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Important COVID-19 Update

Because of the COVID-19 pandemic, we’ve been receiving questions about Telehealth/Telemedicine services and how they should be billed with US Family Health Plan.  

Please note that we are accepting GQ, GT, and 95 modifiers.

We now also provide codes for coverage of audio-only telephonic office visits by our network providers: (1) Evaluation and management visits represented by CPT 99441-3; 98966-8; HCPCS G2012; (2) other services such as psychotherapy when reported by the appropriate CPT and/or HCPS codes, and other appropriate coding such as place of service or modifiers; and (3) subsequent, new, or re-numbered codes as appropriate for medically or psychologically necessary care and treatment eligible for reimbursement and cost-sharing.

Administrative services (for example, making appointments or verifying prescriptions) are not separately reimbursed services.  

We are also temporarily waiving any cost sharing and copayments for all covered in-network telehealth services. 

These measures are effective as of May 12, 2020 and expire upon the expiration of the President’s national emergency for the COVID-19 outbreak.

If you have any questions, please call us at 1.800.818.8589.

 


 

US Family Health Plan provides the full TRICARE Prime benefit, including doctor visits, hospitalizations, emergency care, and prescription medications to nearly 15,000 members in southern New England. Tufts Health Plan, our third-party administrator, provides claims processing, referral management, and member-relations services.

The Plan is available to families of active-duty service members and to retired service members and their families.

Provider Manual

Providers can find information about referral management, billing, our complex care management programs, and appeals in our Provider Manual. Stephanie Tooley and Tom Leonard are also available to answer your questions by phone or e-mail.

Provider Manual

Stephanie Tooley

Provider Relations Manager

Stephanie, originally from western New York, now lives with her family in Swansea, Massachusetts. She enjoys running around after her outgoing and spirited four-year-old son, Ryker, and cooking (mostly the prep work). She has been with US Family Health Plan since 2013.

E-mail Stephanie

Tom Leonard

Provider Relations Specialist

A native of Hopkinton, Massachusetts, Tom majored in communications and media studies in college. He runs and has an interest in healthy cooking, especially sous-vide cooking. Tom and Bark Lee, an American yellow Lab, live in Allston. Tom has worked with US Family Health Plan since 2011.

E-mail Tom