CHICAGO – Blue Cross and Blue Shield of Illinois (BCBSIL) is responding to the coronavirus (COVID-19) pandemic by offering additional options for telehealth services to give members improved access to care while reducing their risk of exposure.
Effective immediately, BCBSIL will have 24 telehealth procedure codes that providers may use when billing BCBSIL for medically necessary health care services, including codes for behavioral health therapy. This adds 18 additional procedure codes beyond what was announced on Tuesday, March 11. BCBSIL will review submitted claims consistent with the terms of each member’s benefit plan.
“As this crisis evolves, we are continuing to evolve our response,” said Steve Hamman, president of Blue Cross and Blue Shield of Illinois. “We want to help remove barriers, increase options and give our members, employer customers and providers tools and support as we all work together to fight this pandemic.”
This expanded telehealth benefit applies to eligible BCBSIL PPO and Blue Choice members for medically necessary services with an in-network provider who offers telehealth services. Telehealth benefits for medically necessary services are also available for qualified HMO members from providers in their medical group who offer telehealth.
Benefits may be different for our members covered under certain employer-funded health plans depending on the decisions their employer makes about telemedicine.
BCBSIL will continue to follow the applicable guidelines of the Illinois Department of Healthcare and Family Services and Centers for Medicare & Medicaid Services as appropriate for Blue Cross Community Health PlansSM (BCCHPSM) (Medicaid Plans), Blue Cross Community MMAI Plans (Medicare-Medicaid Plan)SM and Blue Cross Medicare Advantage (PPO)SM Plans.
Available telehealth visits with BCBSIL providers currently include two-way, live interactive telephone communication and digital video consultations, which can allow members to connect with physicians while reducing the risk of exposure to contagious viruses or further illness.
Some BCBSIL members also enjoy benefits for telehealth services delivered by MDLIVE®, a vendor that offers telehealth by independently contracted board-certified doctors.*
Whether with their own provider or MDLIVE, BCBSIL is also temporarily lifting cost-sharing for medically necessary health services delivered via telehealth. This applies to all fully insured members whose benefit plan includes telehealth benefits.
“During this time, we don’t want our members to have to choose between risking exposure to COVID-19 and getting needed care. We want to ensure that our members can stay connected with their care team, for certain medical or behavioral health needs that can appropriately be delivered using a virtual visit,” said Derek Robinson, MD, MBA, FACEP, chief medical officer for Blue Cross and Blue Shield of Illinois. “This will strengthen the ability of our health care system to preserve in-person capacity for those most in need while limiting COVID-19 transmission. Together, we will get through one of the greatest public health crises in recent history.”
Between now and April 30, BCBSIL will continue to consider whether to extend the timeframe of this temporary cost sharing change.
BCBSIL will continue to evaluate the telehealth program overall and make adjustments to best serve our members.
Providers can visit our website for additional details or contact their Provider Network Consultant.
BCBSIL members with questions about their coverage or benefits can call the phone number on their ID card.
 Services for allowed billing codes covered by the member’s benefit plan must be provided by in-network Illinois health care professionals who are authorized by Illinois State law to provide those services via telehealth. Under current Illinois State law, "health care professional" includes physicians, physician assistants, optometrists, advanced practice registered nurses, clinical psychologists licensed in Illinois, prescribing psychologists licensed in Illinois, dentists, occupational therapists, pharmacists, physical therapists, clinical social workers, speech-language pathologists, audiologists, hearing instrument dispensers, and mental health professionals and clinicians authorized by Illinois law to provide mental health services.
*MDLIVE is a separate company that operates and administers Virtual Visits for Blue Cross and Blue Shield of Illinois. MDLIVE is solely responsible for its operations and for those of its contracted providers. MDLIVE operates subject to state laws and regulations and may not be available in certain states. MDLIVE is not an insurance product nor a prescription fulfillment warehouse. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA-controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. MDLIVE physicians reserve the right to deny care for potential misuse of services.
About Blue Cross and Blue Shield of Illinois
Blue Cross and Blue Shield of Illinois (BCBSIL) is committed to expanding access to quality, cost-effective health care to as many people as possible in Illinois. BCBSIL is dedicated to innovation and exploring, nurturing and activating future possibilities to make the health care system work better for our members and our communities.