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October 2018

Members can no longer receive prescriptions for DME/P&O items through telehealth visits

Blue Cross Blue Shield of Michigan is concerned that members are receiving durable medical equipment and prosthetic and orthotic items without clear demonstration of medical necessity or proper fitting.

Therefore, effective Nov. 1, 2018, health care providers won’t be able to prescribe or issue DME/P&O supplies during telehealth visits. A telehealth visit doesn’t meet the medical necessity requirements for prescribing these items. Prescription and issuance resulting from a telehealth visit may be subject to audit review and recovery.

A telehealth visit includes:

  • Phone call
  • Both email and postal mail
  • Video chat

All telehealth formats are excluded from issuing DME and prosthetic and orthotic items.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2017 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.