Billing & Reimbursement

Telehealth Coverage Policies

Sustainable billing and reimbursement models for telehealth services are a key priority of the SCTA. During the COVID-19 pandemic, federal, state, and private payers temporarily expanded telehealth coverage policies to increase access to health care services while maintaining social distancing recommendations. A number of these flexibilities are still in place during the continued Federal Public Health Emergency (PHE) declaration. Check out the resources below for updates and policies from state, federal, and private payers:

Sustainable billing and reimbursement models for telehealth services are a key priority of the SCTA. During the COVID-19 pandemic, federal, state, and private payers temporarily expanded telehealth coverage policies during the COVID-19 pandemic to increase access to health care services while maintaining social distancing recommendations. Many of these flexibilities are still in place during the continued Public Health Emergency (PHE) declaration. Check out the resources below for updates and policies from state, federal, and private payers:

• Center for Connected Health Policy (CCHP) provides up-to-date info on Federal and State policies

• CMS List of Telehealth Services for Calendar Year 2022

• BCBSSC’s Telemedicine Policy (CAM176 – accept Disclaimer and search for policy under ‘T’)

• UnitedHealthcare Telehealth/Virtual Health Policy (PDF)

• SC Department of Health and Human Services (SCDHHS) Bulletin: Update on Telehealth Flexibilities Issued During the COVID-19 Public Health Emergency

SCTA Payer Priorities

The SCTA Sustainability Workgroup has outlined some key recommendations as to the future of telehealth reimbursement in South Carolina. Read the full Payer Priority outline.

As the SCTA works collaboratively with payer partners on coverage recommendations, we've created the SC Payer Scorecard, which outlines how SC payers compare to key SCTA coverage priorities. The scorecard will be regularly updated and is intended to serve as a tool for SCTA partners and telehealth stakeholders in South Carolina.

Download the Payer Scorecard (PDF) for more details.

Please contact the SCTA with any specific questions regarding telehealth reimbursement and sustainability.