Changes to Federal Employees Health Benefits program and Postal Service Health Benefits program telemedicine services

Effective April 5, 2025, telemedicine claims for Federal Employees Health Benefits (FEHB) program and Postal Service Health Benefits (PSHB) — Standard Option, Basic Option, and FEP Blue Focus — members will be considered non-covered for inpatient and outpatient professional services if the CMS-1500 form contains all three of these fields:

• Procedure code
• Diagnosis code
• Place of service

Listed below are the procedure code, diagnosis code, and place of service codes:

• Procedure code, (Box 24D on the HCFA 1500), is not 90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, 90849, 90853, 90863, 90951, 90952, 90954, 90955, 90957, 90958, 90960, 90961, 90963, 90964, 90965, 90966, 90967, 90968, 90969, 90970, 92227, 92228, 92507, 92508, 92521, 92522, 92523, 92524 92526, 92601, 92602, 92603, 92604, 93228, 93229, 93268, 93270, 93271, 93272, 96040, 96105, 96116, 96121, 96125, 96156, 96158, 96159, 96160, 96127, 96164, 96165, 96167, 96168, 96170, 96171, 96202, 96203, 97110, 97112, 97116, 97161, 97162, 97165, 97166, 97530, 97535, 97750, 97755, 97760, 97761, 97802, 97803, 97804, 98000, 98001, 98002, 98003, 98004, 98005, 98006, 98007, 98008, 98009, 98010, 98011, 98012, 98013, 98014, 98015, 98016, 98966, 98967, 98968, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99231, 99232, 99233, 99242, 99243, 99244, 99245, 99252, 99253, 99254, 99255, 99307, 99308, 99309, 99310, 99406, 99407, 99408, 99409, 99417, 99418, 99495, 99496, G0071, G0108, G0109, G0270, G0271, G0296, G0316, G0317, G0318, G0320, G0321, G0396, G0397, G0406, G0407, G0408, G0425, G0426, G0427, G0506, G0508, G0509, G2012, G2025, G2086, G2087, G2088, G2211, G2212, G2252, G3002, G3003, S9152, S9452 or S9470.
• Diagnosis code (Box 21 A‑L on the CMS-1500) and pointer indicated (Box 24E) is any covered diagnosis code.
• Place of service code (Box 24B on the CMS-1500) is 02 or 10 and/or modifier (Box 24D) 93, 95, GT, G0.

If you have questions, please contact FEP Customer Service at: