Attention PCPs: Temporary Telehealth Expansion for Pediatric Preventive Visits

Attention PCPs: Temporary Telehealth Expansion for Pediatric Preventive Visits

In response to the COVID-19 pandemic, BlueCross BlueShield of South Carolina and its subsidiary BlueChoice® HealthPlan are expanding telehealth services to allow preventive medicine services for pediatric patients between the ages of 2-21, effective April 16, 2020.  The code sets 99382-99385 and 99392-99395 must be filed with the 95 modifier to represent these services.

Physicians will need to use the previously established telehealth application process to apply if telehealth credentialing has not already been approved.  Normal components of a well visit (weight, height, vital signs, physical exam and in-office testing and screening) must be completed within 60 days of the pandemic end with no submission of additional evaluation and management (E&M) codes. The office records from the completion of the telehealth service must contain the date of the telehealth visit for auditing purposes.

Additionally, vaccines and immunizations related to these telehealth visits should be administered and filed with no change to coding or associated reimbursement for those services, also within 60 days of the termination of the pandemic. Audit of these visits and follow-up care will be done at the discretion of the plan.

As for the place of service (POS), if services are rendered on campus at an outpatient hospital and telemedicine equipment is involved, claims should be submitted with the POS 02.  If services are not rendered on campus at an outpatient hospital, continue to submit claims with the appropriate POS (i.e. office, laboratory, etc.).

NOTE: This does not apply to telephone based services which are reflected in the code set 99441-99443.

For more information, please see CAM 176 for Telehealth.

After clicking the link to CAM 176, accept the disclaimer and search for “Telehealth”.

For any additional questions, please contact Provider Education using the Provider Education Contact Form located on BlueChoiceSC.com.

For all FAQs related to COVID-19, please click here.