residence
PD Physician office to community mental health center, federally qualified health center, rural health center, urgent care facility, non-provider-based ambulatory surgical center or freestanding emergency center, or location furnishing dialysis services that is not affiliated with an end-stage renal facility
PE* Physician office to residential, domiciliary, custodial facility (other than skilled nursing) if the facility is the beneficiary’s home
PH Physician office to hospital
PR* Physician office to home
RH Residence to hospital
RN* Residence to SNF

*These modifiers do not currently apply to Federal Employee Program members. We will post an update once a decision is made.

Are prior authorizations or referrals required for testing and treatment for COVID-19?

No. Referrals and prior authorizations are not required for medically necessary testing and treatment for COVID-19 throughout the Massachusetts-declared state of emergency.

Additionally, if a member is being evaluated or treated for suspected or confirmed COVID-19, Blue Cross will remove all referral and authorization requirements for outpatient care. This applies to in- and out-of-network providers and to in-person and telehealth/virtual/telephonic visits.

Are prior authorizations required for inpatient services during the Massachusetts declared COVID-19 related state of emergency?

No. Prior authorizations are not required for inpatient care throughout the Massachusetts-declared state of emergency. However, notification is required.

During the COVID-19 Massachusetts state of emergency and to facilitate inpatient capacity across the health delivery system, we have moved to a notification-only requirement for all inpatient levels of care, including acute, long-term acute (LTAC), acute and subacute rehabilitation (rehab) and Skilled Nursing Facility (SNF) admissions. While this requirement is in place, we will not perform medical necessity reviews for inpatient levels of care through June 23, 2020. Timely notification by facilities will help us facilitate optimal care coordination, mobilize additional services to support transition-of-care and discharge planning, and ensure claims processing.

Administrative changes & other updates

Will Medicare Advantage reimbursement be temporarily adjusted in any way during this time?

As part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, the Centers for Medicare and Medicaid Services (CMS) has suspended the mandatory payment reductions known as “sequestration” from May 1, 2020 through December 31, 2020. We will follow CMS by suspending the reimbursement reductions for our Medicare Advantage hospital rates and professional rates for the same time period.

Can we have more time to file initial claim submissions?

To support your ability to submit timely claims during the stay-at-home period in Massachusetts, we have extended the filing limit for initial claim submissions.

For dates of service between March 1, 2020 and May 31, 2020, you’ll have 150 days from the date of service or the date of discharge (for inpatient stays) to submit your claims for HMO/POS, Medicare Advantage, and PPO members.

We’ll resume our usual 90-day timely filing limit for dates of service or dates of discharge on and after June 1, 2020.
There is no change to the timely filing guidelines for Indemnity claims.

This policy update applies to all medical providers.

Do you have a process in place to expedite the credentialing and enrollment process during the Massachusetts public health state of emergency?

Yes, we do. We are making every effort to credential providers within seventy-two (72) hours of the date we receive your application.

Simply fill out our Public Health Emergency Credentialing Application (PHE App). Then have an authorized representative of the group you are joining sign the form and send it back to PHEexpeditedCred@BCBSMA.com

Providers who are approved under this process will receive a Welcome Letter with their effective date.

Will you continue to do provider audits?

Effective immediately, Blue Cross will be pausing all provider audit and claim review activities for the next 60 days, or for the duration of the state of emergency (whichever comes first). This pause will include activities related to all:

  • Retrospective facility (both inpatient and outpatient) and professional provider audits
  • Forensic claims prepayment reviews
  • Any other claim recovery activities

Please note that we will continue to evaluate paid claims for duplicate payments as well as Coordination of Benefits and Subrogation. Blue Cross also continues to conduct medical reviews and claim recovery activities if there is an indication of potential fraud.

Member support (cost share waivers, more)

Are members responsible for copayments, co-insurance, and deductibles for in-person visits or telehealth during the Massachusetts state of emergency?

We removed all member cost share (copayments, co-insurance, and deductibles) for all telehealth services (COVID-19 and non-COVID-19-related) for in-network providers, including:

  • A telephone call in place of an office visit
  • A virtual visit/video service

We also removed all member cost share for in-person doctor, urgent care, and emergency room visits related to the testing, counseling, vaccination and treatment of COVID-19.

For Federal Employee Program (FEP) members:

Member cost share will also be removed for inpatient acute care hospitals, inpatient rehab facilities, long term acute care hospitals, and skilled nursing facilities for services related to COVID-19.

We’ve removed the member cost share for all telehealth services (COVID-19 and non-COVID-19-related) received through the Teladoc network. Members can register for Teladoc by visiting fepblue.org/coronavirus. For providers not in the Teladoc network, the applicable cost share will apply (unless COVID-19 related).

FEP will determine coverage for the vaccine once it becomes available.

Are members responsible for costs associated with inpatient care for COVID-19 diagnoses?

