Guidance on coverage and billing during COVID-19

Avera Health Plans has been fielding questions around the coverage of telehealth services during the current COVID-19 pandemic. We're providing flexibility to providers during this difficult time and this page will help navigate telehealth during these circumstances.

Providers:

  • Will be expected to follow normal CPT coding and billing guidelines;
  • Should document the means by which the telehealth service was provided and billed; and
  • May append telehealth services using HIPPA compliant, real-time audio-video technology with modifier 95, although it will not be required.

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Medical codes for telehealth visits

Avera Health Plans has reached a decision on the expansion of telehealth reimbursement during COVID-19. We have established the following list of codes that have been updated and approved for telehealth.

We will post any additions or revisions on the website if they occur so check the list frequently for updates.

Our team is here to help

Our Provider Relations staff are available to help answer further questions related to this announcement. If you have questions and want to reach out, please see our team territory map and contact information below.

For more information around COVID-19 benefits and coverage for members/patients, visit our COVID-19 Health Insurance Information page.