Given the urgency, BCBSWY wants to provide telemedicine guidance for visits to the patient’s home in a timely manner. We sent guidance earlier this week and have received some frequent follow up questions. Here is some additional guidance you may find helpful. Ensuring consistency and alignment is important to us and we will continue to offer additional and timely updates.
As of 6/18/20 this communication has been updated with changes in red.
1.) Which Place of Service (POS) codes should we use?
Providers should NOT use POS. Please use the same POS code as you would typically use for the service being rendered.
2.) Can I use modifier 95?
No, our system is currently configured to only use the GT modifier.
3.) How much do you pay?
Reimbursement for services is no different than those rendered in the office.
4.) Do I bill an originating site?
No. Only the distant site (provider location) is reimbursable when the patient is at home.
5.) Where can I go for more FEP information?
Go to: www.fepblue.org/telehealth
6.) What codes can I bill?
Services provided via telemedicine need to be appropriate and safe to render at a distance. The standard of care must be met.
7.) Is it legal to perform telephonic services in Wyoming?
Yes, it is legal to perform telephonic services in Wyoming.
8.) What if the provider is out of state?
If the provider is an employee or subcontractor of a Wyoming provider, claims can be submitted to BCBSWY. If the provider is independent normal Blue Card rules apply and the claim should be processed to the Blue plan in the state the provider is located in.
9.) What if I am a provider working remotely?
Providers are permitted to work remotely at home, as long as the service provided replicates an office visit or telephonic visit similar to what would be done in the office, including medical record documentation.
10.) Is all cost-share waived during this time?
No, only the services pertaining to testing of COVID-19 waive cost shares. Visits regarding other medical diagnosis (i.e. psychological, substance abuse services, PT, OT, ST, etc) will continue to apply normal benefit cost sharing amounts. Effective 3/18/20, BCBSWY will waive cost share on all telemedicine services through 8/31/20.
11.) What services can I provide via telemedicine?
Any service that can be safely rendered.
Updated Telemedicine Guidance
As an emergency measure, in response to the spread of COVID-19, Blue Cross Blue Shield of Wyoming is adjusting its telemedicine policy to allow for telephonic and telemedicine visits at the patient’s home. We understand that COVID-19 has inhibited our members’ ability to seek care through normal channels, whether that care is directly related to COVID-19 or not. In order to facilitate social distancing and help alleviate concerns about access to care, this policy will be reviewed and updated throughout the pandemic.
BCBSWY will permit telephonic and telemedicine visits to occur to the patient’s home when the following conditions are met:
- The services provided are within the provider’s scope of license.
- Telecommunications technologies utilized must comply with applicable federal and state legal requirements of health/medical information privacy, including compliance with HIPAA.
- Services must be medically appropriate to be rendered at a distance.
- Providers should bill the service that they render with a GT modifier.
- Physical therapy, occupational therapy, and speech therapy should bill without the GT modifier.
- 99441, 99442, and 99443 will be permitted for telephonic visits. No GT modifier is required for these codes.
- These guidelines apply only to BCBSWY members. Providers should seek guidance from other Blues plans for potential changes to their policies.
- These guidelines do not apply to members of the Federal Employee Program.
- Other benefit and cost share rules will continue to apply. It is important to note that only services that can be rendered through telemedicine should occur. Services that cannot be safely or adequately provided through this means should be avoided. Effective 3/18/20, BCBSWY will waive cost share on all telemedicine services through 8/31/20.
- Get email updates! Ask to be added to receive Provider Updates at firstname.lastname@example.org
For more information see: CDC COVID-19 or State of Wyoming COVID-19.