Table 3.
List of Most Common Insurance Carriers
| Carrier | Location Code |
Telemed Codes Allowed |
Telephone Only Codes | Modifier | Effective Dates | Comments |
|---|---|---|---|---|---|---|
| Aetna | 02 | 99201-99203 (GT or 95) or 99212-99215 (GT or 95) | Will accept nonvisual too | GT or 95 | 3/16/20- 12/31/20 | No E&M visit 7 days before or 24 hours after |
| BCBS | 02 | 99201-99203 (95) or 99212-99215 (95) | 99441 (5-10 min) 99442 (11-20 min) 99443 (21-30 min) No modifier needed |
95 on telemedicine only. No modifier for telephone only | 3/16/20-12/31/20 | Telemedicine requires secure audio and video. If audio only must use 99441-99442. Likely HIPAA encryption required after 10/1/20 No E&M visit 7 days before or 24 hours after |
| Cigna | 02 | 99201-99203 (GQ) or 99212-99215 (GQ) | Will accept nonvisual too | GQ | 3/2/20-12/31/20 | No E&M visit 7 days before or 24 hours after |
| EBMS (Employee Benefit Management Services) | 02 | 99201-99203 (95) or 99212-99215 (95) | Will accept nonvisual too | 95 | 3/16/20-12/31/20 | No E&M visit 7 days before or 24 hours after |
| Humana | 02 | 99201-99203 (95) or 99212-99215 (95) | Will accept non visual too | 95 | 3/23/20 to sunset | If no access to video systems, Humana temporarily accepts audio-only visits with reimbursement the same as telehealth visits. |
| Medicaid of SC (example state)-for other states check the state specific Medicaid site | 02 | 99201-99203 (95) or 99212-99215 (95) | 99441 (5-10 min) 99442 (11-20 min) 99443 (21-30 min) No modifier needed |
(95) on telemedicine only. No modifier on telephone only | 3/15/2020 until sunset by Medicaid of SC | Telemedicine requires secure audio and video. If audio only must use 99441-99442. No E&M visit 7 days before or 24 hours after |
| Medicare Advantage-Aetna | 02 | 99201-99203 (GT or 95) or 99212-99215 (GT or 95) | Will accept non visual too | 3/16/2020-12/31/2020 | No E&M visit 7 days before or 24 hours after | |
| Medicare Advantage-BCBS | 02 | 99201-99203 (95) or 99212-99215 (95) | 95 | 3/16/2020-12/31/2020 | No E&M visit 7 days before or 24 hours after | |
| Medicare Advantage-Humana | 02 | 99201-99203 (95) or 99212-99215 (95) | Will accept non visual too | 95 on telemed only. No modifier on telephone calls only | 3/23/2020 until sunset | No E&M visit 7 days before or 24 hours after HIPAA encryption required after 10/1/20 |
| Medicare Advantage-UHC | 11 | 99201-99203 (95) or 99212-99215 (95) | Will accept nonvisual too | 95 | 3/18/2020-12/31/2020 | No E&M visit 7 days before or 24 hours after |
| Medicare | 11 | 99201-99203 or 99212-99215 G0402, G0438, G0439-Annual wellness visits can be done via telehealth |
G2012 | 95 | 3/1/2020 until sunset | No E&M visit 7 days before or 24 hours after |
| UHC | 11 | 99201-99203 (95) or 99212-99215 (95) | 95 | 3/18/2020-12/31/2020 | No E&M visit 7 days before or 24 hours after |
BCBS = Blue Cross and Blue Shield; E&M = evaluation and management; HIPAA = Health Insurance Portability and Accountability Act; SC = South Carolina; UHC = United Health Care.