Reminder about Telehealth Services

On Mar. 10, 2022, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) communicated the extension of the expanded reimbursement for telehealth.  

In addition to this communication, Blue Cross NC would like to remind Blue Cross NC contracted providers who utilize out-of-state providers for telehealth services of the following policy regarding the filing of out-of-state claims. 

Policy Overview:

If a telehealth provider is not located in NC and when providing telehealth services, the telehealth claim should be submitted to the host plan where the provider is located when the telehealth services are rendered. The claim will then be processed through the BlueCard® Inter-Plan Program (IPP). This reminder is targeted for NC-based contracted providers who utilize telehealth services, not providers who are telehealth only.   

• Example Scenario #1: If a provider is located physically in NC and contracted with Blue Cross NC when the services are rendered, the provider can file and receive reimbursement for telehealth. As a reminder the provider needs to be licensed and located in NC, NOT out-of-state.  
  
• Example Scenario #2:  If a telehealth provider is located physically in Florida at the time the services are rendered and provides telehealth services for a Blue Cross NC member, the claim would have to be filed with Blue Cross and Blue Shield of Florida (BCBSF) through IPP. 
  

Please note that this policy applies to existing commercial, Medicare Advantage and State Health Plan network providers.