Excellus BlueCross BlueShield MNT coverage: codes and telehealth
The short answerExcellus's telemedicine policy lists individual and group medical nutrition education as an eligible synchronous telehealth service and puts 97802 to 97804, G0270 and G0271 on its telemedicine code list with modifier 95. The only public document found was last revised in 2017, so confirm it is current.
By Javier Alvarez · Updated · 1 min read
1 row: Excellus BlueCross BlueShield. Public policy, not the member's benefits.
Excellus BlueCross BlueShield
Medical Policy 1.01.49 Telemedicine and Telehealth (last revised 12/14/17) · New York
| 97802 | Listed (on the telemedicine code list of the policy (revised 12/14/17). No coverage rules for in-person MNT were found.) [1] |
|---|---|
| 97803 | Listed (on the telemedicine code list of the policy (revised 12/14/17). No coverage rules for in-person MNT were found.) [1] |
| G0270 | Listed (on the telemedicine code list of the policy (revised 12/14/17). No coverage rules for in-person MNT were found.) [1] |
| G0271 | Listed (on the telemedicine code list of the policy (revised 12/14/17). No coverage rules for in-person MNT were found.) [1] |
| Where it applies | Commercial products (including Essential Plan) and Medicaid products when the service is a covered benefit. Medicare Advantage members get the same telemedicine benefits as commercial under a supplemental benefit. Policy revised 12/14/17. [1] |
| Diagnoses | Not published: call the payer. |
| Other codes | 97804 (group MNT) is in the same code range on the telemedicine code list. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | The listed codes are not telemedicine specific. Identify them with modifier 95 (synchronous audio and video), GT (interactive audio and video) or GQ (asynchronous). [1] |
| Telehealth rules | Individual and group medical nutrition education is listed among the synchronous telehealth services considered medically appropriate when the patient is present and benefits are available under the subscriber contract. 97802 to 97804, G0270 and G0271 are on the code list. [1] |
| Visit limits | Not published: call the payer. |
| Referral and prior auth | Not published: call the payer. |
Check an Excellus BlueCross BlueShield claim against the row
Before an Excellus BlueCross BlueShield claim goes out, compare it with the row above: the code is one the policy lists, the place of service and modifier match for a video visit, and the units fit the limit. Change the filters to compare Excellus BlueCross BlueShield with another payer, then download the PDF of what you see.