Medicare has expanded the list of eligible services provided via telehealth with the passage of the Coronavirus Preparedness and Response Supplemental Appropriations Act and the CARES Act

List of expanded codes

Medicare Telehealth FAQs

Guidance on Medicare coverage

Medicare telehealth coding

CMS Physician and Practitioner Guidance

Several states have passed laws to remove barriers to telemedicine utilization during the COVID-19 pandemic. The Center for Connected Health Policy is the best resource for state-by-state billing and coding as well as state-by-state actions related to COVID-19.

Insurers are rapidly evolving their policies of what with and will not be covered or what will be cost-shared. America’s Health Insurance Providers (AHIP) has detailed changes insurers have made regarding coverage for COVID-19 related expenses and can be a useful tool. 

We’ve included below details on several large insurers below, but when in doubt it’s best to first refer back to your contract to determine what language exists around how telemedicine billing, from there you can reach out to your insurance partners to learn their policy for telemedicine billing and best practices.

Waiving co-pays for all diagnostic testing. That includes all member costs associated with diagnostic testing for Commercial, Medicare, and Medicaid lines of business. Self-insured plan sponsors will be able to opt-out of the program at their discretion. 

Offering zero co-pay telemedicine visits for any reason, and it is extending its Medicare Advantage virtual evaluation and monitoring visit benefit to all fully insured members.

People diagnosed with COVID-19 will receive a care package.

CVS Health is also offering several programs to help people address associated anxiety and stress.

Waiving member cost-sharing for inpatient admissions at all in-network facilities for treatment of COVID-19 or health complications associated with COVID-19. This policy applies to all Aetna-insured commercial plan sponsors and is effective immediately for any such admission through June 1, 2020.

Waiving costs for COVID-19 testing provided at approved locations in accordance with the CDC guidelines.

Waiving copays, coinsurance and deductibles for visits associated with COVID-19 testing, whether the care is received in a physician’s office, an urgent care center or an emergency department. This coverage applies to Medicare Advantage and Medicaid members as well as commercial members. 

Expanding provider telehealth access and waiving member cost sharing for COVID-19 testing-related visits.

Opening a special enrollment period for some of its existing commercial customers beginning March 23 through April 6 due to the COVID-19 pandemic. UnitedHealthcare is also suspending prior authorization requirements to a post-acute care setting through May 31, and suspending them when a member transfers to a new provider through May 31.

Waiving member cost sharing for the treatment of COVID-19 through May 31, 2020 for its fully insured commercial, Medicare Advantage, and Medicaid plans.

Starting March 31, 2020 until June 18, 2020, UnitedHealth will also waive cost sharing for in-network, non-COVID-19 telehealth visits for its Medicare Advantage, Medicaid, and fully insured individual and group market health plans.

Covering the cost of coronavirus testing

Waiving all co-pays or cost-shares for fully insured plans, including employer-provided coverage, Medicare Advantage, Medicaid, and individual market plans available through the Affordable Care Act. Organizations that offer Administrative Services Only (ASO) plans will also have the option to include coronavirus testing as a preventive benefit. 

Recognizing that health outbreaks can increase feelings of stress, anxiety and sleeplessness and sometimes loss. Cigna is also staffing a second phone line for customers.

Waiving customers’ out-of-pocket costs for COVID-19 testing-related visits with in-network providers, whether at a doctor’s office, urgent care clinic, emergency room or via telehealth, through May 31, 2020. This includes customers in the United States who are covered under Cigna employer/union sponsored group insurance plans, globally mobile plans, Medicare Advantage, Medicaid and the Individual and Family plans. Employers and other entities that sponsor self-insured plans administered by Cigna will be given the opportunity to adopt a similar coverage policy. 

Making it easier for customers with immunosuppression, chronic conditions or who are experiencing transportation challenges to be treated virtually by in-network physicians with those capabilities, through May 31, 2020. 

Cigna’s Express Scripts Pharmacy offers free home delivery of up to 90-day supplies of prescription maintenance medications. Cigna has opened a 24-hour toll-free help line (1-866-912-1687) to connect people directly with qualified clinicians who can provide support and guidance.

Offering a webinar to the general public raising awareness about tools and techniques for stress management and building resiliency, along with the ability to join telephonic mindfulness sessions.

Waiving prior authorizations for the transfer of its non-COVID-19 customers from acute inpatient hospitals to in-network long term acute care hospitals to help manage the demands of increasingly high volumes of COVID-19 patients.

Waiving customer cost-sharing and co-payments for COVID-19 treatment through May 31. The policy applies to customers in the U.S. who are covered under Cigna’s employer/union sponsored insured group health plans, insured plans for U.S. based globally mobile individuals, Medicare Advantage, and Individual and Family Plans. Cigna will also administer the waiver to self-insured group health plans.

Waiving prior authorizations for diagnostic tests and covered services for COVID-19

Covering those tests at no cost share to members

Waiving prescription refill limits on maintenance medications

Expanding access to telehealth and nurse/provider hotlines. This applies to fully insured, individual, and Medicare Advantage plan members, and plans are working with state Medicaid and CHIP agencies to ensure people have access to needed testing and services.

Waiving cost sharing for telehealth services for fully insured members for the next 90 days.