Telehealth

General
Policy Number: GP-X-016

Last Updated: April 25, 2025 

Telehealth

Blue Cross and Blue Shield of Nebraska’s (BCBSNE) telehealth services policy includes the following providers:

  • Medical doctors
  • Doctors of osteopathy
  • Physician assistants
  • Nurse practitioners
  • Behavioral health providers
  • Occupational, physical and speech therapists 
  • Certified diabetic educators (effective April 1, 2022)
  • Licensed medical nutritional therapists (effective April 1, 2022)
  • Advanced Practice Midwife (effective July 1, 2023)

Legislative mandate: Out-of-network telehealth services will be covered at no cost to the member if related to COVID-19 diagnostic testing through May 11, 2023. Starting May 12, 2023, standard health plan provisions will apply with cost shares as applicable.

Effective May 1, 2023, providers exclusively delivering telehealth services must live in the state of Nebraska, be a member of a credentialed Nebraska-based PHO or employed by a licensed or credentialed facility in Nebraska. Providers will also still need to meet the credentialing criteria that is available at Credentialing Information for Providers

Telehealth Codes

Member cost shares apply as of Jan. 1, 2021. The codes below are the only applicable telehealth codes that should be billed. Additionally, the below codes are the only applicable telehealth codes that should be billed with POS 02 or POS 103 and modifier 95. All other procedure codes are not medically appropriate to be performed via telehealth.


90785 925084
96156
97162
99406-99407
90791 925214
96158 
97165
994084
90792 92522
96159-96161
97168
994094
90832-90840 92523
96164
97530 G01083
90845-90847  925244
96165
97542
G01095
90853 92526
96167
97802-97804
G0296
90951 92609
96168
98000-980076
G0396-G0397
90954 93107
97110
99202-99204
G0406-G0408
90955 952513
97112
99211-99214
G0436-G0437
90957 960404
97116
99307-99310
G0442-G0447
90958 960416
971293
99354-99355
G05606
90960 961104
971303
99381-993843
G2025
90961 96116
97151 H00013
G0270
90963-90970 961273
97155-97156
Q30141
G2086-G2088
92507
97161

 
1Q3014 - See additional information below
2POS 10 - See additional information below
3Effective 04/01/2022 
4Effective 09/01/2023
5Effective 07/01/2024 
6Effective 01/01/2025

Telehealth institutional/facility claims will no longer be allowed, except as follows: 

  • Effective Nov. 1, 2020: OT/PT/ST
  • Effective April 1, 2022: POS 10 is effective with BCBSNE
  • Effective April 1, 2022: G0108 Diabetic Self-Management Training
  • Effective April 1, 2022: Q3014 Originating Site Fee
    • Appropriate billing of Q3014:
      Facility:
      • Claim form: UB04
      • Type of bill: 12X (Medicare Part B only), 13X, 22X (Medicare Part B only), 23X, 71X, 72X, 73X, 76X and 85X
      • Revenue code: 078X 
      • Must be billed by a critical access hospital
      • Procedure code: Q3014
      Professional:
      • Claim form: HCFA 1500
      • Procedure code: Q3014
      • Place of service: 11 (must be billed by a rural health clinic)
    • Provider at the distant site who is performing the telehealth visit with the member may bill their services on a HCFA 1500 form      

The below will not be considered for telehealth:

  • Quick care
  • Urgent care
  • Retail clinic
  • Ambulatory Surgical Center (ASC)
  • Minute clinic
  • Pharmacy

These changes are specific to BCBSNE members; please check benefits for Federal Employee Program (FEP) or out-of-state Blue Cross and Blue Shield members.

Our members may seek telehealth services through their current physician/provider, or they can receive services through Amwell®. This information has been communicated separately to our members.

 

Amwell is an independent company that provides telehealth services for Blue Cross and Blue Shield of Nebraska.