Update on Audio-Only Care and Reminder on Telemedicine Options
To maintain continuity of care during the COVID-19 Public Health Emergency (PHE), help minimize the risk of spreading COVID-19 and offer members a level of comfort and safety, CareFirst BlueCross BlueShield (CareFirst) implemented enhanced telehealth options as an alternative to in-person provider visits. One key enhancement was the temporary coverage of audio-only calls.
CareFirst strongly believes that real-time synchronous care, whether in-person or through audio-visual telemedicine visits, offers the best value and outcomes for our members. Now, with the end of the federal PHE and no significant health or safety barriers to care, we are revisiting our temporary coverage. Our data shows a shift in consumer demand as well—over the past 12 months, utilization of audio-only calls has less than 1% of all telemedicine visits in our region.
Effective October 1, CareFirst will only cover audio-only calls where mandated by law. This means we are ending audio-only coverage for fully insured members in Virginia. Fully insured members in Maryland and DC will retain coverage. Coverage for self-insured accounts will vary. Additional details are available on the Coronavirus Resource Center under the Audio-Only Telehealth section. For specific member eligibility and benefit questions, providers are encouraged to use CareFirst Direct or contact provider service at the number on the back of the member ID card.
Providers may choose to engage in electronic messaging to communicate with patients. Such messages are part of normal patient/physician interaction, and therefore part of services already payable under the terms of your contract. Claims for CPT codes 99421, 99422, and 99423 will be denied. Your contract does not allow direct billing of CareFirst members for these messages.
We are committed to continued investment in telemedicine services delivered by our network providers.
- Coverage for audio-visual telemedicine visits remains unchanged. The expanded medical policy enacted during the public health emergency is still in place, allowing providers to deliver more services virtually now than before the COVID-19 pandemic. If your practice offers telemedicine to patients, great! Please continue.
- If your practice does not offer telemedicine, know that your patients have access to several virtual care options when you are not available. Encourage them to visit our Virtual Care Options page if an urgent need arises when your office is closed.
We will continue to monitor evolving needs of the communities we serve and keep you informed of any changes to our policies. Thank you for your partnership.