• Chronic issues, sudden symptoms, accidents or anxiety? Gia is available 24/7 by phone, web or mobile app to expertly assess your health needs and quickly refer you to the right
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  1. Chronic issues, sudden symptoms, accidents or anxiety? Gia is available 24/7 by phone, web or mobile app to expertly assess your health needs and quickly refer you to the right
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Guidance for Providers Treating MVP Health Care Members 

Gia Health Care Services

The Gia® by MVP mobile app connects MVP Members to the right care, right away. It has replaced MVP’s myERnow mobile app. Members can download the new app from our website. 

Gia is be available for free on New York and Vermont fully insured plans, Medicaid, and most Medicare plans. Self-funded employers can elect to offer Gia. MVP RxCare, and Child Health Plus Members are not eligible for Gia services. 

Gia includes access to telemedicine services, including 24/7 urgent and emergency care, psychiatry, behavioral health, and more, and referrals to in-person care from nearby doctors, specialists, labs, pharmacies, and other Providers. 

Gia telemedicine is not the same as a Member using their current doctors’ telehealth platform or offering. If an MVP Member makes a telehealth appointment or has a telehealth visit with his/her own doctor, and not through Gia, co-pays or a cost-share will apply per plan details.

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Telemedicine 

MVP is covering all telemedicine services at no cost-share to the Member during the declared State of Emergency. 

Providers should submit claims for Covered Services as outlined below in order for the Member cost-share to be waived: 

  • Submit the appropriate Evaluation & Management (E/M) or CPT code (for example 99212 or 99213) 
  • Submit the claim with the appropriate place of services (POS) code that would have been reported had the services been furnished in person. 
  • Claim modifiers “95” or “GT” should be appended as appropriate on each claim that represents a service delivered via Telemedicine. 
    • 95 modifier – Synchronous telemedicine service rendered via real-time interactive audio and video telecommunication system. 
    • GT modifier – Via interactive audio and video telecommunication systems. 

Providers do not have to have an existing patient relationship with a Member to be reimbursed for telephone triage services and health care services delivered through telemedicine or audio-only telephone. 

While we encourage Providers to bill consistent with an office visit – and understand that certain services can be time consuming and complex even when provided virtually – such services should be coded at a level of care appropriate for provision through a telephonic mechanism and Providers should maintain documentation in the medical record for the level of care billed. 

Telemedicine visits will be included in any applicable Member benefit visit limitations. 

 

Store and Forward 

In Vermont, MVP is covering Store and Forward technology when the below code, or any other appropriate procedure code, is billed, along with modifier GQ: 

 

CPT Code   Description 
  G2010      Remote evaluation of recorded video and/or images submitted by the patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment.  

Telephone Visits 

New York Commercial Members 

Virtual Check-In 

Providers should bill the following G codes for all Commercial Members when conducting visits via telephone. These will be covered at no cost-share* to Members during the declared State of Emergency.

CPT Code   Description 
 G2012       Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management [E/M] services, provided to an established patient, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion 
 G2010  Remote evaluation of recorded video and/or images submitted by the patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment. 

 

The codes below may also be used for telephonic visits with Commercial Members. These will be covered at no cost-share* to the Member during the declared State of Emergency. 

 

CPT Code   Description 
 99441     Telephone evaluation and management service; 5-10 minutes of medical discussion 
 99442  Telephone evaluation and management service; 11-20 minutes of medical discussion
99443   Telephone evaluation and management service; 21-30 minutes of medical discussion 

 

Self-funded Members should consult directly with their employer to see if their employer is waiving cost-share for telemedicine or telephone visits. 

New York Medicaid Members

The codes below should be used for telephonic visits with Medicaid Members. These will be covered at no cost-share to the Member during the declared State of Emergency.

 

CPT Code   Description 
 99441  Telephone evaluation and management service; 5-10 minutes of medical discussion 
99442 Telephone evaluation and management service; 11-20 minutes of medical discussion 
99443  Telephone evaluation and management service; 21-30 minutes of medical discussion 

Vermont Commercial Members 

As of March 13, 2020, MVP is covering telephone-only codes as a telemedicine visit at no cost-share to Members in Vermont. Providers will be reimbursed same as in person visits, rates based on their Provider Agreement. 

Providers should submit claims for telephone only visits as telemedicine visits for Covered Services as outlined below in order for the Member cost-share to be waived: 

  1. Submit the appropriate Evaluation & Management (E/M) or CPT code (for example 99212 or 99213) 
  2. Submit the claim with the POS code that would have been reported had the services been furnished in person 
  3. Claim modifiers “95” or “GT” should be appended as appropriate on each claim that represents a service delivered via Telemedicine. 
    1. 95 modifier – Synchronous telemedicine service rendered via real-time interactive audio and video telecommunication system. 95 modifier – Synchronous telemedicine service rendered via real-time interactive audio and video telecommunication system.
    2. GT modifier – Via interactive audio and video telecommunication systems. 
  1. Submit the appropriate Evaluation & Management (E/M) or CPT code (for example 99212 or 99213) 
  2. Submit the claim with the POS code that would have been reported had the services been furnished in person 
    • Submit the claim with the POS code that would have been reported had the services been furnished in person 
    • Submit the claim with the POS code that would have been reported had the services been furnished in person 

Providers do not have to have an existing patient relationship with a Member to be reimbursed for telephone triage services and health care services delivered through telemedicine or audio-only telephone. 

While we encourage Providers to bill consistent with an office visit – and understand that certain services can be time consuming and complex even when provided virtually – such services should be coded at a level of care appropriate for provision through a telephonic mechanism and Providers should maintain documentation in the medical record for the level of care billed. 

In addition, MVP will also cover the following telephonic codes. These will be covered at no cost-share to the Member during the declared State of Emergency. 


CPT Code   Description 
99441     Telephone evaluation and management service; 5-10 minutes of medical discussion
 99442 Telephone evaluation and management service; 11-20 minutes of medical discussion 
99443 Telephone evaluation and management service; 21-30 minutes of medical discussion 
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  • Accordion Item 1

    If an individual has been in close contact with a person known to have COVID-19, showing symptoms of COVID-19, or recently traveled from an area with ongoing community spread of COVID-19, they need to be evaluated by a health care provider.

    • Call a primary care doctor’s office or urgent care facility before you go to the location,or use the Gia® by MVP mobile app.  
    • Wear a mask before you go into a doctor’s office, urgent care facility, or hospital. 
    • If an individual is low risk for COVID-19, but still feeling sick, consider using telemedicine alternatives. 
  • Accordion Item 2