March 1, 2022
Blue Cross and Blue Shield of Illinois (BCBSIL) is continuing to update services it will provide benefits for when delivered via telehealth.
What’s Changing: Effective June 1, 2022, we are discontinuing coverage for some services delivered via telehealth because they can only be delivered in-person, such as vaccine administration and radiology procedures. Others are being discontinued because a more appropriate telehealth-specific code for that service is available and should be billed if the service is rendered by telehealth.
This notification applies to our fully insured and self-funded employer group members. Telehealth benefit coverage will be for clinically appropriate and medically necessary services and treatments consistent with the member’s benefit plan, including copays, coinsurance and deductibles.
Medicare members’ telehealth coverage is consistent with Centers for Medicare & Medicaid Services (CMS) requirements. Our Medicaid members’ telehealth benefits are defined by state Medicaid requirements.
More Information: Fee schedules will reflect the code change beginning June 1, 2022. Professional providers participating in our PPO and Blue Choice PPOSM networks may download our Fee Schedule Request form on the Forms page of our Provider website.
Continue to visit the News and Updates and the Blue Review for any additional updates regarding telehealth.
This information does not apply to HMO providers.
Checking eligibility and/or benefit information and/or obtaining prior authorization is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. If you have any questions, call the number on the member's BCBSIL ID card.