COVID-19 Payer Information
Quadax is dedicated to keeping our clients up-to-date on the billing, reporting, and procedural information specific to each payer as it pertains to COVID-19.
Click here for Laboratory Specific Information
Latest Updates
Last updated 11/2/2022| Last Update | Payers and Organizations | Overview |
| 8/2/2022 | Aetna |
UPDATE - COVID-19 Update. Q - Which COVID-19 vaccinations will Aetna cover (8/2/22)? A - Consistent with CARE Act requirements, Aetna plans cover any COVID-19 vaccine that has received FDA authorization or approval, at no added cost to members. READ MORE |
| 6/7/2022 | American Medical Association (AMA) |
UPDATE - AMA Update 6/7/22. CPT® Category I New SARS-CoV-2 Vaccine Codes Long Descriptors. CPT® Category I New SARS-CoV-2 Vaccine Codes. READ MORE 6/7/2022 - New Current Procedural Terminology (CPT®) codes have been created that streamline the reporting of immunizations for the novel coronavirus (SARS-CoV-2, also known as COVID-19). READ MORE |
| 3/2/2022 | Amerigroup |
COVID-19 information (February 2022 update). READ MORE |
| 5/20/2021 | Amerigroup Medicare Advantage | Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQ. READ MORE |
| 7/13/2022 | Amerigroup Arizona, New Jersey, New Mexico, Tennessee, Texas, Washington |
Provider notice for COVID-19 testing: Evaluation and management services for COVID-19 testing — professional. READ MORE Effective with dates of service on or after September 1, 2022, Amerigroup Community Care will facilitate review of selected claims for COVID-19 visits reported with Evaluation and Management (E/M) services submitted by professional providers to align with CMS reporting guidelines. When the purpose of the visit is for COVID-19 testing only, reimbursement for CPT® code 99211 (office or other outpatient visit) is allowed when billed with place of service office (11), mobile unit (15), walk-in retail health clinic (17), or urgent care facility (20). Claims for exposure only may be affected. Professional providers are encouraged to code their claims to the highest level of specificity in accordance with ICD-10 coding guidelines. |
| 10/13/2021 | Amerigroup Louisiana, Mississippi, Texas |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 1/19/2022 | Amerigroup (Maryland) |
Response to COVID-19 state of emergency (January 2022) Amerigroup Community Care appreciates your commitment to our members and all Maryland residents. READ MORE |
| 12/1/2021 | Amerigroup (New Jersey) |
Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies. READ MORE |
| 8/25/2021 | Amerigroup (New Mexico) | Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies. READ MORE |
| 10/13/2021 | Amerigroup (Oregon) |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 10/6/2021 | Amerigroup (Tennessee) |
Medicaid CoverKids member FAQ: How to identify and how to bill vaccines. READ MORE |
| 12/1/2021 | Amerigroup (Washington) |
Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies. READ MORE |
| 9/1/2022 | Anthem California |
UPDATE - The California Department of Managed Health Care has issued a number of All Plan Letters (APLs) to date addressing California legislation that went into effect in calendar years 2022 and 2021. Anthem Blue Cross (Anthem) is summarizing certain key parts of the APLs. READ MORE |
| 8/10/2022 | Anthem Colorado |
UPDATE: Information from Anthem for Care Providers about COVID-19 (Updated 8/8/22). We recently updated information about coverage dates for telephonic-only care. READ MORE |
| 6/1/2022 | Anthem Connecticut |
Medicare News 6/1/22. Provider Notice for COVID-19 Testing. Evaluation and management services for COVID testing — professional. READ MORE |
| 8/10/2022 | Anthem Georgia |
UPDATE: Information from Anthem for Care Providers about COVID-19 (Updated 8/8/22). We recently updated information about coverage dates for telephonic-only care. READ MORE |
| 8/10/2022 | Anthem Indiana |
UPDATE: Information from Anthem for Care Providers about COVID-19 (Updated 8/8/22). We recently updated information about coverage dates for telephonic-only care. READ MORE |
