​​Effective January 1, 2024, AmeriHealth Insurance Company of New Jersey (AmeriHealth) implemented a new telehealth reimbursement rate for Medicare Advantage members in New Jersey.

When eligible physical health telehealth services are performed through telehealth by an AmeriHealth-participating professional provider, reimbursement for the physical health telehealth service is at 85 percent of the provider allowance, subject to the specific terms and conditions of the participation agreement.

This reimbursement rate does NOT apply to behavioral health telehealth services. Reimbursement for behavioral health telehealth services is at 100 percent.

We view telehealth 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 telehealth when it is appropriate. We strive to develop policies that get patients the right care at the right time and place.

For more information, please view MA00.036i: Telehealth Services.​ ​​​​Please note that over time, this policy link may expire as policies become updated.

To access the most updated version of any active policy, please refer to the Medical and Claim Payment Policy Portal or simply navigate to the Commercial or Medicare Advantage policy bulletins.​​

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