Members will not have to pay co-pays for any telemedicine visits through June 4 and Aetna has waived cost-sharing for all virtual visits. Here is a guide to covered visits and their codes. The company’s policy as of Jan. 1, 2020, was to reimburse for two-way, real time audiovisual interactive communication between patients and providers.
The codes that need an audiovisual connection include:
1. G2061, G2062 and G2063: qualified non-physician healthcare professionals doing an online assessment for established patients
2. H0015 GT or 95: Outpatient treatment for alcohol or drug services, including the assessments, counseling and crisis intervention
3. H0035 GT or 95: Partial hospitalization mental health treatment
4. H2012 GT or 95: Per-hour behavioral health day treatment
5. H2036 GT or 95: Per diem alcohol and/or drug treatment
5. S9480 GT or 95: Per diem intensive outpatient psychiatric services
6. 97151 GT or 95: Qualified healthcare professional administering behavioral identification assessment
7. 97155 GT or 95: Qualified healthcare professional administering an adaptive behavior treatment with protocol modification
8. 97156 GT or 95: Qualified healthcare professional administering family adaptive behavior treatment guidance
9. 97157 GT or 95: Qualified healthcare professional administering multiple-family group adaptive behavior treatment guidance
10. 98970, 98971, 98972: Qualified nonphysician healthcare professional online digital evaluation and management services for establishing a patient
11. 99421, 99422, 99423: Online digital evaluation and management services for an established patient
The following codes need audiovisual connections or a telephone:
12. G2010: Remotely evaluating a video or image submitted by an established patient, interpretation and follow-up
13. G2012: Virtual check-in or other brief check-in for a technology-based service
14. 98966, 98967, 98968: Telephone assessment and management services from a qualified non-physician healthcare professional to establish a patient, parent or guardian
15. 99441, 99442, 99443: Telephone assessment and management service by a physician or other qualified healthcare professional to establish a patient, parent or guardian not related to E/M service provided within the past seven days or leading to an E/M service or procedure within 24 hours or the soonest available appointment
16. 90791, 90792; GT or 95: Psychiatric diagnostic interview examination
17. 90832, 90833, 90834, 90836, 90837, 90838; GT or 95: Individual psychotherapy
18. 90839, 90840; GT or 95: Psychotherapy for a crisis
19. 90845; GT or 95: Psychoanalysis
20. 90846, 90847, 90853; GT or 95: Family or group psychotherapy
21. 90863; GT or 95: Pharmacologic management
22. 96116; GT or 95: Neurobehavioral status examination
Behavioral health – IOP procedure codes with televideo only
23. H0015: Alcohol and/or drug services
24. H2012: Per hour behavioral health day treatment
25. S9480: Per diem intensive outpatient psychiatric services
Behavioral health – PHP procedure codes with televideo only
26. H0035: Mental health partial hospitalization, treatment, less than 24 hours
27. H2036: Per diem alcohol and/or other drug treatment program
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