POS 10 Telehealth Service Code Changes by Insurance Company [2022]

pos 10 telehealthThis article intends to help mental health providers understand which insurance companies will be using POS 10 for telehealth billing and which ones will not.

Most mental health providers will be furnishing services using Place of Service code 10 (POS 10) when providing telehealth services.  Below is a definition of POS 02 and POS 10 for CMS-1500 forms, alongside a list of major insurance brands and their changes.

POS 02: Telehealth Provided Other than in Patient’s Home

The location where health services and health related services are provided or received, through telecommunication technology. Patient is not located in their home when receiving health services or health related services through telecommunication technology.

POS 10: Telehealth Provided in Patient’s Home

The location where health services and health related services are provided or received through telecommunication technology. Patient is located in their home (which is a location other than a hospital or other facility where the patient receives care MLN Matters: MM12427 Related CR 12427 Page 2 of 2 in a private residence) when receiving health services or health related services through telecommunication technology

(Source)

Place of Service Code 10 Effective Date

Many insurance companies are now allowing POS 10 for insurance claims billing starting 1/1/2022.  Medicare place of service code 10 changes will be in effective on 4/4/2022.  (Source)

POS 10 Implementation by Insurance Company

Insurance CompanyPOS 10 Telehealth Code ChangeURL
MedicareYeshttps://www.cms.gov/files/document/mm12427-newmodifications-place-service-pos-codes-telehealth.pdf
Harvard Pilgrim HealthYeshttps://www.harvardpilgrim.org/provider/new-and-updated-telehealth-place-of-service-codes/
Premera Blue CrossYeshttps://www.premera.com/wa/provider/news/reminders-updates/teleheath-place-of-service/
BCBS MichiganYeshttps://www.bcbsm.com/content/dam/public/shared/documents/coronavirus/provider/alerts/telehealth-services-require-service-code.pdf
Blue Cross MAYeshttps://provider.bluecrossma.com/ProviderHome/wcm/connect/bd17444e-525d-4027-978c-a3cf3c39c2ad/COVID-19_Public_Health_Emergency_payment_policy.pdf?MOD=AJPERES
United Health Care / Optum / United Behavioral Health / UMRYeshttps://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-reimbursement/COMM-Telehealth-and-Telemedicine-Policy.pdf
AetnaNohttps://www.aetna.com/health-care-professionals/covid-faq/billing-and-coding.html
CignaNohttps://static.cigna.com/assets/chcp/resourceLibrary/medicalResourcesList/medicalDoingBusinessWithCigna/medicalDbwCVirtualCare.html
Regence Blue ShieldNohttps://www.regence.com/provider/library/whats-new/fep-telehealth
WellcareYeshttps://www.wellcare.com/Providers/Medicare-Bulletins/Medicare-Billing-Updates
Beacon Health Options / Beacon Health Strategies / Value OptionsNohttps://pa.beaconhealthoptions.com/wp-content/uploads/sites/9/Beacon-Billing-Guide.pdf
Anthem Blue Cross of CaliforniaYeshttps://providernews.anthem.com/nevada/article/reimbursement-policy-update-virtual-visits-professional-and-facility-10
MagellanNohttps://www.magellanprovider.com/media/51606/telehealth_services.pdf
BCBS ILNohttps://www.bcbsil.com/pdf/standards/manual/ma_hmo_claims_processing.pdf
Kaiser PermanenteNohttp://testinfo.kaiserpermanente.org/info_assets/cpp_mas/mas_2020-0519_Telehealth_Guide.pdf
MHNNohttps://www.mhn.com/content/dam/centene/mhn/pdf/MHN_Prov_Newsletter_May2020_Final.pdf
Carefirst BCBSNohttps://individual.carefirst.com/individuals-families/about-us/coronavirus-telemedicine.page
TriCare WestNohttps://www.tricare-west.com/content/hnfs/home/tw/prov/claims/billing_tips/telemedicine.html
TriCare EastNohttps://www.upasolutions.com/documents/Tricare-East-COVID-19-Telemedicine-FAQ-Updated-June-2020.pdf
BCBS TXNohttps://www.bcbstx.com/provider/clinical/tele_services.html
Empire Blue (NY)Nohttps://mediprovider.empireblue.com/docs/gpp/NYE_CAID_TalkingPointsCOVID19.pdf?v=202201041418
Horizon BCBSNohttps://www.horizonblue.com/providers/policies-procedures/policies/reimbursement-policies-guidelines/telemedicine-services
MolinaNohttps://www.molinahealthcare.com/-/media/Molina/PublicWebsite/PDF/Providers/wa/Medicaid/comm/COVID-Behavioral-Health-Telehealth-Billing-Policy_508c.pdf
AmbetterNohttps://ambetter.superiorhealthplan.com/content/dam/centene/Superior/Ambetter/PDFs/AMBETTER-PROVIDER-BILLING-GUIDE-010515.pdf

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