Premera Extends the POS Payment of Telehealth Visits

  • October 15, 2020

    Premera will be extending the payment of telehealth visits at the in person allowed amount, during the national public health emergency, beyond 9/1/20 as previously communicated.

    • For providers that are delivering services via telehealth, Premera will require providers to continue use the telehealth place of service (POS) 02 with the procedure code appended with either modifier 95 or GT.
    • Claims with modifiers indicating they were telehealth, if billed with POS 11, will be rejected up front and will require the correct the POS to match the service billed.
    • We will no longer accept POS 11 for telehealth services.
    • We recognize that action needs to be taken to resolve claims submitted between September 1 and October 1 and are exploring options that take into consideration provider administrative burden.
    • Providers don't need to submit corrected bills for this change.
    • Premera wants to emphasize that this is a temporary relaxation of the rules during this nationwide public health emergency. As additional information becomes available from CMS or other state regulators, we'll adjust our policies and notify you of the change.

    This guidance is in effect for Washington group plans, FEP and Individual plans. Shared Admin are excluded from this guidance. Some Washington Self-funded groups elected not to participate in this guidance.

    This FAQ can help answer your questions and is updated regularly to provide you with the most accurate information.

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