Billing change for IOP services provided via telehealth for some members, for dates of service on or after Oct. 1

For dates of service on or after Oct. 1, 2021, you should no longer include procedure code Q3014 on claims for behavioral health intensive outpatient program services provided via telemedicine.

Instead, you should bill revenue code 0905 or 0906 with modifier GT or 95.

As you may recall, we started allowing IOP via telehealth as a temporary measure in the early days of the COVID-19 pandemic.

This change affects all Blue Care Network commercial members, all BCN Advantage℠ members and select Blue Cross Blue Shield of Michigan commercial group members.

Keep the following in mind:

• Facilities can provide IOP services to BCN commercial and BCN Advantage members only when their contracts specifically include IOP services.
• For Blue Cross commercial members, most plans don’t cover IOP services for mental health disorders. IOP services for substance use disorders must be delivered by a substance abuse treatment facility. Be sure to check member eligibility and benefits before performing services.

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

• Telehealth for behavioral health providers
• Billing tips COVID-19 at a glance

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

Note: For Medicare Plus Blue℠ members, see the Medicare-covered telehealth services for the COVID-19 PHE document to determine which IOP and partial hospital program procedure codes are billable for telehealth.