Retroactive to March 6, 2020, we are waiving member cost share (copayments, deductible, co-insurance) for medically necessary inpatient acute care hospital services when the claim includes a diagnosis of COVID-19. This will apply to in- and out-of-network services received at an acute care hospital.

It does not include care received at chronic care and long-term acute care hospitals, psychiatric facilities, rehabilitation hospitals, skilled nursing facilities, and substance use disorder facilities.

This policy will be in effect for the duration of the Massachusetts COVID-19 public health emergency. It applies to Blue Cross Blue Shield of Massachusetts members* in the following plans:

  • Commercial HMO/POS and PPO (fully insured accounts)
  • Federal Employee Program
  • Indemnity
  • Medex
  • Medicare Advantage

Note: Employers who are self-insured may choose not to offer waived cost share for their employees. When the claim processes and you receive your Provider Detail Advisory, you’ll know whether the member has a cost to collect.

*Blue Plan members receiving care in Massachusetts are covered according to their Home plan’s benefits and coverage.

Can a member get an early refill of their medication?

We are lifting limits on early refills of most prescription medications, allowing members to obtain one additional fill of their existing prescription. This is in place for the duration of the Massachusetts state of emergency and at the discretion of the prescriber and/or dispensing pharmacist. At the same time, Blue Cross Blue Shield of Massachusetts continues to monitor and comply with all applicable state and federal regulations, including regulation of opioid prescribing and dispensing.

How can members find out about these new covered services?

Members can get information in a variety of ways:

  • On our Coronavirus Resource Center at bluecrossma.com/coronavirus. We’re updating this site regularly as new information becomes available.
  • Email. We have sent an email to our members.
  • Social media channels (Facebook, Twitter).

FEP members can find updated information at fepblue.org/coronavirus.

Who can members call with questions?

Members can call our dedicated coronavirus help line at 1-888-372-1970.

  Pharmacy

Can a member get an early refill of their medication?

We are lifting limits on early refills of most prescription medications, allowing members to obtain one additional fill of their existing prescription. This is in place for the duration of the Massachusetts state of emergency and at the discretion of the prescriber and/or dispensing pharmacist. At the same time, Blue Cross Blue Shield of Massachusetts continues to monitor and comply with all applicable state and federal regulations, including regulation of opioid prescribing and dispensing.

Are you covering chloroquine and hydroxychloroquine (brand name: Plaquenil)?

As of April 1, for the duration of the COVID-19 public health emergency, we have added a 10-day supply limit to these medications for:

  • Members who are newly prescribed the medication for rheumatological and dermatological use (for example, to treat lupus, malaria, rheumatoid arthritis).
  • Members using the medication for a COVID-19-related diagnosis.

This supply limit applies to members who use our standard Blue Cross Blue Shield of Massachusetts formulary.

What if the member needs more than a 10-day supply of chloroquine or hydroxychloroquine (if they will be using it long-term for rheumatological and dermatological use, for example)?

You can request an authorization to cover more. To make this request, please submit the Massachusetts Standard Form for Medication Prior Authorization Requests (Click the link and find the form by choosing Authorization – Pharmacy). Or, contact our Clinical Pharmacy Operations area.

What about members who previously filled prescriptions for chloroquine or hydroxychloroquine?

Members who filled a prescription for rheumatological and dermatological use within the previous 180 days are excluded from the quantity limit. We’re contacting them to suggest that they take advantage of our early refill policy during this public health emergency, so they can have a supply of their medication. Some members may also contact you for a prescription for up to a 90-day supply from the Express Scripts Pharmacy®' (mail order).

Why is Blue Cross making this change to prescriptions for chloroquine and hydroxychloroquine?

You may be aware that on March 30, 2020, the Food and Drug Administration (FDA) issued an emergency authorization to use chloroquine and hydroxychloroquine as experimental coronavirus treatment.

The Massachusetts Division of Insurance (DOI) issued a March 26, 2020 Bulletin addressing this topic. The DOI asked insurers to continue covering these medications for rheumatologic or dermatologic conditions under their current policies. For COVID-19-related diagnoses, they asked insurers to add quantity limits.

What about members who are prescribed chloroquine or hydroxychloroquine who have pharmacy coverage with another formulary?

For Federal Employee Program and Medicare Advantage members, coverage for these drugs remains the same at this time.

For members using the National Preferred Formulary (managed by Express Scripts, Inc.), there are new quantity limits for these medications.

Behavioral Health

For behavioral health covered services, are members’ telehealth and in-person co-pays for behavioral health services being waived during the Massachusetts state of emergency?

For the duration of the Massachusetts public health emergency, we have removed member cost share (copayments, co-insurance, and deductibles) for medically necessary telehealth (virtual video/audio) services or telephonic visits for behavioral health services. The COVID-19 Temporary payment policy applies.