| 8/10/2022 | Anthem Kentucky |
UPDATE: Information from Anthem for Care Providers about COVID-19 (Updated 8/8/22). We recently updated information about coverage dates for telephonic-only care. READ MORE |
| 8/10/2022 | Anthem Maine |
UPDATE: Information from Anthem for Care Providers about COVID-19 (Updated 8/8/22). We recently updated information about coverage dates for telephonic-only care. READ MORE |
| 8/10/2022 | Anthem Missouri |
UPDATE: Information from Anthem for Care Providers about COVID-19 (Updated 8/8/22). We recently updated information about coverage dates for telephonic-only care. READ MORE |
| 8/10/2022 | Anthem Nevada |
UPDATE: Information from Anthem for Care Providers about COVID-19 (Updated 8/8/22). We recently updated information about coverage dates for telephonic-only care. READ MORE |
| 8/10/2022 | Anthem New Hampshire |
UPDATE: Information from Anthem for Care Providers about COVID-19 (Updated 8/8/22). We recently updated information about coverage dates for telephonic-only care. READ MORE |
| 6/1/2022 | Anthem New York |
Provider Notice for COVID-19 Testing. This communication applies to the Commercial and Medicaid programs from Empire. Evaluation and management services for COVID-19 testing - professional. READ MORE |
| 8/10/2022 | Anthem Ohio |
UPDATE: Information from Anthem for Care Providers about COVID-19 (Updated 8/8/22). We recently updated information about coverage dates for telephonic-only care. READ MORE |
| 8/10/2022 | Anthem Virginia |
UPDATE: Information from Anthem for Care Providers about COVID-19 (Updated 8/8/22). We recently updated information about coverage dates for telephonic-only care. READ MORE |
| 8/10/2022 | Anthem Wisconsin |
UPDATE: Information from Anthem for Care Providers about COVID-19 (Updated 8/8/22). We recently updated information about coverage dates for telephonic-only care. READ MORE |
| 5/19/2022 | Blue Cross Blue Shield Alabama |
The U.S. Food and Drug Administration (FDA) on May 5, 2022, limited the authorized use of the Janssen COVID-19 vaccine to the following individuals: Those who are 18 or older and for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate; or, Those 18 or older who elect to receive the Janssen COVID-19 vaccine because they would otherwise not receive a COVID-19 vaccine. READ MORE |
| 6/15/2021 | Blue Cross Blue Shield Arkansas |
COVID-19 Update June 2022. Status of COVID-19 expanded benefits. READ MORE |
| 1/27/2022 | Blue Cross Blue Shield Federal Employee Program |
Attached link provides how to complete a claims form to be reimbursed for COVID over the counter tests. READ MORE |
| 7/20/2022 |
Blue Cross Blue Shield |
UPDATE - The Federal Public Health Emergency has been extended through October 13, 2022. |
| 6/15/2022 | Blue Cross Blue Shield Illinois |
We're Collecting Telehealth Information for Our Provider Directories. READ MORE |
| 6/30/2022 | Blue Cross Blue Shield Massachusetts |
Updated Payment Policies Now Available. Telehealth (Telemedicine) – Medical Services. |
| 8/3/2022 | Blue Cross Blue Shield Michigan |
CS Modifier Limited to Specific Codes That Result in COVID-19 Testing for Commercial Plans, Effective 9/1/22. READ MORE |
| 9/6/2022 | Blue Cross Blue Shield Nebraska |
BCBSNE has made an enhancement to our system which will allow DX Z23 to be in any position along with the COVID-19 vaccine charge on institutional claims effective with DOS 9/15/22 and forward. BCBSNE will no longer require the COVID-19 vaccines to be billed on a separate claim when Z23 is the primary diagnosis. READ MORE |
| 2/17/2021 | Blue Cross Blue Shield New Mexico |
Blue Cross has updated the standard non-RVU fee schedule for COVID-19 testing as follows in accordance with the member’s benefit plan for all lines of business. READ MORE |
| 4/16/2021 | Blue Cross Blue Shield New York Empire |
Clarification for COVID-19 Vaccine and Monoclonal Antibody Treatment Reimbursement for Commercial and Medicare Advantage Lines of Business. READ MORE |
