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Blue Cross and Blue Shield of Illinois (BCBSIL) is responding to the novel coronavirus (COVID-19) pandemic by offering additional options for telehealth* services to give fully insured members improved access to care while reducing their risk of exposure. If you offer an employer-funded health plan, benefits may be different for your employees depending on the decisions you make about telemedicine.
What’s new: Effective immediately, BCBSIL will add 24 telehealth procedure codes that Illinois providers may use when billing BCBSIL for medically necessary health care services, including codes for behavioral health therapy. This adds 18 additional procedure codes beyond what was announced last week. BCBSIL will review submitted claims consistent with the terms of your benefit plan.
“As this crisis evolves, we are continuing to evolve our response,” said Steve Hamman, BCBSIL president. “We want to help remove barriers, increase options and give our members, employer customers and providers tools and support as we all work together to fight this pandemic.”
Who this applies to: This expanded telehealth benefit applies to eligible fully insured BCBSIL PPO and Blue Choice members for medically necessary services with an in-network provider who offers telehealth services. Telehealth benefits for medically necessary services are also available for qualified HMO members who see a provider in an in-network medical group that offers telehealth services.
BCBSIL will continue to follow the applicable guidelines of the Illinois Department of Human Services and Centers for Medicare & Medicaid Services as appropriate for Blue Cross Community Health PlansSM (BCCHPSM) (Medicaid Plans), Blue Cross Community MMAI Plans (Medicare-Medicaid Plan)SM and Blue Cross Medicare Advantage (PPO)SM Plans.
Telehealth services: Available telehealth visits with BCBSIL providers** currently include two-way, live interactive telephone communication and digital video consultations, which can allow your covered employees, if applicable pursuant to benefits, to connect with physicians while reducing the risk of exposure to contagious viruses or further illness.
If included in your benefit plan offerings, your employees may also enjoy benefits for telehealth services delivered by MDLIVE®, a vendor that offers telehealth by independently contracted board-certified doctors.***
“During this time, we don’t want our members to have to choose between risking exposure to COVID-19 and getting needed care. We want to ensure that our members can stay connected with their care team, for certain medical or behavioral health needs that can be appropriately delivered by a virtual visit,” said Derek Robinson, MD, MBA, FACEP, BCBSIL chief medical officer. “This will strengthen the ability of our health care system to preserve in-person capacity for those most in need while limiting COVID-19 transmission. Together, we will get through one of the greatest public health crises in recent history.”
Whether with their own provider or MDLIVE***, BCBSIL is also temporarily lifting cost-sharing for medically necessary in-network health services delivered via telehealth to fully insured members. Further, this applies to all fully insured members whose benefit plan includes telehealth benefits. Between now and April 30, BCBSIL will continue to consider whether to extend the timeframe of this temporary cost sharing change.
BCBSIL will also continue to work with you as you evaluate your telehealth benefits overall and make adjustments to best serve your covered employees.
BCBSIL members with questions about their coverage or benefits can call the phone number on their ID card.
*Virtual Visits and telehealth services may not be available for all plans. Virtual Visits and telehealth services are subject to the terms and conditions of your benefit plan, including, but not limited to, benefits, limitations, and exclusions. Other State law limitations related to telehealth may also apply.
**Under current Illinois State law, "health care professional" includes physicians, physician assistants, optometrists, advanced practice registered nurses, clinical psychologists licensed in Illinois, prescribing psychologists licensed in Illinois, dentists, occupational therapists, pharmacists, physical therapists, clinical social workers, speech-language pathologists, audiologists, hearing instrument dispensers, and mental health professionals and clinicians authorized by Illinois law to provide mental health services.
***MDLIVE is a separate company that operates and administers Virtual Visits for Blue Cross and Blue Shield of Illinois. MDLIVE is solely responsible for its operations and for those of its contracted providers. MDLIVE operates subject to state laws and regulations and may not be available in certain states. MDLIVE is not an insurance product nor a prescription fulfillment warehouse. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA-controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. MDLIVE physicians reserve the right to deny care for potential misuse of services.