CommercialOctober 1, 2021
Clarification to reimbursement policy update: Virtual Visits - Professional and Facility
Beginning with dates of service on or after November 1, 2021, Anthem Blue Cross and Blue Shield (Anthem)’s current Telehealth policy will be renamed Virtual Visits.
Anthem allows reimbursement for professional and facility Virtual Visits when interactive services occur between the member and the provider, when they are not in the same location, unless provider, state, or federal contracts and/or mandates indicate otherwise. Reimbursement is allowed for professional and facility Virtual Visits rendered at the distant site via live audio visual services and for Remote Patient Monitoring. Services reported by a professional provider with a place of service Telehealth (02) will be eligible for non-office place of service reimbursement. In addition, facility Virtual Visits will be allowed for the originating site fee only when the member is physically located in the originating facility. The Related Coding section details the modifiers allowed for reimbursement.
Anthem allows reimbursement for professional and facility Virtual Visits when interactive services occur between the member and the provider, when they are not in the same location, unless provider, state, or federal contracts and/or mandates indicate otherwise. Reimbursement is allowed for professional and facility Virtual Visits rendered at the distant site via live audio visual services and for Remote Patient Monitoring. Services reported by a professional provider with a place of service Telehealth (02) will be eligible for non-office place of service reimbursement. In addition, facility Virtual Visits will be allowed for the originating site fee only when the member is physically located in the originating facility. The Related Coding section details the modifiers allowed for reimbursement.
PUBLICATIONS: October 2021 Anthem Provider News - Kentucky
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