Telemedicine Services Matrix

Effective December 1, 2020, BCBSWY will permit telephonic and telemedicine visits to occur to the patient’s home. The below guidance is intended to assist professional providers understand the types of services permitted during this time. 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 telemedicine should be avoided. These guidelines apply only to BCBSWY members and may differ for some self-funded groups, please call 888-359-6592 to confirm group specific benefits. Providers should seek guidance from other Blues plans for potential changes to their policies.

BCBSWY Telemedicine Services

BCBSWY Telemedicine Services Matrix PDF

Type of Service  

What is the Service

HCPCS/CPT Codes Place of Service/Modifiers Coverage PT/OT/Speech Therapy Rules
Telehealth/Telemedicine Visits A service that can safely and appropriately be rendered at a distance. Services provided should be within the provider’s scope of license and meet the standard of care. Services can be rendered to the patient’s home. HCPCS or CPT code(s) that can safely and appropriately be rendered at a distance as determined by BCBSWY.  Use standard place of service codes, do not bill POS code 2. Bill modifier GT or 95.  BCBSWY has historically provided coverage for telemedicine services when a patient was located at an originating site (physician office or other place of service). During the COVID-19 crisis BCBSWY will extend benefits to services rendered at the patient’s home. Should bill standard codes without a GT modifier. To ensure that patient cost share is appropriately waived, these providers should bill 99199 with a penny charge.
Telephone Services Telephone evaluation and management service by a physician or other qualified health professional for an established patient. 99441
99442
99443
Use standard place of service codes, do not bill POS code 2. The GT or 95 modifier is not required. BCBSWY will benefit these services temporarily during the COVID-19 crisis. Can bill these codes.
e-Visits Online digital services for an established patient, through an online patient portal. 99421       G2061
99422       G2062
99423       G2063
Not applicable. Not a benefit. These codes are not reimbursed by BCBSWY at this time. Not applicable.
Virtual Check-Ins Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient. G2010
G2012
Not applicable. Not a benefit. These codes are not reimbursed by BCBSWY at this time. Not applicable.

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