Behavioral health services delivered via synchronous telemedicine

With the Nov. 1, 2021, updates to the following medical policies, additional behavioral health and autism spectrum disorder, or ASD, services are payable when delivered via telemedicine:

• Telemedicine Services
• Autism Spectrum Disorder Services

Behavioral health and ASD services must be delivered synchronously (in real time), with the exception of *96130 and *96156, which can be delivered asynchronously.

Telemedicine asynchronous (store and forward) care is generally not payable for behavioral health services.

This applies to Blue Cross commercial, Medicare Plus Blue^SM, BCN commercial and BCN Advantage^SM members.

For more information about providing behavioral health and ASD services via telemedicine, see the Telehealth for behavioral health providers document, which is available on our public website at bcbsm.com/coronavirus or within Provider Secured Services.

You can view the updated medical policies through the BCN Medical Policy Manual. To do this:

1. Log in as a provider at bcbsm.com/providers.
2. Click the BCN Provider Publications and Resources link on the right.
3. Click Medical Policy Manual on the left, under “Other Resources.”
4. Click Policies by name on the right.
5. Do one of the following:
   • Click A, scroll to Autism Spectrum Disorder Services and click the link.
   • Click T and then click Telemedicine Services.

Soon, the updated policies will also be available through our Medical Policy & Pre-Cert/Pre-Auth Router on bcbsm.com.

*CPT codes, descriptions and two-digit modifiers only are copyright 2020 American Medical Association. All rights reserved.

Posted: November 2021
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network