We will reimburse medically necessary telehealth and telephonic visits at the same rate as an in-person visit, for all providers, including behavioral health providers.

Member cost-share still applies for an in-person, outpatient visits and for inpatient and residential services.

Can I bill for partial hospitalization and intensive outpatient using telehealth?

Yes, you can bill all services for which you are contracted using the telehealth codes with the telehealth modifier.

How should I bill for telehealth and telephonic services?

Blue Cross is covering behavioral health visits by telehealth (video/virtual) or by telephone (“telephonic visits”) throughout the Massachusetts public health state of emergency. Please follow the billing instructions outlined in our COVID-19 Temporary payment policy.

To bill for telehealth/video services during the state of emergency

  • Bill the same as you would for in-person visits, and include the following modifiers with the applicable place of service code*: modifier GT, 95, G0, or GQ via synchronous/asynchronous telehealth audio and/or video telecommunications systems to differentiate a telehealth (telemedicine) encounter from an in-person encounter with the patient.
  • When reporting modifier GT, 95, G0, or GQ, you are attesting that services were rendered to a patient via synchronous/asynchronous telehealth audio and/or video telecommunications systems.

When reporting the telehealth modifier, if applicable, please place the telehealth modifier after the license modifier.

*UB-04 billers do not need to submit a place of service code.

To bill for telephonic services
How you will bill for telephonic services depends upon your specialty. See below for details.

If you are this provider type

Follow these billing instructions

  • Alcohol drug treatment facility
  • Clinical nurse specialist
  • Clinical psychologist
  • Community mental health center
  • Licensed alcohol & drug counselor
  • Licensed applied behavior analyst (LABA)
  • Licensed mental health counselor
  • Licensed independent clinical social worker
  • Licensed marriage family therapist
  • Licensed mental health counselor
  • Opioid treatment program
  • Psychiatric and state psychiatric hospital
  • Psychiatric nurse practitioner
  • Registered nurse clinical specialist
  • Substance use disorder facility
Do not bill the specific telephonic CPT codes.
  • Bill all covered services that you render as if you are performing an in-person service using the codes that are currently on your fee schedule.
  • You must use one of the following telehealth modifiers (GT, 95, G0, and GQ) with the applicable place of service code.

This will enable us to pay you the same rate we pay you for in-person visits.

*UB-04 billers do not need to submit place of service code.

  • Psychiatrist
  • Psychiatric neurologist
Use the telephonic CPT codes as indicated in the telehealth billing guidelines with the applicable place of service code*.

The billing guidelines are included in the COVID-19 Temporary payment policy

*UB-04 billers do not need to submit a place of service code.

I have submitted telehealth claims that were not reimbursed at the in-person rate, and the provider detail advisory said the member was responsible for co-pays. Do I need to resubmit my claim?

You can either wait for our systems to identify the claim and correct it, or call Provider Service and ask us to reprocess the claim at one of the following toll-free numbers.

  • 1-800-882-2060 (Physicians)
  • 1-800-451-8123 (Hospitals)
  • 1-800-451-8124 (Ancillary providers)

Will you be lifting restrictions for unlicensed and not independently licensed therapists so more people can have access to teletherapy?

At this time, there are no changes to our licensure requirements.

I bill on a UB-04. There is no place to enter a place of service.

UB-04 billers do not need to enter place of service codes when billing for telephonic services.

Does this apply to self-insured accounts?

Yes, this applies to all accounts except the Federal Employee Program (FEP).

For Federal Employee Program patients, do I need to be a Teladoc provider to offer telehealth services to my FEP patients?

No. Effective March 10, 2020, we’ve expanded the telehealth benefit and removed the member cost share for all COVID-19 related telehealth services. For non COVID-19 related telehealth services,cost share will apply when billed with the appropriate modifiers.

Find additional coding information on Provider Central.

Member cost share is being waived for all Teladoc visits (COVID-19 and non-COVID-19) during this emergency period.

To learn more about Teladoc, visit https://www.teladoc.com/providers/

Dental

Are there any restrictions or limitations on the type of technology I can use to bill for code CDT 0140? Other dental providers have certain limitations.

We do not have any restrictions on the video or voice platform the dentist can use.

How do I know if my patient has coverage for problem-focused exams?

You can use Dental Connect for Providers to verify member eligibility and benefits. If you haven’t used Dental Connect before, you’ll need to register for Dental Connect using partner code BCMA01DPS (this is an important step for registration; Blue Cross Blue Shield of Massachusetts sponsors monthly fees for this service. Or, you can call Dental Provider Services at 1-800-882-1178.

Is there a cost share for the member for a telehealth consultation?

No, members who already have coverage for problem-focused exams (D0140) will have no cost share (deductible, copayment, or co-insurance.)*

*For the Federal Employee Program, benefits and cost share are applicable according to the member’s plan.