State-based commercial insurers’ COVID-19 telehealth policies

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Policies and coding guidance for extended telehealth coverage during the COVID-19 emergency

This list of state-based payers provides details on more than 50 of the better-known commercial insurers’ policies for extended telehealth (TH) coverage during the COVID-19 emergency.

Note: Expiration dates are rapidly changing. While we strive to keep the information updated, please check with the insurer directly for current information.

View policies for national and regional payers

About this list

How created

This listing is the result of the largest ever collaboration between APA Services, Inc. (specifically Practice’s Legal and Regulatory Affairs and Office of Health Care Finance) and the Inter Organizational Practice Committee (IOPC), a group of national neuropsychology groups.

The initial research on scores of state insurers was done by a team of neuropsychology graduate students supervised by IOPC leaders. The information benefited from feedback from the APA-affiliated state psychological associations’ Directors of Professional Affairs and insurance/reimbursement leaders.

How to read the information

The national and regional payer section has listings for national companies like Aetna, Optum, Cigna, and Anthem BCBS, and regional companies that are in multiple states. The state-based listing provides our initial group of companies that are exclusively/primarily in one state (see Focus on commercial insurance below).

In each section, you’ll see

  • basic information on the company and web links
  • the common behavioral health (BH) procedures/codes covered by the company’s emergency TH policies
  • general information on billing, co-pays, out-of-network, etc.
  • a list of less common BH procedures/codes covered by those policies

Focus on commercial insurance

These listings focus on commercial insurance but include some specific information on variations for other programs like Medicaid and Medicare Advantage. Within commercial insurance, a company’s TH policies do not necessarily apply to the large portion of self-insured plans of large companies; those plans (known as ERISA plans) are administered but not controlled by the insurance companies.

For more information, see and APA Service’s FAQs practicing psychologists have about COVID-19 (see 6th FAQ regarding ERISA plans):

We are evaluating whether to expand the listings to include Medicaid MCOs and Medicare Advantage plans, although it appears that those companies are primarily driven by directives from state Medicaid agencies and CMS respectively.

The listings are a work in progress

Developing these listings was made challenging not only by the scope and complexity of so many companies’ TH policies, but also by the fact that they are constantly changing. Some larger companies update them very frequently.

We are still finalizing our analysis of several single state companies (e.g., BCBS companies in Alabama, Arkansas, Louisiana, and two in New York) that will be added to the state chart.

We will update the charts periodically, more frequently for major companies. Please email us with significant updates or corrections.

End dates

Most companies are either constantly extending the end dates for their TH Policies as they approach or planning to end their policies when the federal or state government declares the emergency over. While most states are in various stages of opening and re-opening, many of their public health emergency (PHE) orders are likely to stay in place as long as there is some level of COVID-19 restrictions, e.g., prohibitions on mass gatherings. (A few states’ PHE orders have already expired and some are set to expire in December.) 

APA Services is advocating on multiple fronts for payers to keep their TH policies in place for at least 12 months after the federal emergency declaration ends. It is also advocating for payers to permanently adopt appropriate extensions of their TH policies when the crisis is over.

Disclaimer

We prepared this page to provide information to psychologists in this rapidly changing landscape. Because the law and related information continually change, we will strive to update the page regularly. Please email us with any updates.

Please note this document does not constitute legal advice. APA cannot guarantee the completeness or accuracy of this document, and we recommend that psychologists independently verify this information (partly by using the references included in each listing) and consult with counsel in their state with appropriate experience before relying on or making decisions based on this information.

 

State payers

Alaska

Premera Blue Cross

Type of plan: Commercial and Medicare/Medicaid
Coverage dates: ABA through December 31, 2021; PHP and IOP telehealth policy allowing ongoing coverage for mental health and substance abuse effective January 1, 2021.

