March 28, 2022
What’s Changing: Blue Cross and Blue Shield of New Mexico (BCBSNM) has updated its telemedicine commercial reimbursement guidelines due to recent Centers for Medicare & Medicaid Services (CMS) updates.
CMS recently made updates to the telehealth POS codes:
- adding POS 10 “Telehealth Provided in Patient’s Home”
- updating POS 02 from “Telehealth or Telemedicine” to “Telehealth Provided Other than in Patient’s Home”
Providers will need to continue using POS 02 with telehealth claims even when telehealth is provided in a patient’s home. Claims using POS 10 may be rejected.
BCBSNM will notify you when POS 10 should be used for telehealth claims as appropriate.
The above POS code changes are intended to differentiate telehealth in the home as opposed to outside the patient’s home. The POS 02 code changes do not impact the services covered.
This notification applies to our commercial member claims. For Medicare Advantage member claims providers should follow CMS guidelines including using POS 10 and POS 02 appropriately.
More Information: Continue to visit the News and Updates page on the provider website and the Blue Review newsletter for further updates regarding telemedicine. Visit the CMS website for more information on modifications to the POS codes for telehealth.
Checking eligibility and/or benefit information and/or obtaining prior authorization is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. If you have any questions, call the number on the member's ID card.