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Thank you for your tireless, selfless effort to care for us, our members, our loved ones, and our communities. We know you are tired. We thank you for fighting on.

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Telehealth Services Update for Providers

Your safety and the safety of our members is importance to us.

We are encouraging our members to use telehealth services to help reduce exposure in healthcare settings as well as prevent community spread. We are waiving member cost share (copay, deductible, coinsurance) for medically necessary telehealth (phone or video conference) visits with in-network healthcare providers through April 15.

How do providers bill for telehealth visits?

The Capital BlueCross/Blue Card contracted provider may schedule the visit with the member through the provider’s normal scheduling platform then instruct the member how to connect (via telephone or FaceTime, etc.). When billing, the provider must identify that it was a telehealth service by billing with the ‘02’ place of service. The service will then be covered under our reimbursement policy and subject to the member’s benefits. Providers can access Network Reimbursement Policy (NR-30.026) in the Provider Library via the provider portal.

Eligible Providers1

In-network providers who are eligible to provide telehealth services:

  • Physicians
  • Physician Assistants (PAs)
  • Certified Nurse Midwives (CNMs)
  • Clinical Nurse Specialist (CNA)
  • Certified Registered Nurse Anesthetists (CRNAs)
  • Clinical Social Workers (CSWs)
  • Clinical Psychologist (CPs)
  • Registered dietitian or nutrition professional
  • Nurse Practitioners (NPs)
  • Licensed Professional Counselors (LPCs)
  • Licensed Family and Marriage Therapist (LFMTs)

Due to the COVID-19 pandemic temporary enhancements we have also temporarily expanded our eligible telehealth services through at least April 15:

  • Physical Therapy, Occupational Therapy, Speech Therapy
  • Applied Behavioral Analysis (ABA)
  • Intensive Outpatient Program (IOP)
  • Partial Hospitalization Program (PHP)

What happens after April 15?

On April 16, member cost share (copays, deductibles, coinsurance) will apply for telehealth visits. Throughout this pandemic, we are continually assessing our policies to meet the evolving needs of our members and community. We will revisit our telehealth policy as the situation evolves.

What is telehealth?

Telehealth or telemedicine is the delivery of medical services through phone or video conferencing.

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1For CHIP members, only Family Practice, General Practice and Pediatricians are eligible to provide telehealth services.