South Carolina
Medicare Advantage / Absolute Total Care MMA / Allwell Medicare HMO
Commercial / BCBS of South Carolina
Medicare Advantage / EON Health HMO
Medicare Advantage / Wellcare HMO
Medicare Advantage / Absolute Total Care MMA / Allwell Medicare HMO
| Last Checked Date | 7/31/20 | 7/31/20 |
|---|---|---|
| CPT Codes | G2012 | 99201-99215 |
| Communication Type | Telephone call allowed – Video not required | Video required |
| Type of Service | Telephonic encounter (Virtual check-in) | Office or other outpatient visits |
| POS | 11 | 11 |
| Modifier | Blank | GT or 95 |
| Additional Notes | ||
| Cost sharing for Telemedicine | Waived | Waived |
| Policy Termination Date | Not available | Not available |
| Policy Link/Update Link | Click Here | Click Here |
| Additional Policy PDF |
Commercial / BCBS of South Carolina
| Last Checked Date | 7/31/20 | 7/31/20 |
|---|---|---|
| CPT Codes | 99201-99203 99211-99215 |
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 | NA |
| Additional Notes | BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan has extended the temporary expansion for telehealth services through October 1, 2020. This expansion continues to help minimize unnecessary exposure to individuals needing medical care. Effective August 1, 2020, both plans will revert back to requiring the use of HIPAA-secured telehealth systems in which care is delivered synchronously using both audio and visual modalities in order for services to be reimbursed. | BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan has extended the temporary expansion for telehealth services through October 1, 2020. This expansion continues to help minimize unnecessary exposure to individuals needing medical care. Effective August 1, 2020, both plans will revert back to requiring the use of HIPAA-secured telehealth systems in which care is delivered synchronously using both audio and visual modalities in order for services to be reimbursed. |
| Cost sharing for Telemedicine | Check with payer | Check with payer |
| Policy Termination Date | 1/10/2020 | 1/10/2020 |
| Policy Link/Update Link | Click Here | Click Here |
| Additional Policy PDF | Click Here | Click Here |
Medicare Advantage / EON Health HMO
| Last Checked Date | 7/31/20 | 7/31/20 | 7/31/20 |
|---|---|---|---|
| CPT Codes | 99201-99215 | 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; Virtual check-in | Telephonic encounter (Virtual check-in) | Telephonic encounter (Virtual check-in) |
| POS | 11 | 11 | 11 |
| Modifier | 95 | Blank | Blank |
| Additional Notes | Follows Medicare guideline | Follows Medicare guideline | Follows Medicare guideline |
| Cost sharing for Telemedicine | Waived for Covid only | Waived for Covid only | Waived for Covid only |
| Policy Termination Date | Not available | Notavailable | Not available |
| Policy Link/Update Link | Click Here | Click Here | Click Here |
| Additional Policy PDF | Click Here | Click Here | Click Here |
Medicare Advantage / Wellcare HMO
| 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; Virtual check-in | Telephonic Encounter (Virtual check-in) |
| POS | 11 | 11 |
| Modifier | 95 | Blank |
| Additional Notes | Waiving in-network member costs for all primary care visits for the rest of 2020. We are also waiving member costs for outpatient, non-facility-based behavioral health visits and are extending telehealth cost share waivers for all telehealth visits – primary care, specialty, and behavioral health – for in-network providers for the remainder of 2020. This does not include inpatient hospital, behavioral health facility, or urgent care visits. Medicare members with state benefits will continue to receive support through coordination with their states. | Waiving in-network member costs for all primary care visits for the rest of 2020. We are also waiving member costs for outpatient, non-facility-based behavioral health visits and are extending telehealth cost share waivers for all telehealth visits – primary care, specialty, and behavioral health – for in-network providers for the remainder of 2020. This does not include inpatient hospital, behavioral health facility, or urgent care visits. Medicare members with state benefits will continue to receive support through coordination with their states. |
| Cost sharing for Telemedicine | Waived | Waived |
| Policy Termination Date | Not available | Not available |
| Policy Link/Update Link | Click Here | Click Here |
| Additional Policy PDF | Click Here | Click Here |
State Telemedicine Policy
