Telehealth – Expanding access to care

To support providers with caring for their Humana patients while promoting both patient and provider safety, we have updated our existing telehealth policy for the duration of the COVID-19 public health emergency (PHE). At a minimum, we will always follow Centers for Medicare & Medicaid Services (CMS) telehealth or state-specific requirements, opens in new window that apply to telehealth coverage for our insurance products. This policy will be reviewed periodically for changes based on the evolving COVID-19 PHE 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.

  • 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.
    • As of 1/1/21, Medicare Advantage benefits include no member cost share for in-network telehealth visits for primary care, urgent care and behavioral health. For specialty telehealth visits, please verify member plan benefits as any applicable member cost share would apply.
    • From 3/6/20 to 12/31/20, member cost-share was waived for telehealth visits with all participating/in-network providers. This applied to Humana Medicare Advantage, fully-insured group commercial, and some Humana self-insured group commercial members.

  • 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.

 

Please refer to Humana’s COVID-19 Telehealth and Other Virtual Services policy, opens in new window, for further information.

Note: When the policy link is clicked, it will automatically download the policy. Due to the file size, this may take a moment to open on your computer.

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.

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 Health & Human Services Office for Civil Rights (HHS OCR) will exercise enforcement discretion and waive penalties for Health Insurance Portability and Accountability Act of 1996 (HIPAA) violations against healthcare providers that serve patients in good faith through everyday communications technologies, such as FaceTime or Skype. Read more about guidance and application options for telehealth services, opens in new window here.

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.