Aug. 13 Update
- For commercial telehealth claims, urgent care and facility providers should bill the same as if the services were done face to face. Please visit our Details and Coding Guidance page for more information.
- For IPP Host claims (i.e. members with out-of-state Blue Cross plans seeing a provider in North Carolina), the provider should check the back of the member's ID card and use the contact information listed to verify any coding requirements before submitting the claim. Providers also can visit the Blue Cross and Blue Shield Coronavirus website to access web pages and resources for local Blues plans.
July 22 Update
Upon further investigation, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has learned that the telehealth claims reimbursement issue reported below extends to providers in all specialties. All other details below, including the member segments impacted, remain unchanged. If you have any additional questions about claims or reimbursement, please complete this form.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) recently identified an error in telehealth claims reimbursements for behavioral health providers. Due to an error in our systems, behavioral health providers who submitted claims under our COVID-19 expanded telehealth measure (service dates on or after March 6, 2020) may not have been paid at parity with their face-to-face reimbursement rate. The issue affects claims for fully insured, administrative services only (ASO/employer groups), State Health Plan, Inter-Plan Program Host (IPP Host) and Federal Employee Program (FEP) members.*
There is no action required on your part. We are currently working to resolve this issue in our systems and to send corrected reimbursements to the impacted providers. We do not yet have a timeframe of when these payments will be sent, but we will provide an update on this as soon as possible. We sincerely apologize for this error.
Additionally, our coding guidance for telehealth has not changed. You should continue to follow the guidance posted on this page. If you have any additional questions about claims or reimbursement, please complete this form.
*Please Note: Members of Medicare Advantage plans that Blue Cross NC offers or administers, including Experience Health, were not impacted by this issue. For Medicare telehealth claims, providers should continue following CMS coding guidance. If you find that a Medicare telehealth claim was coded incorrectly, please submit a corrected claim.