Intensive outpatient program and partial hospital program services now payable via telemedicine on an ongoing basis

As previously communicated, Blue Cross Blue Shield of Michigan and Blue Care Network began allowing behavioral health IOP and PHP services to be payable when provided by contracted facilities via telemedicine as a temporary measure during the COVID-19 pandemic.

Effective Nov. 1, 2021, we're updating our Telemedicine Services medical policy to allow these services to be payable when delivered by contracted facility providers via synchronous (real time) telemedicine on an ongoing basis, rather than as a temporary measure. We're doing this to make it easier for members to receive these services beyond the COVID-19 pandemic.

For more information, including information about billing for these services, see the Telehealth for behavioral health providers document.

Reminders

• Facilities can provide behavioral health IOP and PHP services to BCN commercial and BCN Advantage^SM members only when their contracts specifically include IOP and PHP services.
• For Blue Cross commercial members, most plans don't cover IOP services for mental health or PHP services for substance use disorders. IOP services for substance use disorders must be delivered by a substance abuse treatment facility. Be sure to check member eligibility and benefits through web-DENIS or Provider Inquiry prior to performing services.
• For Medicare Plus Blue^SM members, follow Centers for Medicare & Medicaid Services guidance.

Updated documents

By Nov. 1, we'll update the following documents to reflect this change:

• Telehealth for behavioral health providers
• Temporary changes due to the COVID-19 pandemic

You can find these documents on our public website at bcbsm.com/coronavirus or within Provider Secured Services.

You can view the updated Telemedicine Services medical policy 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. Click T and then click Telemedicine Services.

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

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