Coverage of Interprofessional Internet Consultation



    Policies Impacted

    MA00.036d Remote Patient Management: Telemedicine Services
    MA00.026g Always Bundled Procedure Codes

    Purpose

    The purpose of this communication is to provide notice regarding a change in coverage position from not covered to covered for interprofessional internet consultation, retroactively effective to January 1, 2019, for our Medicare Advantage members.

    Background

    An interprofessional internet consultation is defined as an assessment and management service in which an individual’s treating professional provider requests the opinion and/or treatment advice of a consultant with specific specialty expertise to assist the treating professional provider in the diagnosis and/or management of the individual’s problem without the need for the individual’s face-to-face contact with the consultant.

    Effective January 1, 2019, the Centers for Medicare and Medicaid Services (CMS) updated their coverage position for interprofessional internet consultation from a not covered service to a covered service.

    Coverage Statement

    NOT ELIGIBLE FOR SEPARATE REIMBURSEMENT

    The Company covers interprofessional internet consultation but considers it to be an integral part of other services for which it provides coverage. Therefore, interprofessional internet consultation are not eligible for separate reimbursement consideration.

    Coding

    99446, 99447, 99448, 99449, 99451, 99452


    Issued on - 09/12/2019

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Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.