PROVIDER ALERT - Effective Immediately:
Telemedicine Care
At Prominence Health Plan we support the evolving care needs of our members,
and we are taking proactive measures to address this very important time in our public health environment.
 
In an effort to increase safe access to care, please see below for how qualified providers can bill for Telemedicine Services.

FOR REGULAR E & M VISITS OVER THE PHONE OR VIDEO, PLEASE NOTE THE FOLLOWING STANDARD BILLING CODES:
Provider Bills:
99201-99205 or 99211-99215
Place of Service:
02
This is applicable for both Medicare and Commercial lines of coverage.

Just as if it were a face-to face encounter, the documentation for a telemedicine encounter must support the level of service you are billing.

The telemedicine service can occur via telephone or video encounter. Reimbursement will mirror a traditional face-to-face office encounter. 

Member Outreach
Due to the COVID-19 outbreak, we are already instructing our health plan membership to call provider offices before visiting in person. We will begin communications about this extended level of care to our membership next week.

For More Information
Please refer to the FAQs provided below for more detail. If you have any additional questions, contact PHP-ProviderRelations@uhsinc.com.

Thank you for the care your office provides in order to maintain the health and safety of our members and countless others. We appreciate you.
Frequently Asked Questions
Does the encounter have to be telephone and video? 
Although Medicare requires both a telephone and video encounter, Prominence Health Plan allows either a telephone or video for established patients. Prominence recommends that New Patient Telemedicine encounters occur through telephone and video. 

When can my office start providing telemedicine encounters?
Effective immediately, Prominence Health Plan will begin to reimburse for telemedicine care. As soon as your office can begin providing telemedicine care and can accept patients via phone or video you can begin to bill the health plan accordingly.
 
Who can have a telemedicine visit?
Any Prominence Health Plan Commercial or Medicare member.

Is there special credentialing required to provide telemedicine services?
No. As long as you are a credentialed, in-network provider with Prominence, you can provide telemedicine services.
 
Who is a qualified provider for telemedicine services?
Qualified providers are:
  • Physicians
  • Nurse Practitioners
  • Physician Assistants
  • Nurse mid-wives
  • Clinical nurse specialists
  • Certified registered nurse anesthetists
  • Clinical psychologists
  • Clinical social workers
  • Registered dieticians
  • Nutrition professionals

For general information about COVID-19 in Nevada, visit here >

For general information about COVID-19 in Texas, visit here >
Follow us online