Arizona

Arizona BCBS

Type of plan: Commercial and Medicaid/Medicare
Coverage dates: Extended for duration of COVID-19 Public Health Emergency

California

Blue Shield of California

Type of plan: Commercial and Medicare/Medicaid
Coverage dates: Effective March 17, 2020 through the end of the COVID-19 public health emergency

Connecticut

ConnectiCare

Type of plan: Commercial/Medicaid
Coverage dates: March 1, 2020–end of COVID-19 public health emergency

Florida

Florida BCBS

Type of plan: Commercial, Medicaid
Coverage dates: Updated November 5, 2020, and remains in effect until further notice.

Georgia

Ambetter

Type of plan: Commercial and Medicare/Medicaid
Coverage dates: March 17, 2020–June 30, 2020

Idaho

Blue Cross of Idaho

Type of plan: Commercial and Medicare/Medicaid
Coverage dates: Implemented Telehealth policy effective January 21, 2021

Kansas

BCBS Kansas

Type of plan: Commercial
Coverage dates: The expansion of telehealth and virtual services that were effective March 16, 2020, will continue to be allowed through the end of the PHE or end of year, whichever occurs first

Massachusetts

BCBS of Massachusetts

Type of plan: Commercial and Medicare/Medicaid
Coverage dates: For the duration of the Massachusetts public health emergency

Tufts Health Plan

Type of plan: Commercial
Coverage dates: effective for dates of service March 6, 2020 until further notice (unless otherwise specified)

Michigan

BCBS of Michigan

Type of plan: Commercial, Medicare Plus, and BCN Advantage
Coverage dates: March 1, 2020, until further notice

Priority Health

Type of plan: Commercial
Coverage dates: From March 26 through end of PHE.

Minnesota

BCBS Minnesota

Type of plan: Commercial and Medicaid
Coverage dates: All temporary virtual care coverage changes currently in effect will be extended through December 31, 2021

Missouri

BCBS of Kansas City

Type of plan: Commercial, Medicare, and Self Insured
Coverage dates: March 9, 2020 until end of PHE

Nebraska

BCBS Nebraska

Type of plan: Commercial
Coverage dates: March 13, 2020–December 31, 2020

New Hampshire

Tufts

Type of plan: Commercial and Medicare/Medicaid
Coverage date: March 6, 2020 until further notice

New Jersey

Horizon BCBS

Type of plan: Commercial
Coverage dates: March 1, 2020 through at least 90 days after the end duration of Public Health Emergency

New Mexico

Presbyterian Health Plan (AKA Centennial Care)

Type of plan: Commercial, Medicaid, Medicare Advantage
Coverage dates: through the duration of the emergency declaration

True Health New Mexico

Type of plan: Appears to be both commercial and Medicare/Medicaid
Coverage Dates: March 12, 2020 through duration of COVID-19 Pandemic

New York

Excellus BCBS

Type of plan: Commercial and Medicare/Medicaid
Coverage dates: Telehealth services provided from March 13, 2020 through the expiration of the NYS emergency regulation (on telehealth: December 31, 2021; on testing/visits: October 1, 2021) (refer to the Regulatory Time Frames tab for current expiration date).

Group Health Incorporated (AKA Emblem Health)

Type of plan: Commercial and Medicare
Coverage dates: Telehealth service provided from March 1, 2020 through end of COVID-19 public health emergency.

North Carolina

BCBS North Carolina

Type of plan: Commercial and Medicare/Medicaid
Coverage dates: March 6, 2020 through December 31, 2020; will reevaluate if an additional extension is needed as approach December 31.

North Dakota

BCBS North Dakota

Type of plan: All products. BCBSND will work with self-funded clients for potential expanded coverage for their employees.
Coverage dates: Effective March 1, 2020, through the end of the emergency declaration

Ohio

Medical Mutual

Type of plan: Medicare Advantage plans, fully insured commercial members, Medicare Supplement, and individual members
Coverage dates: Medical Mutual is allowing the expanded telehealth services through December 31, 2020, at which time they will begin to follow Ohio Revised Code Section 3902.30, effective January 1, 2021.

  • Per Ohio Revised Code Section 3902.30: A health benefit plan shall provide coverage for telemedicine services on the same basis and to the same extent that the plan provides coverage for the provision of in-person health care services.

