COVID-19 Healthy Montana Kids Telemedicine-Telehealth And Cost-Share Changes

April 02, 2020

Effective immediately and until further notice, the Montana Department of Public Health and Human Services (DPHHS) instructed Blue Cross and Blue of Shield of Montana (BCBSMT) to adopt the recent Medicaid coverage and reimbursement policy for Telemedicine/Telehealth services and suspension of cost-share requirements for Healthy Montana Kids (HMK) members during Montana’s COVID-19 state of emergency.

Telemedicine Policy Changes:

Key components of the new HMK telemedicine/telehealth policy for HMK participating providers include:

  • Allowing coverage/reimbursement for telemedicine visits conducted by secure portal messaging, secure instant messaging, telephone, e-mail, or facsimile transmissions, in addition to interactive audio-video means;
  • Allowing CPT codes 99441, 99442, 99443, 98966, 98967, and 98968, for telephone-only evaluations/ telemedicine and telehealth services; and
  • Allowing CPT code Q3014 to be used for reimbursing enrolled originating site providers. Allowable fee is $26.65 per site use.

Cost-Share Requirement Suspension:

  • BCBSMT will set all cost share amounts for all covered HMK services at $0 until further notice from DPHHS.
  • Copayments made or incurred prior to March 25, 2020 are valid and nonrefundable. HMK members who are charged a copay after March 25, 2020 should contact the health care provider and request a refund.

For questions, please contact:

Providers – 1-800-447-7828

HMK Members – 1-855-258-3489