| 8/18/2022 | Blue Cross Blue Shield North Carolina |
UPDATE - Blue Cross North Carolina Extends Telehealth Policy Through December 31, 2022. |
| 3/22/2022 | Blue Cross Blue Shield Texas |
Not Covered: Testing for surveillance reasons is not eligible for coverage. Including: If testing a member for surveillance reasons, unless they have symptoms or have a known or suspected exposure to COVID-19, claims for such testing are not eligible for reimbursement and should not be submitted. |
| 8/31/2022 | BCBS Texas Medicaid |
UPDATE - In continued response to COVID-19, the Texas Health and Human Services Commissions (HHSC) is extending the authorization of the below procedure codes through September 30, 2022, unless the federal public health emergency ends sooner. READ MORE 8/31/2022 - Per the Texas Health and Human Services Commission , we will continue to waive CHIP co-payments for medical office visits only through September 30, 2022, unless the federal public health emergency ends sooner. READ MORE 8/30/2022 - For dates of service on or after July 13, 2022, the U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) of the vaccine administration procedure codes 0041A and 0042A for the administration of the first and second dose of the Novavax COVID-19 vaccine as benefits of Medicaid and CHIP for individuals 18 years of age and older. READ MORE 8/19/2022 - For dates of service on or after June 17, 2022, the U.S Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) of the vaccine administration procedure codes 0091A, 0092A, and 0093A, for the administration of the Moderna COVID-19 vaccine as benefits of Medicaid and CHIP for individuals 6 through 11 years of age. READ MORE 8/19/2022 - For dates of service on or after June 17, 2022, the U.S Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) of the Pfizer-BioNTech and Moderna vaccines. READ MORE
|
| 6/30/2022 | Blue Cross Blue Shield Vermont |
Provider News and Updates. June 30, 2022. READ MORE COVID Vaccine and Administration for Pediatric Patients Age 6 months to 4 years. As of July 1, 2022 are billable. The codes for these services are 91308, 0081A, 0082A and 0083A. The eligibility of these services will be retroactive to June 17, 2022 the date the CDC approve the use of these services. |
| 6/8/2022 | Blue Cross of Idaho |
UPDATE - COVID-19 Treatment Update 6/8/22. Effective service dates on or after August 1, 2022, claims for COVID-19 treatment will be processed under a normal medical benefit subject to full member cost share in the form of deductibles, copays, and coinsurance amounts. This applies to all Blue Cross of Idaho member contracts. READ MORE COVID-19 Prior Authorizations & Pharmacy Coverage Updates 6/8/22. Prior Authorizations & Referrals. READ MORE |
| 6/22/2021 | Blue Shield of California |
IPA/Medical Groups Financially Responsible for COVID-19 Testing Costs for HMO Commercial Plan Members, Effective 8/1/2021. READ MORE |
| 6/15/2022 | Buckeye Health Plan |
The Ohio Medicaid Managed Care Plans have decided to continue to extend the temporary payment policy allowing for reimbursement to non-VFC providers for both the toxoid and the administration of needed immunizations for children and adolescents ages 0-20 years old. This policy will take effect for dates of service beginning on 01/01/2022 and will continue through 12/31/2022. READ MORE |
| 4/15/2022 | CareFirst BCBS |
CareFirst Provider Newsletter April 2022: CMS Adds Place of Service 10. READ MORE |
| 7/15/2022 | CareSource Ohio |
COVID-19 Ohio Medicaid Provider News 7/14/22. Ohio managed care plans (MCPs) will continue the enhanced vaccine administration payment program. The COVID-19 vaccine administration fees will continue to be paid at $100 as part of the provider enhanced reimbursement program. This is applicable for dates of service starting November 1, 2021 through November 30, 2022. READ MORE |
| 3/16/2021 | Centene |
Centene's Medicaid, Medicare Advantage, and Marketplace members can access COVID-19 vaccines at no cost as they become available to them in accordance with state and federal (CMS) requirements and timelines. READ MORE |
