New Jersey

Last Checked Date7/27/2020
CPT Codes99201-99215
Communication TypeTelephone Call Allowed- Video Not Required
Type of ServiceOffice or other outpatient visits
POS2
Modifier95
Additional Notes
Cost sharing for TelemedicineWaived
Policy Termination DateNot available
Policy Link/Update LinkClick Here
Additional Policy PDF
Last Checked Date7/15/207/15/207/15/20
CPT Codes99201-9921599441-99443G2012
Communication TypeVideo requiredTelephone call allowed- Video not requiredTelephone call allowed- Video not required
Type of ServiceOffice or other outpatient visitsTelephonic encounter (Virtual check-in)Telephonic encounter (Virtual check- in)
POS222
ModifierGT or 95 ( Add CS modifier if member cost share was not collected )Blank ( Add CS modifier if member cost share was not collected )Blank ( Add CS modifier if member cost share was not collected )
Additional NotesBeginning with dates of service on and after July 15, 2020, this cost-share waiver is only in effect for services when the primary diagnosis is COVID-19. Specifically: Outpatient claims will not have member cost sharing if the primary diagnosis is U07.1, Z03.818 or Z20.828. This change applies to fully insured members including those covered by Medicare Advantage, and Individual and Small Group policies. Self-insured health plans are responsible for the specific plan designs they choose to offer to their employees, and Horizon BCBSNJ will continue to work with them to administer their plan designs as directed.Beginning with dates of service on and after July 15, 2020, this cost-share waiver is only in effect for services when the primary diagnosis is COVID-19. Specifically: Outpatient claims will not have member cost sharing if the primary diagnosis is U07.1, Z03.818 or Z20.828. This change applies to fully insured members including those covered by Medicare Advantage, and Individual and Small Group policies. Self-insured health plans are responsible for the specific plan designs they choose to offer to their employees, and Horizon BCBSNJ will continue to work with them to administer their plan designs as directed.Beginning with dates of service on and after July 15, 2020, this cost-share waiver is only in effect for services when the primary diagnosis is COVID-19. Specifically: Outpatient claims will not have member cost sharing if the primary diagnosis is U07.1, Z03.818 or Z20.828. This change applies to fully insured members including those covered by Medicare Advantage, and Individual and Small Group policies. Self-insured health plans are responsible for the specific plan designs they choose to offer to their employees, and Horizon BCBSNJ will continue to work with them to administer their plan designs as directed.
Cost sharing for TelemedicineWaived for Covid onlyWaived for Covid onlyWaived for Covid only
Policy Termination Date03/01/2020-Until further update03/01/2020-Until further update03/01/2020-Until further update
Policy Link/Update LinkClick HereClick HereClick Here
Additional Policy PDFClick HereClick HereClick Here
Last Checked Date7/20/207/20/20
CPT Codes99201-9921599441-99443
Communication TypeVideo requiredTelephone call allowed- Video not required
Type of ServiceOffice or other outpatient visitsTelephonic encounter (Virtual check-in)
POS1111
Modifier95Blank
Additional NotesWaiving in-network member costs for all primary care visits for the rest of 2020. We are also waiving member costs for outpatient, non-facility-based behavioral health visits and are extending telehealth cost share waivers for all telehealth visits-primary care, specialty, and behavioral health-for in-network providers for the remainder of 2020. This does not include inpatient hospital, behavioral health facility, or urgent care visits. Medicare members with state benefits will continue to receive support through coordination with their states.Waiving in-network member costs for all primary care visits for the rest of 2020. We are also waiving member costs for outpatient, non-facility-based behavioral health visits and are extending telehealth cost share waivers for all telehealth visits-primary care, specialty, and behavioral health-for in-network providers for the remainder of 2020. This does not include inpatient hospital, behavioral health facility, or urgent care visits. Medicare members with state benefits will continue to receive support through coordination with their states.
Cost sharing for TelemedicineWaivedWaived
Policy Termination DateNot availableNot available
Policy Link/Update LinkClick Here
Click Here
Click Here
Click Here
Additional Policy PDFClick HereClick Here
Last Checked Date7/15/20207/15/20207/15/20207/15/2020
CPT Codes99201-9921599241-9924599441-99443G2012
Communication TypeVideo requiredVideo requiredTelephone call allowed- Video not requiredTelephone call allowed- Video not required
Type of ServiceOffice or other outpatient visitsOffice or other outpatient visitsTelephonic encounter (Virtual check-in)Telephonic encounter (Virtual check-in)
POS11 or 211 or 21111
ModifierGT or 95 ( Add CS modifier if member cost share was not collected )GT or 95 ( Add CS modifier if member cost share was not collected )Blank ( Add CS modifier if member cost share was not collected )Blank ( Add CS modifier if member cost share was not collected )
Additional NotesBeginning with dates of service on and after July 15, 2020, this cost-share waiver is only in effect for services when the primary diagnosis is COVID-19. Specifically: Outpatient claims will not have member cost sharing if the primary diagnosis is U07.1, Z03.818 or Z20.828. This change applies to fully insured members including those covered by Medicare Advantage, and Individual and Small Group policies. Self-insured health plans are responsible for the specific plan designs they choose to offer to their employees, and Horizon BCBSNJ will continue to work with them to administer their plan designs as directed.Beginning with dates of service on and after July 15, 2020, this cost-share waiver is only in effect for services when the primary diagnosis is COVID-19. Specifically: Outpatient claims will not have member cost sharing if the primary diagnosis is U07.1, Z03.818 or Z20.828. This change applies to fully insured members including those covered by Medicare Advantage, and Individual and Small Group policies. Self-insured health plans are responsible for the specific plan designs they choose to offer to their employees, and Horizon BCBSNJ will continue to work with them to administer their plan designs as directed.Beginning with dates of service on and after July 15, 2020, this cost-share waiver is only in effect for services when the primary diagnosis is COVID-19. Specifically: Outpatient claims will not have member cost sharing if the primary diagnosis is U07.1, Z03.818 or Z20.828. This change applies to fully insured members including those covered by Medicare Advantage, and Individual and Small Group policies. Self-insured health plans are responsible for the specific plan designs they choose to offer to their employees, and Horizon BCBSNJ will continue to work with them to administer their plan designs as directed.Beginning with dates of service on and after July 15, 2020, this cost-share waiver is only in effect for services when the primary diagnosis is COVID-19. Specifically: Outpatient claims will not have member cost sharing if the primary diagnosis is U07.1, Z03.818 or Z20.828. This change applies to fully insured members including those covered by Medicare Advantage, and Individual and Small Group policies. Self-insured health plans are responsible for the specific plan designs they choose to offer to their employees, and Horizon BCBSNJ will continue to work with them to administer their plan designs as directed.
Cost sharing for TelemedicineWaived for Covid onlyWaived for Covid onlyWaived for Covid onlyWaived for Covid only
Policy Termination Date03/01/2020-Until further update03/01/2020-Until further update03/01/2020-Until further update03/01/2020-Until further update
Policy Link/Update LinkClick HereClick HereClick HereClick Here
Additional Policy PDFClick HereClick HereClick HereClick Here

State Telemedicine Policy

AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY DC