Florida Blue Telemedicine Billing: 5 Easy Essentials

Florida Blue telemedicine billing follows the plan’s Virtual Visits payment policy, which changed for commercial plans on January 1, 2026. Florida Blue is the trade name of Blue Cross and Blue Shield of Florida, Inc., and it describes itself as an independent licensee of the Blue Cross and Blue Shield Association, so its rules do not carry over to other Blue plans. This guide on Florida Blue telemedicine billing shows which codes, modifiers and place-of-service codes to use, and where psychotherapy still needs a call to the plan.

What Florida Blue telemedicine billing covers

Florida Blue’s Virtual Visits payment policy (ID 20-069) defines a virtual visit as an evaluation and management (E/M) visit or other service delivered in place of an in-person visit, using real-time interactive telecommunications. Email, text, fax and mail alone do not count. The policy applies to in-network providers, requires technology that meets CMS telehealth guidelines and HIPAA, and does not guarantee payment, because benefits depend on the member’s contract. It took effect January 1, 2021; the latest revision is January 1, 2026.

Florida Blue telemedicine billing for psychiatrists: E/M visits

Psychiatrists and other prescribers bill telemedicine E/M visits differently from therapists. For commercial plans, a December 2025 Florida Blue notice says that from January 1, 2026 only the new telemedicine codes are accepted. Office E/M codes 99202-99205 and 99212-99215 with modifier 93 or 95 no longer apply to commercial telemedicine E/M claims. The table lists the five visit types to get right.

Visit type	Commercial plans (from 1/1/2026)	Florida Blue Medicare (Medicare Advantage)
Audio and video, new patient	98000-98003, no modifier 93 or 95	99202-99205 with modifier 95 and the right POS
Audio and video, established patient	98004-98007, no modifier	99212-99215 with modifier 95 and the right POS
Audio only, new patient	98008-98011, no modifier	99202-99205 with modifier 93 and the right POS
Audio only, established patient	98012-98015, no modifier	99212-99215 with modifier 93 and the right POS
Brief check-in (established, patient-initiated)	98016	98016

For commercial claims, pick the level by medical decision making or total time on the date of the encounter, and expect payment at your contract rate. The policy says not to use 98000-98015 for Medicare Advantage. It does not say how these codes pair with a psychotherapy add-on code, so ask Florida Blue before you bill that combination.

Florida Blue telemedicine billing for psychotherapy: modifiers and place of service

For services other than E/M that can be done virtually, the policy says to report the appropriate code with the telemedicine modifier: 95 for audio-video, 93 for audio-only. Place of service (POS) 02 means telehealth delivered somewhere other than the patient’s home, and POS 10 means telehealth delivered in the patient’s home. The policy does not mention behavioral health or psychotherapy by name, so confirm that your psychotherapy codes are eligible for telehealth under your contract before you bill. Our insurance verification steps include asking about telehealth coverage.

Private payers, Medicare and Medicaid, and state rules

Private payers

Florida Blue telemedicine billing applies to Florida Blue’s own commercial and Medicare Advantage plans. Other payers have different codes and modifiers, so check each contract before you reuse your Florida Blue telemedicine billing setup. You must be in network for the Virtual Visits policy to apply; our guide to in-network and out-of-network credentialing explains the difference.

Medicare and Medicaid

The table shows Florida Blue’s Medicare Advantage rule only. Original Medicare and Florida Medicaid set their own telehealth rules, and Medicaid fee-for-service requires the GT modifier under state rule 59G-1.057, according to the Center for Connected Health Policy. Do not apply Florida Blue’s codes to those programs.

State rules

Under Florida Statutes section 456.47, a telehealth provider must meet the same standard of care as an in-person provider in Florida. A clinician licensed in another state who treats a patient located in Florida must register with the Florida board or the Department of Health first. The Center for Connected Health Policy lists Florida payment parity as “no”, and notes that a contract provision paying telehealth differently from in-person care must be initialed by the telehealth provider.

What modifier does Florida Blue telemedicine billing require?

For commercial telemedicine E/M visits, none: codes 98000-98015 do not need modifier 93 or 95. For other virtual services, and for Florida Blue Medicare E/M visits, use 95 for audio-video or 93 for audio-only, with POS 02 or 10. Florida Blue telemedicine billing depends on the member’s plan type, so check which one applies before you pick a code.

What to do Monday morning

1. List your Florida Blue patients and mark each plan as commercial or Medicare Advantage, since the rules differ by plan type.
2. Prescribers: stop reporting 99202-99215 with modifier 93 or 95 on commercial telemedicine E/M claims.
3. Add POS 02 or 10 to your telehealth templates and record where the patient was during the visit.
4. Ask Florida Blue in writing which psychotherapy codes it pays by telehealth under your contract.
5. Check recent denials on your remittance advice and look up each reason in our guide to CARC and RARC codes.

The short version: Florida Blue telemedicine billing

Florida Blue telemedicine billing now uses codes 98000-98015 for commercial E/M visits and no 93 or 95 modifier. Psychotherapy and Medicare Advantage claims keep the modifier and a POS code. Confirm psychotherapy eligibility with the plan, since the policy is silent on it.

How MCM South helps

MCM South Medical Billing Service, LLC bills exclusively for mental and behavioral health. We work with psychotherapists and psychiatrists in solo and medium-size practices, and we bill out-of-network claims for clients.

Want a second set of eyes on your telehealth claims? We can talk through your practice.

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Where MCM South works

MCM South Medical Billing Service, LLC works with psychotherapists and psychiatrists in our ten currently served states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. We serve solo and medium-size practices that bill mental and behavioral health. Founder Michael Williams has worked with insurance payers in all 50 states. Browse the state and regional billing guides for rules that vary by state, or see our billing services.

This post is operational guidance for billing, not legal advice. Rules change, so confirm with the payer or your counsel.