|Date: March 24, 2020
Applies to: All
In efforts to help slow the spread of the coronavirus disease known as COVID-19, health professionals and their patients may turn more frequently to the use of telehealth (telemedicine) visits. Please review the summaries below: to better understand the coverage for these services.
Telehealth (telemedicine) visits (covered by all plans)
- Telehealth (telemedicine) visits are primarily scheduled visits between patients and healthcare providers with an established relationship, and may be handled by computer, tablet or smartphone.
- Telehealth (telemedicine) visits are for patients needing routine care for chronic or general health conditions. They are covered just like any other medically necessary office visit.
- They are billed with office visit codes; modifiers are not required.
- Behavioral health visits are included.
On-demand virtual visits (covered by most plans)
- On-demand virtual visits are a subset of telehealth (telemedicine). These types of visits typically include 24/7 virtual access to licensed healthcare professionals with whom the patients do not have an established relationship.
- They are similar to visits to an urgent care facility and are typically needed due to an acute health issue.
- Visits are typically covered like primary care provider visits unless otherwise specified.
- Behavioral health visits are not covered as on-demand virtual visits.
- Examples of plan-specific covered on-demand virtual visit providers include the Cleveland Clinic’s Express Care online services and Teladoc.
If you have any questions about telehealth (telemedicine) benefits, please contact your Cornerstone Senior Marketing Representative