AmeriHealth Pennsylvania has updated its reimbursement rate for Telemedicine Services, effective June 1, 2022.

When the physical health services listed in Claim Payment Policy #00.10.41j: Telemedicine Services are performed through telemedicine by an AmeriHealth Pennsylvania participating professional provider, reimbursement for the physical health service will be at 85 percent of the provider allowance, subject to the specific terms and conditions of the participation agreement.

The reimbursement change does not apply to telemedicine for AmeriHealth New Jersey members or behavioral health services.

We view telemedicine as a complement to, not a replacement for, in-office services. It is not designed for all care. We hope that you will continue to work with your patients on treatment plans, using telemedicine when it is appropriate. We strive to develop policies that get patients the right care at the right time and place.

To learn more about the policy, including the eligible services, communication modes, capitation, and billing codes, please read Claim Payment Policy #00.10.41j: Telemedicine Services. If you have questions about this change, please email ahtelemedicine@amerihealth.com.