Insurance | Service Type | Status | CPT Codes | Requirements | Reimbursement | Tips |
|---|---|---|---|---|---|---|
Horizon NJ Health |
Evisits |
Covered |
99201-99205, 99211-99215, 99231-99233*, 99241-99245, 99251-99255, 99307-99310, 99354-99357, 99406-99409, 90791-90792, 90832-90834, 90836-90839, 90845-90847, 90951-90952, 90954-90955, 90957-90958, 90960-90961, 90963- 90970, 96116, 96150-96154, 96160-96161, 97802-97804, 99495-99498, G0108-G0109, G0270, G0296, G0396-G0397, G0406-G0408, G0420-G0421, G0425-G0427, G0442, G0444, G0506, G0508-G0509 |
Attach appropriate modifier and pos code. Document requirements are the same as in-person visit. |
Same as in-person visit. Depending on the code used | |
United Healthcare (All Plans) |
Virtual Check-In |
Covered |
G2012 (Telephone), G2010 (Captured video or image), 99421-99423 (Online portal), G2061-G2063 (non-physician using online portal) |
Cannot be related to a vist in the seven days prior, or 24 hours post. Document the visit using notes in your EHR. Keep recordings if possible |
Medicare rate - based on the code. $16.43 - $54.81 |
Will continue until 04/30/2020 unless expanded |
United Healthcare (All Plans) |
Telephonic Services |
Covered |
See above |
See above |
See above |
Will continue until 04/30/2020 unless expanded |
United Healthcare (All Plans) |
Evisits |
Covered |
99201-99205, 99211-99215, 99231-99233*, 99241-99245, 99251-99255, 99307-99310, 99354-99357, 99406-99409, 90791-90792, 90832-90834, 90836-90839, 90845-90847, 90951-90952, 90954-90955, 90957-90958, 90960-90961, 90963- 90970, 96116, 96150-96154, 96160-96161, 97802-97804, 99495-99498 |
Attach appropriate modifier and pos code. Document requirements are the same as in-person visit |
Same as in-person visit. Depending on the code used |
Will continue until 04/30/2020 unless expanded |
Medicare |
Virtual Check-In |
Covered |
G2012 (Telephone), G2010 (Captured video or image), 99421-99423 (Online portal) |
G2010 and G2012 Cannot be related to a vist in the seven days prior, or 24 hours post. Document the visit using notes in your EHR. Keep recordings if possible.99421-99423 are time-based codes. Time is aggregated over a 7 day period |
Medicare rate - based on the code. $16.43 - $54.81 | |
Medicare |
Evisits |
Covered |
99201-99205, 99211-99215, 99231-99233*, 99241-99245, 99251-99255, 99307-99310, 99354-99357, 99406-99409, 90791-90792, 90832-90834, 90836-90839, 90845-90847, 90951-90952, 90954-90955, 90957-90958, 90960-90961, 90963- 90970, 96116, 96150-96154, 96160-96161, 97802-97804, 99495-99498 |
Attach appropriate modifier and pos code. Document requirements are the same as in-person visit |
Same as in-person visit. Depending on the code used |
Throughout the COVID-19 Crisis |
Horizon BCBS |
Evisits |
Covered |
99201-99205, 99211-99215, 99231-99233*, 99241-99245, 99251-99255, 99307-99310, 99354-99357, 99406-99409, 90791-90792, 90832-90834, 90836-90839, 90845-90847, 90951-90952, 90954-90955, 90957-90958, 90960-90961, 90963- 90970, 96116, 96150-96154, 96160-96161, 97802-97804, 99495-99498 |
Attach appropriate modifier and pos code. Document requirements are the same as in-person visit. |
Same as in-person visit. Depending on the code used |
Throughout the COVID-19 Crisis |
Cigna |
Evisits |
Covered |
99201-99205, 99211-99215, 99231-99233*, 99241-99245, 99251-99255, 99307-99310, 99354-99357, 99406-99409, 90791-90792, 90832-90834, 90836-90839, 90845-90847, 90951-90952, 90954-90955, 90957-90958, 90960-90961, 90963- 90970, 96116, 96150-96154, 96160-96161, 97802-97804, 99495-99498 |
Attach appropriate modifier and pos code. Document requirements are the same as in-person visit. |
Same as in-person visit. Depending on the code used |
Will cover through 05/31/2020 |
Aetna |
Evisits |
Covered |
99201-99205, 99211-99215, 99231-99233*, 99241-99245, 99251-99255, 99307-99310, 99354-99357, 99406-99409, 90791-90792, 90832-90834, 90836-90839, 90845-90847, 90951-90952, 90954-90955, 90957-90958, 90960-90961, 90963- 90970, 96116, 96150-96154, 96160-96161, 97802-97804, 99495-99498 |
Attach appropriate modifier and pos code. Document requirements are the same as in-person visit. |
Same as in-person visit. Depending on the code used | |
Wellcare |
Evisits |
Covered |
99201-99205, 99211-99215, 99231-99233*, 99241-99245, 99251-99255, 99307-99310, 99354-99357, 99406-99409, 90791-90792, 90832-90834, 90836-90839, 90845-90847, 90951-90952, 90954-90955, 90957-90958, 90960-90961, 90963- 90970, 96116, 96150-96154, 96160-96161, 97802-97804, 99495-99498 |
Attach appropriate modifier and pos code. Document requirements are the same as in-person visit. |
Same as in-person visit. Depending on the code used | |
Clover |
Evisits |
Covered |
99201-99205, 99211-99215, 99231-99233*, 99241-99245, 99251-99255, 99307-99310, 99354-99357, 99406-99409, 90791-90792, 90832-90834, 90836-90839, 90845-90847, 90951-90952, 90954-90955, 90957-90958, 90960-90961, 90963- 90970, 96116, 96150-96154, 96160-96161, 97802-97804, 99495-99498 |
Attach appropriate modifier and pos code. Document requirements are the same as in-person visit. |
Same as in-person visit. Depending on the code used |