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Provider News

New Reimbursement Policy: Professional Telehealth Services to be implemented 12/1/2019

Effective December 1, 2019, HPP will be implementing a new reimbursement policy: RB.012.A Professional Telehealth Services.

Telehealth is the use of electronic information and communications technologies by a health care provider to deliver services to a member that is located at a different site. Telehealth can provide remote access to services such as medical consultations and information, health assessments and diagnosis. Telehealth services are provided to members by a health care professional through interactive telecommunication devices.

All medical necessity, claim payment and drug policies, including the Telehealth policy, can be reviewed and downloaded from our Policy Bulletin Library.

HPP’s policy bulletins define medical necessity criteria, coding guidance and coverage positions on topics such as medical services, procedures, DME and therapies. Our claim payment policy bulletins provide reimbursement rules and billing guidelines necessary to ensure timely and appropriate payment, and our drug policies document our position on pharmaceutical topics and drugs.

HPP will create and update policy bulletins as appropriate. New and updated policies are typically published 30 days in advance of actual implementation. We welcome you to review Telehealth immediately, and we will adhere to this policy position beginning December 1, 2019.

If you have questions, contact our Provider Services Helpline at 1-888-991-9023 (Monday–Friday, 9 a.m.–5:30 p.m.) or your NAM (Network Account Manager).