|
5/6/2022
|
CGS Administrators - J15 A/B |
CGS Medicare Claims Processing Log. Issue - Some COVID codes were set up incorrectly. Claims were denied in error for referring physician, or the physician was not eligible to bill the service. Also, some claims applied deductible and co-insurance incorrectly. READ MORE
|
| 9/15/2022 | Centers for Medicare & Medicaid Services (CMS) |
UPDATE - MLN Connects 9/15/2022. Make Your Voice Heard Request for Information Seeks Public Comment to Promote Efficiency, Reduce Burden, & Advance Equity within CMS Programs. 9/12/2022 - MLN Connects 9/12/22. Updated COVID-19 Vaccines Providing Protection Against Omicron Variant Available at No Cost. READ MORE 9/9/2022 - MLN Matters MM12885 October 2022 Update of the Hospital Outpatient Prospective Payment System (OPPS). READ MORE 9/1/2022 - MLN Connects 9/1/22. COVID-19: Novavax Vaccine Authorized for Patients 12–17 Years Old. READ MORE 8/18/2022 - MLN Connects/Special Edition 8/18/22. Creating a Roadmap for the End of the COVID-19 Public Health Emergency. READ MORE 8/16/2022 - COVID-19 FAQs on Medicare FFS Billing (Updated 8/16/22). READ MORE >>>Click here for past updates, MLN Newsletters, Webinar recordings, etc. |
| 8/18/2022 | Cigna |
UPDATE - Network News for Providers 3rd Q 2022. Virtual Care Services Should Now Be Billed With POS Code 02. 8/4/2022 - On July 15, 2022, the Secretary of Health and Human Services (HHS) renewed the national public health emergency (PHE) period for COVID-19 through October 13, 2022. Consistent with the new end of the PHE period, Cigna has extended cost-share waivers for COVID-19 diagnostic testing and related office visits through October 13, 2022. READ MORE |
| 7/1/2022 | Colorado Medicaid |
Provider News Bulletin for July 2022 - Physician Services, All COVID-19 Vaccine Providers. New COVID-19 Vaccine Counseling Visits for Adults and Children. On June 8, 2022, the Centers for Medicare & Medicaid Services (CMS) released stand-alone Medicaid & Children’s Health Insurance Program (CHIP) vaccine counseling Healthcare Common Procedure Coding System (HCPCS) codes. Codes will be loaded into the claims processing system and updating rates. Providers should wait until the system is updated to bill the new codes. Communication will be issued once the codes are ready. |
| 2/17/2021 | Connecticare | Commercial and Medicare Advantage - Updated policy to include CPT Code U0005 new code effective 1/01/2021. READ MORE |
| 2/17/2021 | Connecticut Medicaid |
Add-on procedure code U0005 will be added to the laboratory fee schedule and priced at $25.00. The add-on code U0005 was created to be billed in combination with procedure codes U0003 or U0004 only when providers meet the specific criteria outlined by CMS. READ MORE |
| 2/17/2021 | Emblem Health | COVID-19 News. Effective Date: February 11, 2021, U0005 should be listed separately in addition to either HCPCS code U0003 or U0004. READ MORE |
| 3/16/2021 | Empire BCBS | Empire BCBS will cover the cost of the COVID-19 vaccine. Empire members won’t have out-of-pocket costs for the vaccine during the national public health emergency. READ MORE |
| 9/13/2022 | Excellus BCBS New York |
UPDATE - COVID-19 News/Regulatory Time Frames. As we receive updates from New York state or the federal government, we will refresh this information. READ MORE
8/29/2022 - Resumption of Utilization Review Requirements Suspended Under NYS Executive Order #4. Audience: Participating Hospitals. Note: If your NYS-approved certification to suspend preauthorization requirements has already ended at your request, please disregard this message. READ MORE |
| 9/14/2022 | First Coast Service Options - JN A/B |
