Last updated: June 26, 2020 | Posted: April 19, 2020
Keeping up with the necessary telemedicine billing requirements for related and non-related COVID-19 services can be confusing.
To help soften the blow, here's a brief list of major payer requirements for billing for Telemedicine Billing related to patient cost-sharing:
UHC will waive cost-sharing for in-network telehealth services for medical, outpatient behavioral and PT/OT/ST services from March 31, 2020, until June 18, 2020, for Medicare Advantage, Medicaid, and Individual and fully insured Group Market health plan with opt-in available for self-funded employers.
Cigna Healthcare will waive customer cost-sharing related to COVID-19 screening, testing, and treatment through May 31, 2020 and will waive customer cost-sharing for telehealth screenings for COVID-19 through May 31, 2020
(Call Cigna and verify if they are waiving non-related COVID-19 telemedicine out of pocket costs.)
Update: The following changes are effective March 17, 2020, through July 31, 2020.
For the next 90 days, until June 4, 2020, Aetna will waive member cost-sharing for any covered telemedicine visit – regardless of diagnosis.1 Until further notice, Aetna will offer zero co-pay telemedicine visits for any reason to all Individual and Group Medicare Advantage members.
More Aetna Telemedicine services info: https://www.aetna.com/content/dam/aetna/pdfs/health-care-professionals/bh-televideo-service-codes-covid-19.pdf
Update: Cost-share waved through 09/30/2020 for behavioral health telemedicine service.
Anthem and Empire Health Telemedicine (live video + audio via app):
For 90 days effective, unless further extended, March 17, 2020, Empire began waiving member cost-sharing for telemedicine visits, including covered visits for mental health and substance use disorders, for our fully insured employer plans, Individual plans, Medicare plans and Medicaid plans, where permissible.
(This information may vary based on your state)
Effective April 1 that we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis.
The expansion covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020.
Update: Telemedicine services have been extended until September 30, 2020!
Check back frequently for updates!
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1Available in select states for select conditions. Other restrictions apply. To receive these services, you will be connected to a trusted third-party provider.
Empire Source: Provider News: http://providernews.empireblue.com/ Telehealth (COVID-19): https://providernews.empireblue.com/article/information-from-empire-for-care-providers-about-covid-19-updated-april-22-2020