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Update to Additional Coverage to Support Virtual Health February 08, 2023 Medical Policy & Clinical Guidelines Claims & Coding Physicians & Specialists

Effective 4/18/2023, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has updated our Reimbursement Policy "Telehealth" to allow reimbursement for Remote Physiologic and Remote Therapeutic Monitoring codes (98975, 98976, 98977, 98980, 98981, 99453, 99454, 99457, 99458). 

Remote Monitoring Services do not have a face-to-face equivalent and therefore are not to be submitted with a Telehealth “Place of Service” or Modifier(s).  

The addition of these Remote Physiologic and Remote Therapeutic Monitoring codes increases our level of coverage provided under virtual care and provides physicians with additional resources to provide care to members. This change was made with consideration to access to care and improved affordability, and as a direct result of collaboration with provider requests and the Blue Cross NC’s policy review process.  

For further information, review the full Telehealth policy

This communication applies to State Health Plan (SHP), Federal Employee Program (FEP), Administrative Services Only (ASO), Fully Insured, and IPP Host. It does not apply to IPP Home claims.