Timeline Extension Update: Telehealth Audio Only Reimbursable at 100 percent in response to Hurricane Helene

Update November 8: Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is extending the reimbursement of telehealth audio-only claims for members within impacted ZIP Codes at 100 percent (100%) of the allowed amount through November 29, 2024. Member benefits will continue to apply according to their policy.

This temporary extension applies to Fully Insured plans, Administrative Services Only (ASO) plans (that have not opted out of such exceptions) and State Health Plan (SHP).

This does not apply to Federal Employee Health Plan (FEP) and Blue Cross and Blue Shield Association InterPlan Program (IPP) Host members. FEP and IPP Host members follow the normal process related to the requested service and reimburse at 75 percent (75%).

Medicare Advantage and Healthy Blue members are already reimbursed according to CMS guidelines at 100 percent (100%) for audio-only telehealth and are not affected by this communication.

Please contact 800-214-4844 if you are in an impacted area and need support with timely filing.

We will continue to monitor the situation closely and evaluate if a policy extension is needed in the coming weeks.

Update October 11, 2024: Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is extending the reimbursement of telehealth audio-only claims at 100 percent (100%) of the allowed amount through October 28, 2024. Member benefits will continue to apply according to their policy.

We will continue to monitor the situation closely and evaluate if a policy extension is needed in the coming weeks.

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is closely monitoring and re-evaluating our policies in response to the recent destruction from Hurricane Helene to best serve our customers and communities.

Due to power outages, flooding, compromised communications and the displacement of residents from Hurricane Helene, Blue Cross NC will allow audio-only Telehealth visits to be reimbursed at 100 percent (100%) of the allowed amount as opposed to the current allowed amount of 75 percent (75%).

Telehealth claims billed with Modifier FQ/93 indicating audio-only starting with date of service (DOS) September 27, 2024, through October 10, 2024, will automatically reimburse at 100 percent without any additional action required from our provider community.

We will continue to monitor the situation closely and evaluate if a policy extension is needed in the coming weeks.

This communication applies to State Health Plan (SHP), Administrative Services Only (ASO), Fully Insured, Federal Employee Program (FEP) and Blue Cross and Blue Shield Association InterPlan Program (IPP) Host Member claims.

Medicare Advantage and Healthy Blue members are already reimbursed according to CMS guidelines at 100 percent (100%) for audio only and are not affected by this communication.