November 19, 2020
Premera reinstituted the Centers for Medicare & Medicaid Services (CMS) in person place of service billing guidelines for telehealth claims. We’re reprocessing telehealth claims from brick and mortar providers submitted between September 1, 2020 and October 1, 2020 to reimburse at the in person allowed amount. For some providers this additional amount may be less than $5.00.
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. Only claims for telehealth visits from providers who members normally see in-person, in-office will be processed in this manner, and claim costs will be no more than what would have been paid had the member been able to see their providers in person.