Reminder: COVID-19 changes to end, additional ones to take place
For nearly two years, Blue Cross and Blue Shield of Kansas (BCBSKS) has worked with providers to ease some of the financial stress and burdens during the COVID-19 pandemic. As we near the end of the year, we want to make sure you are aware that some of the modifications put in place are coming to an end or are changing. We had communicated through our newsletter that these changes would occur at the end of the year or the end of the declared public health emergency, whichever occurred first.
Effective January 1, 2022:
- Telehealth reimbursement – We recognize the importance and value of telehealth services and are adjusting the pre-COVID allowance to 100% of the professional component of the CPT code billed. QBRP incentives will continue to apply to telehealth. In addition, we will increase the professional component from 100% to 105% for behavioral health telehealth services (applicable CPT codes) to support access to behavioral health services via telehealth due to geographic behavioral health professional shortages in Kansas. Pre-COVID, BCBSKS allowed 85% of the professional component of the CPT code billed.
- Telehealth expansion – BCBSKS is expanding the use of telehealth by doctors and other healthcare providers for conditions that are medically reasonable to be treated in this manner – e-Visits, virtual hospice services, partial hospitalization and hospital-based physical, speech and occupational therapy services.
- In-patient pre-certification – BCBSKS will require pre-certification for all inpatient stays. We will no longer waive the inpatient pre-certification and continued stay review requirement for COVID-19 admissions. Long term acute care and inpatient rehabilitation also require pre-certification.
- COVID-19 cost share – Members will be responsible for their cost share for COVID-19 treatment. BCBSKS will no longer be covering the full cost of care. COVID-19 testing and vaccinations are still fully covered.
If you have any questions regarding this newsletter, please contact your BCBSKS provider representative/consultant.