Telehealth

General
Policy Number: GP-X-016

Last Updated: Sept. 26, 2022 

COVID-19 and Telehealth  

Blue Cross and Blue Shield of Nebraska (BCBSNE) telehealth services policy includes the following providers: 

  • Medical doctors 
  • Doctors of osteopathy 
  • Physician assistants 
  • Nurse practitioners 
  • Behavioral health providers 
  • Occupational, physical and speech therapists 
  • Certified Diabetic Educators (effective Apr. 1, 2022) 
  • Licensed Medical Nutritional Therapist (effective Apr. 1, 2022) 

Legislative mandate: Out-of-network telehealth services will be covered at no cost to the member if related to COVID-19 diagnostic testing. 

Telehealth Codes 

Member cost shares apply as of Jan. 1, 2021. The codes below are the only applicable telehealth codes that should be billed. Additionally, the below codes are the only applicable telehealth codes that should be billed with POS 02 or POS 10*** and modifier 95. All other procedure codes are not medically appropriate to be performed via telehealth.  

Telehealth Codes

Institutional/facility claims will no longer be allowed, except as follows: 

  • Effective 11/1/2020 OT/PT/ST  
  • Effective 4/1/2022 POS 10 is effective with BCBSNE 
  • Effective 4/1/2022 G0108 Diabetic Self-Management Training 
  • Effective 4/1/2022 Q3014 Originating Site Fee 
    • Appropriate billing of Q3014:
      Facility:
      • Claim form: UB04 
      • Type of Bill: 12X (Medicare Part B only), 13X, 22X (Medicare Part B only), 23X, 71X, 72X, 73X, 76X, and 85X 
      • Revenue Code: 078X 
      • Procedure Code: Q3014 
      Professional:
      • Claim form: HCFA 1500 
      • Procedure Code: Q3014 
      • Place of service: 11 (must be billed by a rural health clinic – RHC)  
    • Provider at the distant site who is performing the telehealth visit with the member may bill their services on a HCFA 1500 form 
      • Must use an approved telehealth code with POS 02 and modifier 95 
      • POS 10 is not applicable 

The below will not be considered for telehealth:

  • Quick Care 
  • Urgent Care 
  • Retail Clinic 
  • ASC 
  • Minute Clinic 
  • Pharmacy 

These changes are specific to BCBSNE members; please check benefits for Federal Employee Program (FEP) or out-of-state Blue Cross and Blue Shield (BCBS) members.  

For coverage information on other BCBS Plans, as well as the BCBS FEP, related to COVID-19 treatment go to Blue Cross Blue Shield (bcbs.com)

Providers performing and billing teleservices must be eligible to independently perform and bill the equivalent face-to-face service.  

Our members may seek telehealth services through their current physician/provider, or they can receive services through Amwell®. This information has been communicated separately to our members.  

Amwell® is an independent company that provides telehealth services for Blue Cross and Blue Shield of Nebraska.