Oregon

Moda

Type of plan: Commercial and Medicare/Medicaid
Coverage dates: Oregon Commercial plans—through December 31, 2020, Oregon Medicaid plans—through December 31, 2020, Alaska Commercial plans—the expanded coverage from the state of Alaska directives has been made permanent. (See AS 21.42.422 & SCS HB 29. The Alaska section of RPM052, “Telehealth And Telemedicine Services” is also being updated.), and Medicare Advantage plans—until directed by CMS that the temporary expanded coverage has ended.
*These end dates been extended twice and may be extended further depending upon the status of the PHE.

PacificSource

Type of plan: Commercial and Medicare/Medicaid; Self-insured companies determine if they will provide the same benefit that PacificSource is providing for fully insured groups. Most self-insured groups have decided to provide the same benefits.
Coverage dates: Until further notice

Providence Health Plan

Type of plan: Commercial
Coverage dates: Effective March 6, 2020, through June 30, 2020, or until further notice

Pennsylvania

Capital Blue Cross

Type of plan: Commercial/Medicare Advantage
Coverage dates: from April 1 through October 18, 2021 and duration of COVID-19 Pandemic for Medicare (following CMS guidelines)

Independence BCBS

Type of plan: Commercial/Medicare
Coverage dates: Commercial: March 6, 2020, through dates specified in services chart below; Medicare Advantage: March 6, 2020, and for the duration of the public health emergency.

Quest

Coverage dates: The Office of Civil Rights (OCR) has issued modified HIPAA enforcement discretion guidelines regarding telehealth services during the pandemic. To maintain access to care, Quest will adhere to OCR’s guidelines. Once the OCR ends the modified guidelines, Quest will require all behavioral health appointments to either be conducted via face-to-face session or, if the provider has completed the Telemental Health Attestation process as of September 30, 2021, through a HIPAA-compliant telemental health platform.

UPMC Health Enterprise

Type of plan: Commercial and Medicaid/Medicare
Coverage dates: Commercial and Medicare products: March 20, 2020—August 31, 2021, pending any changes to the current federal and/or state emergency declarations and associated guidance; Medicaid/CHIP/CHC products—policy adopted through August 31, 2021 pending any changes to the current federal and/or state emergency declarations and associated guidance.

Rhode Island

BCBS Rhode Island

Type of plan: Commercial and Medicare
Coverage dates: Effective January 1, 2021—during PHE

Harvard Pilgrim

Type of plan:
Coverage dates: February 2021 onwards

South Carolina

BCBS SC

Type of plan: Commercial and Medicare
Coverage dates: Policy in effect through April 30, 2021. Following April 30, 2021, codes no longer in effect. Beginning May 1, 2021, members are encouraged to consult their physician or other provider for availability of continued access to virtual care.

Tennessee

BCBS Tennessee

Type of plan: Commercial and Medicare/Medicaid
Coverage dates: Effective for dates of service March 16, 2020, until further notice

Utah

Public Employees Health Plan

Type of plan: Commercial
Coverage dates: N/A

SelectHealth (Intermountain)

Type of plan: Commercial and Medicare/Medicaid
Coverage dates: This change is currently effective for dates of service, beginning March 1, 2020. SelectHealth expects this temporary change to end mid-summer, although we will continue to monitor the situation as the current COVID-19 crisis continues to change.

UNI-BNH (University of Utah Health)

Type of plan: Commercial
Coverage dates: July 28, 2021–December 22, 2021

Vermont

BCBS Vermont

Type of plan: Commercial, Medicaid
Coverage dates: Extended thru July 1, 2021; Some services extend through August 31, 2021

Washington

Premera Blue Cross

Type of plan: Commercial and Medicare/Medicaid
Coverage dates: Several benefit extensions ended June 30, 2021. See the key dates grid and related sections for more information.

Wyoming

BCBS Wyoming

Type of plan: Commercial
Coverage dates: N/A

Last updated: April 2022Date created: July 2020