UPDATE - COVID-19 Vaccines and Administration -updated 9/14/22 for Part B Providers. This article will assist Medicare Part B providers with proper billing relating to COVID-19 vaccine and monoclonal antibody infusion. Beneficiary coinsurance and deductible are waived. READ MORE 2022 Payment Rates for COVID-19 Vaccine and Monoclonal Administration (updated 9/14/22). CMS established national payment allowances for the administration of COVID-19 vaccines and monoclonal antibodies. These allowances will be geographically adjusted for many providers. READ MORE |
| 3/16/2021 | Florida Blue | Florida Blue is waiving all copays, deductibles, and coinsurance for the administration of the COVID-19 vaccine for members. The vaccine will be available at $0 cost share to members with employer health plans, individual plans, and Medicare Advantage plans. READ MORE |
| 11/1/2022 | Food and Drug Administration (FDA) |
UPDATE - The FDA revised the emergency use authorizations (EUAs) of all COVID-19 antigen tests. READ MORE 9/27/2022 - FDA Updates COVID-19 Test Policy, Encourages Developers to Seek Traditional Premarket Review for Most Test Types. READ MORE 9/13/2022 - FDA Roundup: The FDA reissued the Aug. 19, 2022, letter of authorization for Novavax COVID-19 Vaccine, Adjuvanted to revise the conditions of authorization related to the Vaccine Adverse Event Reporting System (VAERS) reporting requirements for vaccination providers and Novavax, Inc. to include myocarditis and pericarditis. The letter of authorization and revised fact sheet are available on the FDA’s website. READ MORE COVID-19 Update 8/31/22. The U.S. Food and Drug Administration amended the emergency use authorizations (EUAs) of the Moderna COVID-19 Vaccine and the Pfizer-BioNTech COVID-19 Vaccine to authorize bivalent formulations of the vaccines for use as a single booster dose at least two months following primary or booster vaccination. READ MORE 8/29/2022 - The U.S. Food and Drug Administration announced the removal of N95 respirators from the agency’s medical device shortage list, signaling that demand or projected demand for this type of face protection device commonly used in health care settings no longer exceeds the supply. READ MORE 8/26/2022 - FDA provided additional guidance to help prescribers evaluate potential drug interactions when using Paxlovid therapy for COVID-19. READ MORE 8/19/2022 - FDA Roundup 8/19/22. The FDA authorized the emergency use of Novavax COVID-19 Vaccine. READ MORE 8/18/2022 - Report: FDA's Work to Combat the COVID-19 Pandemic. Outlines much of the broad range of work the FDA is undertaking to combat the COVID-19 pandemic and prepare for future emergencies. READ MORE |
| 7/5/2022 | Georgia Medicaid |
Preparing for the end of the Federal Public Health Emergency. The Georgia Department of Human Services is preparing for redeterminations of Medicaid beneficiary eligibility by asking all clients to update their account information. This is the first step in the process to ensure eligible clients keep their coverage when the federal public health emergency (PHE) ends. READ MORE |
| 4/22/2022 | Hawaii Medical Service Association (HMSA) BCBS |
COVID-19 FAQ and coding guide. READ MORE |
| 10/13/2022 | Department of Health & Human Services (HHS) |
UPDATE - HHS renews COVID-19 public health emergency for 90 days. READ MORE 9/7/2022 - Statement from HHS Secretary Xavier Becerra on CDC’s Recommendation of An Updated COVID-19 Vaccine. READ MORE 8/3/2022 - Biden-Harris Administration Releases Two New Reports on Long COVID to Support Patients and Further Research. READ MORE |
| 4/16/2021 | HHS OIG (Office of Inspector General) |
Coronavirus (COVID-19) Update: FDA Revokes Emergency Use Authorization for Monoclonal Antibody Bamlanivimab. READ MORE |
| 4/8/2022 | Highmark |
Special eBulletin for Professional and Facility Providers. Beginning April 11, 2022, Highmark is introducing a new Interactive Voice Response (IVR) for Inpatient Planned Authorizations to expedite and enhance authorization requests. READ MORE |
| 7/27/2022 |
Horizon Blue Cross Blue Shield |
COVID-19: Referral Requirements for Services Not Related to COVID-19. Horizon encourages you to review the item recently posted to our COVID-19 Information section. |
