Telemedicine Expansion for 2021

In support of our members and employer groups during the ongoing national public health emergency (PHE), and in line with the new administration’s information that we expect the PHE to continue for the duration of 2021, we are expanding the telehealth services we’ll cover through the end of 2021. This means that we are no longer limiting coverage of telehealth services to the Centers for Medicare and Medicaid Services (CMS) and American Medical Association (AMA) permanent lists.

Instead, during 2021, we will cover telehealth services beyond the CMS and AMA telehealth lists. This includes, but is not limited to:

• Applied behavior analysis (ABA) services
• Intensive outpatient program (IOP) services
• Partial hospitalization programs (PHP)
• Physical therapy (PT)
• Occupational therapy (OT)
• Speech therapy (ST)

The details: The change will be retroactive to Jan. 1, 2021. It applies to our fully insured and self-funded group members. Self-funded groups may opt out of the expanded coverage. Always check eligibility and benefits to determine each member’s options. Member cost-share will still apply.

Claims from Jan. 1, 2021 to now: We are working as quickly as possible to process new claims according to the expanded coverage and to adjudicate telehealth claims that may have been denied since Jan. 1, 2021.

Watch for updates related to this change on the Telemedicine and Telehealth Services page on the provider website.