Telehealth Copay – Behavioral Health Not Covered?

I've currently seeing an in-network behavioral health provider via teleahealth for 60 minutes of psychotherapy – procedure code 90837 with modifier 95 attached in the service line and a diagnosis code of: F4322

My plan is from BCBS IL via the marketplace: Blue Choice Preferred Bronze PPO 201

My benefit program outline of coverage document states the following for my Telehelath benefits: [Imgur](https://i.imgur.com/eIIxSyr.png)

And the same document defines telehealth as: [Imgur](https://i.imgur.com/CMLOJcD.png)

So far all of my visits have been billed towards my very high deductible instead of the copay.

But since I'm seeing my in-network provider via video chat, shouldn't the sessions be covered with just a $45 copay?

Has anyone on this or a similar plan had their therapy sessions covered via the teleahealth copay?

I've already spent a great deal of time one the phone with BCBS behavioral health advocates and claims reps and no one has been able to clearly explain how the telehealth copay benefit works and why it wouldn't apply in my case.

I'd really appreciate any advice on whether I should keep fighting to get my visits covered via the copay and if so, any tips on how to work with BCBS to achieve that.

submitted by /u/tedroc97
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