Intensive outpatient program and partial hospital program services now payable on an ongoing basis when delivered through telemedicine

As previously communicated, Blue Cross Blue Shield of Michigan and Blue Care Network began allowing behavioral health intensive outpatient and partial hospital program services to be payable when provided by contracted facilities through telemedicine as a temporary measure during the COVID-19 pandemic.

Effective Nov. 1, 2021, we’re updating our Telemedicine Services medical policy to allow these services to be payable when delivered by contracted facility providers through synchronous (real-time) telemedicine on an ongoing basis, rather than as a temporary measure. We’re doing this to make it easier for members to receive these services beyond the COVID-19 pandemic.

For more information, including information about billing for these services, see the Telehealth for behavioral health providers document on our public website at bcbsm.com/coronavirus or within Provider Secured Services.

Reminders

• Facilities can provide behavioral health IOP and PHP services to BCN commercial and BCN Advantage℠ members only when their contracts specifically include IOP and PHP services.
• For Blue Cross commercial members, most plans don’t cover IOP services for mental health or PHP services for substance use disorders. IOP services for substance use disorders must be delivered by a substance abuse treatment facility. Be sure to check member eligibility and benefits through web-DENIS or by contacting Provider Inquiry before performing services.
• For Medicare Plus Blue℠ members, follow Centers for Medicare & Medicaid Services guidance.

Updated documents

We’ve updated the following documents to reflect this change:

• Telehealth for behavioral health providers
• Temporary changes due to the COVID-19 pandemic

You can find these documents on our public website at bcbsm.com/coronavirus or within Provider Secured Services.

You can view the updated Telemedicine Services medical policy through our Medical Policy & Pre-Cert/Pre-Auth Router on bcbsm.com.