| 8/19/2022 | HRSA - Health Resources & Services Administration |
UPDATE - HRSA eNews 8/18/22. HRSA Telehealth Learning Series. Join our upcoming webinar on telehealth and broadband funding and resources on Tuesday, August 30, 2 p.m. ET. READ MORE |
|
8/3/2022 |
Humana |
UPDATE - An important message regarding Humana’s COVID-19 response: COVID-19 VACCINE FAQs READ MORE |
| 10/13/2021 | Humana Alabama |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 10/13/2021 | Humana Alaska |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 3/16/2022 | Humana Arizona |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 3/2/2022 | Humana Arkansas |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 1/12/2022 | Humana Colorado |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 1/19/2022 | Humana Delaware |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 9/29/2021 | Humana Florida |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 8/11/2021 | Humana Florida Medicaid Long Term Care |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 10/6/2021 | Humana Georgia |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 12/8/2021 | Humana Idaho |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 9/22/2021 | Humana Illinois |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 3/2/2022 | Humana Indiana |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 1/19/2022 | Humana Kansas |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 3/2/2022 | Humana Kentucky |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 10/13/2021 | Humana Louisiana |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 9/15/2021 | Humana Medicare Advantage, Commercial and Medicaid Products |
Humana Claims Payment Policy. READ MORE Humana Claims Payment Policy. READ MORE |
| 3/2/2022 | Humana Michigan |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 12/8/2021 | Humana Minnesota |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 10/13/2021 | Humana Mississippi |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 9/22/2021 | Humana Missouri |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 12/15/2021 | Humana Montana |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 3/2/2022 | Humana New Mexico |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 12/29/2021 | Humana New York |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 3/9/2022 | Humana North Carolina |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 11/03/2021 | Humana Ohio |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 3/2/2022 | Humana Oklahoma |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 9/29/2021 | Humana Oregon |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 10/13/2021 | Humana Tennessee |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 10/13/2021 | Humana Texas |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 3/9/2022 | Humana Utah |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 3/9/2022 | Humana Washington |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 11/17/2021 | Humana West Virginia |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 9/29/2021 | Humana Wisconsin |
An important message regarding Humana’s COVID-19 response. READ MORE |
| 8/18/2022 | Independence Blue Cross Pennsylvania |
UPDATE: COVID-19: Suspension of timely filing requirements extended. Guidance issued by the federal government requires the suspension of timely filing requirements for up to one year during the federal Public Health Emergency (PHE). The PHE is currently in effect and has now been extended through October 13, 2022. READ MORE |
| 7/1/2021 | Indiana Medicaid |
Indiana Health Coverage Programs Bulletin BT202152 7/1/2021: IHCP Rescinds Certain COVID-19 Policy Changes. READ MORE |
| 2/17/2021 | Kansas Medicaid | Effective with date of service on and after January 1, 2021,the rates for the following procedure codes which are used for COVID-19 diagnostic testing have been updated. READ MORE |
| 7/20/2022 | Medica |
Medica COVID-19 Response Provider Facts. Q - How will Medica reimburse providers for COVID-19 testing and telemedicine services? READ MORE |
