CommercialCoverageHigh impact
Telehealth Services
BCBS Arizona·AZ·Specialty Services
Effective date
Jul 15, 2025
We identified it
Jun 16, 2026
Summary
BCBS Arizona has established new telehealth service criteria effective July 15, 2025, covering both BlueCare Anywhere services and in-network provider telehealth visits. The policy defines specific coverage requirements for audio-visual and audio-only services, with different criteria for behavioral health vs. non-behavioral health services.
Action Required
By July 15, 2025: Billing team must update telehealth billing procedures to ensure proper use of modifiers FQ (audio-only), GQ (asynchronous), GT (audio-visual), and 93 (synchronous audio-only) as specified in Attachment 1. Verify member benefits for telehealth coverage before providing services. For audio-only services, document existing provider-patient relationship (except for behavioral health) and member's functional limitations or technology barriers. Ensure encounters are member-initiated or pre-authorized. Claims without proper modifiers or documentation will be denied.