March 16, 2022
What’s Changing: Blue Cross and Blue Shield of Montana (BCBSMT) has updated its telemedicine commercial reimbursement guidelines due to recent updates by the Centers for Medicare & Medicaid Services (CMS).
CMS recently made updates to the telemedicine POS codes:
- adding POS 10 “Telehealth Provided in Patient’s Home”
- updating POS 02 from “Telehealth or Telemedicine” to “Telehealth Provided Other than in Patient’s Home”
Until further notice, providers will need to continue using POS 02 with telemedicine claims. Claims using POS 10 may be rejected.
BCBSMT will notify you when POS 10 can be used for telemedicine claims as appropriate. These changes are intended to only differentiate telemedicine in the home as opposed to outside the patient’s home.
The CMS update of the definition of POS 02 does not change the services considered to be telehealth and telemedicine. Services allowed will continue to be covered within POS 02. You can find the most up-to-date code list .
This notification applies to our commercial member claims. Follow CMS guidelines for Medicare and Medicaid members.
More Information: Continue to visit the News and Updates page on BCBSMT’s provider website and the Blue Review newsletter for further updates regarding telemedicine.
Checking eligibility and/or benefit information and/or obtaining prior authorization is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. If you have any questions, call the number on the member's ID card.