Members can access their medically necessary, covered benefits through providers who deliver services through telehealth technologies. Many of our members also have access to various telehealth vendors.
BCBSMT recommends the following:
- Consider telehealth a mode of care delivery to be used when it can reasonably provide equivalent outcomes as face-to-face visits.
- Choose telehealth when it enhances the continuity of care and care integration if you have an established patient-provider relationship with members.
- Integrate telehealth records into electronic medical record systems to enhance continuity of care, maintain robust clinical documentation and improve patient outcomes.
Providers can use telehealth for members with the following types of benefit plans:
- State-regulated fully insured HMO and PPO plans
- Blue Cross Medicare Advantage (excluding Part D) and Medicare Supplement (see Medicare info in related resources Telemedicine 2021)
- Self-funded employer group plans
- Healthy Montana Kids
Care must be consistent with the terms of the member's benefit plan.
State and federal requirements may apply.
Our self-funded employer group customers make decisions for their employee benefit plans.
Check eligibility and benefits for any variations in member benefit plans, which may include copays, coinsurance and deductibles.
Medicare members' telemedicine coverage is consistent with CMS requirements.
Our Healthy Montana Kids members' telemedicine benefits are defined by state requirements.
For state-regulated fully insured members, providers are not required to use a vendor for telehealth services.
For self-funded members, providers may be required to use specific vendors as outlined in the member’s benefit plan.
BCBSMT's Telemedicine Coding and Compensation Policy and a list of Covered Telemedicine Codes are accessible in Availity® Essentials by using the Plan Documents Viewer application in our BCBSMT-branded Payer Spaces section.
For the latest updates regarding Telehealth coverage please refer to News and Updates.
If you need assistance, please contact Network Management.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSMT. BCBSMT makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.