Education & TrainingHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 6, 2023

Reminder: Telehealth POS codes and modifiers

Anthem Blue Cross and Blue Shield (Anthem) is aligned with the Indiana Health Coverage Programs policy regarding the reimbursement of telehealth services. 

For reimbursement consideration, Anthem is reminding providers of the following coding requirements and modifiers for dates of service on or after July 21, 2022. 

Services rendered in a telehealth or virtual setting must include one of the following place of service (POS) codes:

Option one

 

Option two

POS 02 — Telehealth provided other than in patient’s home

or

POS 10 — Telehealth provided in patient’s home

Services rendered in a telehealth or virtual setting must also include one of the following modifiers:

Option one

 

Option two

Modifier 93 — Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system

or

Modifier 95 — Synchronous telemedicine services rendered via a real-time interactive audio and video telecommunications system

Failure to append the appropriate above-mentioned POS code and modifier to services rendered in a telehealth or virtual setting will result in claim(s) being denied.

For additional information regarding the submission of claims in a telehealth or virtual setting, 

providers are encouraged to review the Telehealth and Virtual Services Provider Reference Module at portal.indianamedicaid.com.

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Availity* Chat with Payer is available during normal business hours. Get answers to your questions about eligibility, benefits, authorizations, claims status, and more. To access Availity Essentials, go to availity.com and select the appropriate payer space tile from the drop-down. Then, select Chat with Payer and complete the pre-chat form to start your chat.

For additional support, visit the Contact Us section at the bottom of our provider website for the appropriate contact.

* Availity, LLC is an independent company providing administrative support services on behalf of the health plan.

INBCBS-CD-019936-23

PUBLICATIONS: August 2023 Provider Newsletter