BCBS NC Releases New Permanent Telehealth Strategy

Blue Cross NC released data on telehealth usage during the COVID-19 pandemic on September 21, 2022. See press release here.

From the Blue Cross NC press release:

Delivering on its commitment to implement a telehealth strategy extending beyond the pandemic, Blue Cross NC will update its telehealth policy, effective Jan. 1, 2023, to significantly expand its list of covered telehealth services, compared to services covered prior to the pandemic.

The new telehealth policy will cover telehealth services for behavioral health, primary care and outpatient visits, which accounted for more than 97% of telehealth claims received during the last two years. In consultation with health care providers, some services were identified as less effective or inappropriate to conduct virtually and will not be covered when provided via telehealth, for example, surgery, anesthesia, laboratory testing and radiology.

Covered services will be significantly expanded compared to the pre-pandemic telehealth policy. Compared to the pre-pandemic policy, members will have access to 77 more telehealth services under the new policy, representing a 71% increase in the number of services covered, compared to the pre-pandemic policy.

In deciding on the new policy, we assessed more than two years of data since the start of COVID-19. The new policy will continue to cover services that make up more than 97% of the telehealth claims received during the last two years, particularly behavioral health, primary care and outpatient office visits. In consultation with health care providers, less than 3% of telehealth payments made during the last two years were identified as less effective or inappropriate to conduct virtually and will no longer be covered the same as in-person visits, for example, surgery, anesthesia, laboratory testing and radiology.

Specifically with respect to autism services, ABA codes 97151, 97156 and 97157 delivered via telehealth will be covered at parity. Please see the list of additional reimbursable service categories below that will be covered at parity (except audio-only services).

Reimbursable Services

• Outpatient Office Visits

• Individual, Group and Family Psychotherapy

• Health Behavior Interventions

• Alcohol and Substance Abuse Services

• Preventive Medicine Counseling

• Medical Nutrition Therapy

• Advance Care Planning

• Tobacco Cessation Counseling

• Established Adult Preventative/Annual Wellness Exams

• Genetic Counseling

• Speech Therapy Evaluations

• Psych/Neuropsychic Testing

• Telephone (audio-only) Visits*

*audio only visits will be reimbursed at 75% of the in-person reimbursement rate

Non-Reimbursable Services

• Dialysis Services

• Physical Therapy/Occupational Therapy Evaluations

• COVID Testing Services

• Emergency Department Evaluation & Management Services

• Hospitalization Evaluation & Management Services

• Prolonged Services

• New Patient Preventive/Annual Wellness Exams

When asked by NASW-NC, BCBSNC indicated they are not requiring providers to participate in Teledoc.

See press release here.