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Medicare AdvantageAdministrativeMedium impact

MAPAP115 - Primary Care Physicians (PCPs) - Updated to reflect a telehealth only provider cannot be a PCP

Blue Cross of Idaho·ID · Family Medicine, Internal Medicine, General Practice +2 more·Medical Policy
Effective date
Aug 1, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

Blue Cross of Idaho updated their Medicare Advantage policy to clarify that telehealth-only providers cannot serve as Primary Care Providers (PCPs). PCPs must provide periodic in-person services in a clinical setting.

Action Required

Action needed
By August 1, 2025: Review current PCP designations and ensure any providers serving as PCPs for Blue Cross of Idaho Medicare Advantage members provide in-person clinical services. Contact Provider Relations to update PCP status for any telehealth-only providers. Update provider enrollment processes to verify in-person service capability before PCP designation.