Telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration.
The following is a comprehensive list of benefits for telehealth services available through network providers:
- HealthChoice covers telehealth services that may or may not be clinical in nature, including interactive audio and video services at an originating provider site between a member and distant site provider.
- Institutional claims must include place of service (POS) 02 and indicate the GT or GQ modifiers to qualify for reimbursement.
- Professional services only require the use of POS 02. Modifiers are not required. Standard member plan provisions apply, including copay (if applicable), deductible and coinsurance.
- HealthChoice will acknowledge and pay telehealth claims according to the CPT, HCPCS and outpatient fee schedules.
- HealthChoice excludes telepharmacy networks that use pharmacists to provide services.
All plan policies and provisions apply including HealthChoice claim editing guidelines.