Posted in Cinga Insurance, Payer Updates, Payers and CPT reinbursement, Training, Updates

Cigna to add more codes to their Virtual Vare Reimbursement Policy and make them permanent, however…

At the beginning of Covid 19 PHE and during, the insurance payers scrambled around to put together virtual care/telehealth/telemedicine policies. Since then, there were many revisions, so it is of no surprise when Cigna announced that they are adding some of the codes that were on non-permanent virtual list to their Virtual Care Reimbursement Policy.


These Codes are:

However, how can home health services like S9123Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when CPT codes 99500-99602 can be used), code that is used for coding and billing Private Duty nursing Billing, be used as a virtual code? This code is used for MLTC members that require around the clock nursing care, members that cannot take care of themselves…so how are the services supposed to be done via “virtual care”?

Just my 2 cents….. 🙂


Would you like to read the full Cinga Virtual Care Reimbursement Policy? Click on this link: https://static.cigna.com/assets/chcp/secure/pdf/resourceLibrary/clinReimPolsModifiers/R31_Virtual_Care.pdf


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Posted in EmblemHealth NY, NY Providers, Training, Updates

EmblemHealth/Connecticare: Telehealth Reimbursement Policy Update for 2022

If you are a provider that accepts patients with EmblemHealth and/or Connecticare Insurance this blog post is for you!

This policy applies to Emblemhealth/Connecticare Commercial, Medicare and Medicaid Members.


Effective 01/01/2022- EmblemHealth/Connecticare has updated their telehealth policy. The following update was added:


Effective 06/01/2022- changes effect modifiers:

Want to learn more? Please click here to see the whole telehealth policy.


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Posted in MVP (NY/VT) Insurance Payer, Training, Updates

MVP-Vermont Providers: Audio-only (telehealth) code reimbursement changes 2022

This blog applies to providers that accept MVP members and practice in Vermont.

This blog post addresses AUDIO ONLY CODES!

Effective 01/01/2022- Providers can continue to bill audio only codes, using telephone-only evaluation and management codes: 99441, 99442, 99443. These codes do not require a modifier.

However, the audio only codes that are EQUIVALENT to IN-Person visit, using audio-only must be billed with:

1.Modifier V3 – in-person services AND

2. Place of Service has to be 99 (OTHER)


Reimbursement Changes effective 03/01/2022:

1.Claims for in-person covered services performed via audio-only will be allowed at 75% of the medical provider contracted rate.

2.Behavioral Health Providers billing codes for in person covered services performed via audio[1]only will be reimbursed as outlined in their contract.


PLEASE NOTE: Other telehealth services should be provided in accordance with and billed following the guidelines outlined in the MVP Telehealth Payment Policy.


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