Thank you for all you do for our members. Visit BCBSTupdates.com for the most up-to-date information.
We want to be sure our members have access to the care they need, now more than ever. We’ve included information on some common questions many providers have asked us since the spread of coronavirus in the United States.
The Centers for Disease Control and Prevention is providing up-to-the-minute information and is a great resource for you. Here are some quick links to help you:
- Click here for the latest information from the Centers for Disease Control and Prevention.
- Read more on the State of Tennessee’s response to the disease.
- Call the Tennessee Coronavirus Public Information Line at 1-877-857-2945.
Q: Will COVID-19 test be covered for my patients?
Yes. We’ll cover our members’ copay and waive their cost-share for any appropriate FDA-approved tests and those currently pending FDA approval you order at this time. This applies for testing through providers outside our network. This may not apply to members of some employer self-funded groups.
Q: Will I have to get a prior authorization for testing or treatment of COVID-19?
No. Prior authorization won’t be required.
Q: How will I be reimbursed for COVID-19 testing?
From now until Dec. 31, we’ll reimburse at 100% of Medicare for COVID-19 FDA-approved tests (as well as those currently pending FDA approval). The following codes are billable for all labs and providers across all BlueCross BlueShield of Tennessee product lines*:
- U0001 – $35.91 (CDC)
- U0002 – $51.31 (Commercial Labs)
- CPT® code (87635) to be priced at the U0002 payment of $51.31 or the lesser of billed charges once physicians can do their own testing.
Q: Can I offer my patients drive-thru testing services for COVID-19?
Yes. We’ll cover our members’ swabs and test results in a drive-thru setting as part of the lab payment. You’ll need to bill for both the swab and the test results in one combined claim. Also, you should use place of service code 99 when billing. All reimbursement will be based on the testing code.
Q: Does drive-thru testing apply to screening services?
No. We’ll only reimburse for our member’s COVID-19 swabs and test results in drive-thru testing.
*Codes included on preferred lab exclusion list for BlueCareSM, TennCareSelect and CoverKids.
Q: Do you have a list of testing sites?
The CDC has linked to each state’s department of health contact information for testing. You can view it here: https://www.cdc.gov/publichealthgateway/healthdirectories/healthdepartments.html
Q: Will BlueCross cover telehealth (telephonic or virtual) consultations with my patients?
Yes. You may bill for telehealth in two ways. From now until April 30, you can use CPT codes 99441–99443 for telephonic provider-to-member consultation. This applies to all lines of business’ PCP or specialist benefits. You can also bill for virtual and telephonic consults with your patients by using E&M codes 99201–99215 from now through April 30. For behavioral health consultations, use codes 90791, 90792, 90832, 90834 and 90837. Please use place of service 02 for all of these options. Pricing for these services would be consistent with your BlueCross fee schedule.
Q: Can I refer patients to use telehealth services to protect them and others from transmission of disease during a possible outbreak?
Yes. We encourage our patients to use their PhysicianNow powered by MDLive® telehealth benefits, if they have them. We also encourage patients to avoid using the emergency room, except in a true medical emergency, to prevent the spread of illness.
Q: Once available, will a COVID-19 vaccine be covered for my patients?
Yes. We’ll cover vaccines developed and approved to treat COVID-19 when available. Member cost-sharing may apply based on benefit plan.
Q: Will my recommended treatments for symptoms of COVID-19 be covered for my patients?
Yes. We’ll cover the care you order for members with COVID-19 to help relieve symptoms, just as we would with any other viral respiratory infection. Your patients’ care will be covered under their usual benefit with the same cost-share.
Q, Will BlueCross cover a hospital quarantine stay for a patient diagnosed with COVID-19?
Yes. If you order a patient be admitted to the hospital and quarantined, we’ll cover it under their usual inpatient benefits with the same cost-share.
Q: Can I bill BlueCross for medical supplies such as masks, gloves and disinfectant given to my patient?
No. We don’t cover these supplies under our health plans.
Q: Can my patients stock up on prescriptions to avoid increased risk of exposure with multiple trips to the pharmacy?
Yes. For members who have BlueCross pharmacy benefits, we’re allowing early refills on most medications, and we also encourage 90-day fills for chronic medications. Controlled substances, such as opioids, and some specialty drugs are excluded from this change. Some members may have a mail-order benefit, if they want to avoid going to the pharmacy.