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Telehealth

Visit our telehealth page to learn about telehealth-related payment information, covered services, how to bill, and more.

Reimbursement for services is contingent upon:

  • Eligibility and coverage. Always remember to verify a member’s benefits and eligibility. Accounts may incorporate riders (for example, to include or exclude out-of-network benefits) on any Blue Cross policy.
  • Medical policy. Services must be considered medically necessary according to our current medical policies.
  • Coding. Your coding must be consistent with our payment policies, claims review systems, and fee schedules.

For in-network providers:

  • Payment is based on your fee schedule. To access your fee schedule, log in and click the Get my fee schedule link on the home page under “I need to….”
  • You can collect up-front payment only for the member’s liability (copayment, deductible, or co-insurance).
  • You may not balance bill the member for the difference between the allowed amount and your submitted charges.

Reminders:

  • Payment is based on your fee schedule.
  • You can collect up-front payment only for the member’s liability (copayment, deductible, or co-insurance).
  • You may not balance bill the member for the difference between the allowed amount and your submitted charges.

Payment policies

Review our mental health related payment policies:

  • Incident To Billing for Supervising Providers for Mental Health Services - Professional
    • This payment policy details scenarios in which mental health providers may supervise and bill for services rendered by non-credentialed providers in their practice.
  • Community Mental Health Centers
  • Mental Health and Substance Use
  • Telehealth (Telemedicine) - Medical Services
  • Telehealth (Telemedicine) - Mental Health

To download our payment policies, log in and click Find a Payment Policy on the right side of your home page. Or, go to Office Resources>Policies & Guidelines>Payment Policies.

Review our mental health related payment policies:

 Incident To Billing for Supervising Providers for Mental Health Services - Professional

  • This payment policy details scenarios in which mental health providers may supervise and bill for services rendered by non-credentialed providers in their practice

 Community Mental Health Centers
 Telehealth (Telemedicine) - Medical Services
 Telehealth (Telemedicine) - Mental Health

Psychiatric collaborative care management (CoCM)

See our detailed CoCM fact sheet to learn about this model that integrates mental health care into primary care and how to bill for it.

Billing information for children and adolescents

In accordance with the Massachusetts Division of Insurance (DOI), we cover certain mental health services to address emotional and behavioral conditions found in children and adolescents under age 19. This includes services such as In-Home Therapy (IHT) and Intensive Care Coordination (ICC).

For a comprehensive list of the treatments we cover, how to bill for them, and commonly asked questions, see our Behavioral Health for Children and Adolescents (BHCA) fact sheet.

Child psychiatry incentive program (CPIP)

If you are a child psychiatrist, you can learn about our incentive program by logging into Provider Central and going to Quality & Performance> Performance Programs>Child Psychiatry Incentive Program.

Child psychiatry incentive program (CPIP)

If you are a child psychiatrist, you can learn about this program by visiting our Child Psychiatry Incentive Program page.