Asynchronous Telemedicine Services

Medicaid:

Pursuant to section 4804 of Act 42 of 2024, Highmark Wholecare covers services rendered via Telemedicine under certain conditions. This includes Asynchronous Interactions and is defined as an exchange of information between a patient and a health care provider that does not occur in real time, including the secure collection and transmission of a patient’s medical information, clinical data, clinical images, laboratory results, and self-reported medical history.

Procedure codes reflecting online digital evaluation and management services and digitally stored data services, also known as remote patient monitoring, include but are not limited to, 99421, 99422, 99423, 98970, 98971, 98972, 99091 and 99457. Please refer to the PA Medicaid Fee Schedule to confirm coverage of additional procedure codes.