Humana update for telehealth visits

To support providers with caring for their Humana patients while promoting both patient and provider safety, we have updated our existing telehealth policy. At a minimum, we will always follow CMS telehealth or state-specific requirements, opens in new window1 that apply to telehealth coverage for our insurance products. This policy will be reviewed periodically for changes based on the evolving COVID-19 public health emergency and updated CMS or state specific rules1 based on executive orders. Please refer to the applicable CMS or state specific regulations prior to any claim submissions, and check this page regularly for the latest information.

  • Extending member cost-share waivers through the end of the calendar year for in-network telehealth visits
    We have seen considerable adoption of telehealth since we introduced our updated policy in March. Given the important role telehealth is playing in providing access to care for members who are staying at home, we are extending our cost-share waivers through the end of the year for individual and group Medicare Advantage members. This waiver applies to audio and video telehealth visits with all participating/in-network providers, including primary care, behavioral health and other specialist providers. In support of this waiver, please do not collect a copay from any Humana individual or group Medicare Advantage patients for any of and telehealth visits outlined above.

  • Temporary expansion of telehealth service scope and reimbursement rules
    • To ease systemic burdens arising from COVID-19 and support shelter-in-place orders, Humana is encouraging the use of telehealth services to care for its members. Please refer to CMS, state, and plan coverage guidelines for additional information regarding services that can be delivered via telehealth
    • In response to this emergency, Humana will temporarily reimburse for telehealth visits with participating/in-network providers at the same rate as in-office visits. In order to qualify for reimbursement, telehealth visits must meet medical necessity criteria, as well as all applicable coverage guidelines

  • Temporary expansion of telehealth channels
    • Humana understands that not all telehealth visits will involve the use of both video and audio interactions. For providers or members who don’t have access to secure video systems, we will temporarily accept telephone (audio-only) visits. These visits can be submitted and reimbursed as telehealth visits
    • Please follow CMS or state-specific guidelines and bill as you would a standard telehealth visit
    • Further information on using mobile devices for telehealth can be found below

  • Temporary expansion of telehealth to broader types of providers

 

With respect to these telehealth changes, note that all other coverage rules will continue to apply, and refer to applicable Humana policies for additional information. Please continue to check this page regularly as we will be updating our information to supplement the information in this update.

Expanded telehealth technologies through mobile devices

During the COVID-19 public health emergency, the new waiver in Section 1135(b), opens in new window of the Social Security Act (found on the CMS Telemedicine Fact Sheet) authorizes use of telephones that have audio and video capabilities to provide Medicare telehealth services.

Additionally, the HHS Office for Civil Rights will exercise enforcement discretion and waive penalties for HIPAA violations against healthcare providers that serve patients in good faith through everyday communications technologies, such as FaceTime or Skype. More guidance and application options for telehealth services can be found here, opens in new window.

For more information on COVID-19 and the expanded access to telehealth services:

CMS

 

AMA

 

Additional

 

1Humana is not affiliated with the Center for Connected Telehealth Policy. This link is provided as a resource for your convenience. Humana has not independently verified the information contained on this website.