National and regional commercial insurers’ COVID-19 telehealth policies

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Policies and coding guidance for extended telehealth coverage during the COVID-19 emergency from more than 50 of the better-known national, regional, and state-based payers.

This list of state-based and national and regional payers provides detail 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 state-based payers

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.

National payers

Aetna

Type of plan: Commercial, Medicare, Self-Insured (at sponsor discretion)
Coverage dates: (effective March 6, 2020) until further notice 

Anthem BCBS

Region: National, but only in certain states:

  • California (Blue Cross but not Blue Shield)
  • Colorado
  • Connecticut
  • Georgia
  • Indiana
  • Kentucky
  • Maine
  • Missouri (excluding 30 counties in the Kansas City area)
  • Nevada
  • New York (only Empire BCBS—other parts of state are coved by other BCBS companies)
  • Ohio
  • Virginia (except District of Columbia suburbs)
  • Wisconsin

Coverage dates: Most telehealth policies effective beginning March 17, 2020 until further notice

BCBS Federal Employee Program (FEP)

Coverage dates: April 17, 2020–end of 2021

Beacon (Carve Out Company)

Type of plan: Commercial
Coverage dates: These temporary policy waivers are retroactive to March 6, 2020. The waiver period will end the earlier of when the national emergency order is lifted (in whole or in part) or when Beacon advises of a change.

Cigna

Type of plan: Commercial and Medicare Advantage
Coverage dates: Cigna implemented a new Virtual Care Reimbursement Policy for commercial medical services, effective January 1, 2021. This policy ensures that providers can continue to receive ongoing reimbursement at face-to-face rates for virtual care provided to their patients with Cigna commercial medical coverage. Please note that Cigna’s interim COVID-19 virtual care guidelines were in place until December 31, 2020. Therefore, please refer to those guidelines for services rendered prior to January 1, 2021. The Virtual Care Reimbursement Policy (PDF, 216KB) only applies to services provided to commercial medical customers, including those with Individual and Family Plans (IFP). Cigna Behavioral Health and Cigna Medicare Advantage customers continue to have covered virtual care services through their own separate benefit plans.

Humana

Type of plan: Commercial and Medicare Advantage
Coverage dates: Through the duration of the COVID-19 public health emergency

Magellan

Region: National—BH Carve out company
Type of plan: Commercial, Medicare, Managed Medicaid
Coverage dates: March 18, 2020 through the end of the federal emergency

Optum/United Health Care

Type of plan: Commercial, Medicare Advantage, Managed Medicaid. Application to self-insured plans not yet clear. Waiver of patient responsibility (see “Developmental / Behavioral Screening and Testing Services” below) clearly excludes self-insured plans but not yet clear for other policies.)

Coverage dates: Effective March 19, 2020

Commercial membership:  This policy change is effective through June 15, 2022 and set to end June 16, 2022 for in-network providers. For out-of-network providers, this policy change was applicable in accordance with the member’s benefit plan and as mandated by state.

Medicare Advantage membership:  This change in policy is effective as follows:
For in-network providers and out-of-network providers through the national public health emergency period, currently in effect through July 14, 2022

Medicaid membership:  State Medicaid guidance/mandates apply. If no mandate was issued, the expanded policy was applicable through June 17, 2022.
After the COVID-19 emergency period ends, Optum will continue to allow members to receive certain covered services via the telehealth modality.

 

Regional payers

Health Partners
Illinois, Iowa, Minnesota, North Dakota, South Dakota, and Wisconsin

Type of plan: Self-Insured, Medicare Cost and Advantage, Medicaid, MSHO, SNBC, WI Marketplace (Coverage for certain products may not be available for all self-insured plans)
Coverage dates: will remain in effect during the COVID-19 National Public Emergency

Oscar

Type of plan: Commercial and Medicare/Medicaid
Coverage dates:
New York—until further notice
New Jersey—for at least 90 days after both state of emergency and PHE
Arizona—duration of PHE
Colorado—until further notice

HCSC–BCBS
Illinois, Montana, New Mexico, Oklahoma, Texas

Illinois

Type of plan: Commercial, Self-Insured (plan-based), Medicare, and Medicaid
Coverage dates: expanded for the duration of Illinois Governor J. B. Pritzker’s Gubernatorial Disaster Proclamation.

Montana

Type of plan: Commercial, Self-Insured (plan-based), Medicare, and Medicaid
Coverage dates: Duration of State Emergency

New Mexico

Type of plan: Commercial, Self-Insured (plan-based), Medicare, and Medicaid
Coverage dates: As the COVID-19 accommodations expire, telemedicine will continue to be a standard offering for our members. Members will be able to access their medically necessary, covered benefits through providers who deliver services through telemedicine. Telemedicine benefits for Medicare Advantage and Medicare Supplement members will continue until CMS directs.

Oklahoma

Type of plan: Commercial, Self-Insured (plan-based), Medicare, and Medicaid
Coverage dates: Beginning January 1, 2021, moving to new, permanent telemedicine offering which covers telemedicine codes on the permanent (not temporary) code lists provided by CMS and AMA, plus codes that support IOP.

Texas

Type of plan: Commercial, Self-Insured (plan-based), Medicare, and Medicaid
Coverage dates: Expanding the telehealth services coverage through the end of 2021

Regence BCBS
Idaho, Oregon, Utah

Type of plan: Commercial and Medicare Advantage
Coverage dates: Expanded into 2021 to allow member access during pandemic (changes in coverage to be communicated at least 30 days in advance)

CareFirst
Maryland; Washington, DC; Virginia Suburbs of DC

Type of plan: Commercial, Medicare Supplement, Medicaid
Coverage dates: Effective March 16, 2020—until the Secretary of HHS declares that the public health emergency no longer exists, or upon the expiration date of the declared public health emergency, including any extensions, whichever occurs first.

Highmark
Pennsylvania (except Independence BC), Delaware, West Virginia

Type of plan: Commercial, Medicare Advantage
Coverage dates: March 6, 2020–duration of PHE

MVP
New York and Vermont

Type of plan: Commercial, Medicaid, Medicare
Coverage dates: March 13, 2020–duration of state of emergency

Wellmark
Iowa and South Dakota

Type of plan: Commercial, Medicare Supplement
Coverage dates: March 16, 2020–until further notice

Last updated: May 2022Date created: July 2020