Washington -

Washington

Medicare Advantag / Amerivantage HMO

Commercial / Premera BCBS

Medicare Advantage / Premera BCBS

Commercial / Regence BlueShield of Select Counties of Washington

Medicare Advantage / Regence BlueShield of Select Counties of Washington

Medicare Advantag / Amerivantage HMO

Last Checked Date	7/20/20
CPT Codes	99201-99215
Communication Type	Telephone call allowed – Video not required
Type of Service	Office or other outpatient visits
POS	2
Modifier	GT or 95 (CS modifer for Covid 19 related)
Additional Notes	Effective from March 17, 2020, through September 30, 2020, Amerigroup health plans will waive member cost shares for telehealth visits, including visits for annual wellness visits, mental health or substance use disorders, for our Medicare Advantage plans. For out-of-network providers, Amerigroup is waiving cost shares from March 17, 2020, through 09/30/2020 Cost sharing will be waived for members using our authorized telemedicine service, LiveHealth Online, and for telehealth received from other providers delivering virtual care through internet video and audio services.
Cost sharing for Telemedicine	Waived
Policy Termination Date	03/19/2020-09/30/2020
Policy Link/Update Link	Click Here
Additional Policy PDF	Click Here

Commercial / Premera BCBS

Last Checked Date	7/20/20	7/20/20
CPT Codes	99201-99215	99441-99443
Communication Type	Video required	Telephone call allowed- Video not required
Type of Service	Office or other outpatient visits	Telephonic encounter (Virtual check- in)
POS	11	11
Modifier	95 or GT	Blank
Additional Notes	Costsharing waived ” This will not apply to shared admin, FEP, BlueCard,Providence, HCA, Medicare Supplement, and self-funded plans who opt out.”	Cost sharing waived ” This will not apply to shared admin, FEP, BlueCard, Providence, HCA, Medicare Supplement, and self-funded plans who opt out.”
Cost sharing for Telemedicine	Waived	Waived
Policy Termination Date	03/06/2020-12/31/2020	03/06/2020-12/31/2020
Policy Link/Update Link	Click Here	Click Here
Additional Policy PDF	Click Here	Click Here

Medicare Advantage / Premera BCBS

Last Checked Date	7/20/20	7/20/20
CPT Codes	99201-99215	99441-99443
Communication Type	Video required	Telephone call allowed- Video not required
Type of Service	Office or other outpatient visits	Telephonic encounter (Virtual check-in)
POS	11	11
Modifier	95	Blank
Additional Notes	Cost sharing waived ” This will not apply to shared admin, FEP, BlueCard, Providence, HCA, Medicare Supplement, and self-funded plans who opt out.”	Cost sharing waived ” This will not apply to shared admin, FEP, BlueCard, Providence, HCA, Medicare Supplement, and self-funded plans who opt out.”
Cost sharing for Telemedicine	Waived	Waived
Policy Termination Date	03/06/2020-12/31/2020	03/06/2020-12/31/2020
Policy Link/Update Link	Click Here	Click Here
Additional Policy PDF	Click Here	Click Here

Commercial / Regence BlueShield of Select Counties of Washington

Last Checked Date	7/31/20	7/31/20	7/31/20
CPT Codes	99201-99203 99212-99214	99441-99443	G2012
Communication Type	Telephone call allowed- Video not required	Telephone call allowed- Video not required	Telephone call allowed- Video not required
Type of Service	Office or other outpatient visits	Office or other outpatient visits	Office or other outpatient visits
POS	11	11	11
Modifier	95 or CS,95	95 or CS,95	95 or CS,95
Additional Notes	CS Modifer be include along with 95 for Covid 19 related treatment	CS Modifer be include along with 95 for Covid 19 related treatment	CS Modifer be include along with 95 for Covid 19 related treatment
Cost sharing for Telemedicine	Waived for Covid only	Waived for Covid only	Waived for Covid only
Policy Termination Date	12/31/2020	12/31/2020	12/31/2020
Policy Link/Update Link	Click Here	Click Here	Click Here
Additional Policy PDF	Click Here	Click Here	Click Here

Medicare Advantage / Regence BlueShield of Select Counties of Washington

Last Checked Date	7/31/20	7/31/20	7/31/20
CPT Codes	99201-99203 99212-99214	99441-99443	G2012
Communication Type	Video required	Telephone call allowed – Video not required	Telephone call allowed – Video not required
Type of Service	Office or other outpatient visits	Office or other outpatient visits	Office or other outpatient visits
POS	11	11	11
Modifier	95 or CS,95	95 or CS,95	95 or CS,95
Additional Notes	The use of Audio and Video Must be Documented in the patient’s chart note. CS Modifer be include along with 95 for Covid 19 related treatment	CS Modifer be include along with 95 for Covid 19 related treatment	CS Modifer be include along with 95 for Covid 19 related treatment
Cost sharing for Telemedicine	Waived for Covid only	Waived for Covid only	Waived for Covid only
Policy Termination Date	12/31/2020	12/31/2020	12/31/2020
Policy Link/Update Link	Click Here	Click Here	Click Here
Additional Policy PDF	Click Here	Click Here	Click Here