| 9/14/2022 | Medi-Cal |
UPDATE - Coming Soon - Bivalent Booster Dose for Select COVID-19 Vaccines. READ MORE 9/6/2022 - ICD-10-CM Code Related to COVID-19 End-Dated. Effective for dates of service on or after April 1, 2022, the Centers for Medicare & Medicaid Services (CMS) has end-dated one ICD-10-CM code related to COVID-19. READ MORE 8/31/2022 - Pregnancy Coverage During the COVID-19 Public Health Emergency. Medi-Cal beneficiaries who are in pregnancy related, limited and restricted scope, aid codes continue to retain eligibility for non-pregnancy related services beyond the end of their postpartum period during the COVID-19 Public Health Emergency (PHE). READ MORE 8/3/2022 - Coming Soon: Novavax COVID-19 Vaccine Authorization. Medi-Cal will announce when the claims adjudication system is prepared to appropriately adjudicate submitted claims, as well as any additional instruction providers should utilize when billing for the Novavax COVID-19 vaccine in a future Medi-Cal update. READ MORE |
| 3/17/2022 | Medical Mutual of Ohio |
News Bulletin March 2022: Reimbursement Policies - Effective April 1, 2022, Medical Mutual is revising the Telemedicine Reimbursement Policy (Policy Number RP-202001). READ MORE |
| 12/1/2021 | Molina |
Molina OH Provider Bulletin/December 2021. Post-acute Authorization Requirements (for Medicare network providers). READ MORE |
| 8/1/2022 | National Government Services (NGS) - J6 A/B, JK A/B |
NGS News 8/1/22. Health and Human Services Office of Inspector General Telehealth and Potential Fraud. READ MORE |
| 6/30/2021 | National Institutes of Health (NIH) |
NIH News Post: NIH-funded screening study builds case for frequent COVID-19 antigen testing - Rapid antigen tests perform on par with lab tests when used every three days. READ MORE |
| 12/13/2021 | New York Medicaid |
UPDATE - New York State (NYS) Medicaid Billing Guidance for COVID-19 Testing, Specimen Collection and Monoclonal Antibody Infusions (updated 12/13/21). READ MORE New York State (NYS) Medicaid Pharmacy Policy and Billing Guidance for At Home COVID-19 Testing Coverage. READ MORE |
| 7/21/2022 | Noridian JE & JF |
COVID-19 Novavax Vaccine, Adjuvanted New Codes. READ MORE |
| 7/20/2022 | Novitas Solutions - JH & JL |
UPDATE - COVID-19 Vaccine: New product and administration codes for the Novavax vaccine. |
| 12/7/2020 | Ohio Department of Health |
ANTIGEN TESTING UPDATE. Governor DeWine discussed the Ohio Department of Health aligning with the Center of Disease Control and Prevention’s (CDC) current case definition. READ MORE |
| 6/25/2021 | Ohio Medicaid |
COVID-19 Vaccine Administration Billing Guidelines. Update 6/25/2021 includes: Added home infusions, additional monoclonal antibody treatments, and vaccine add-on for home administration. READ MORE |
| 9/23/2021 | Oscar | COVID-19 Update: How much will the member be charged for COVID-19 treatment? The Oscar plan will cover treatment associated with COVID-19. READ MORE |
| 8/5/2022 | Palmetto GBA - JJ A/B, JM A/B |
UPDATE: Payment Allowance Update for COVID-19 Monoclonal Antibody Therapy Q0222 Injection, Bebtelovimab, 175 mg. READ MORE |
| 4/14/2022 | Premera Blue Cross Washington State |
Premera BC COVID-19 Updates as of 4/14/22. READ MORE |
| 3/16/2021 | Providence Health Plan |
Providence Health Plan members can receive COVID-19 vaccines at no cost. READ MORE |
| 6/1/2022 | Regence BCBS Utah |
UPDATE - The Bulletin/Policy Updates. Reimbursement policies/Commercial - Changes effective June 1, 2022. READ MORE |
| 10/6/2021 | Select Health SC/First Choice |
Coronavirus Disease 2019 (COVID-19) Third Dose of Vaccine Administration Coverage. READ MORE |
| 5/18/2022 | South Carolina Medicaid |
Provider Bulletin 5/18/22. COVID-19 Temporary Policy Updates: Nurse Aide Training and Competency Evaluation and Paid Feeding Assistant Programs. READ MORE |
| 9/13/2022 | Texas Medicaid |
UPDATE - COVID-19 Vaccine Administration Procedure Codes 0041A and 0042A Age Range Has Changed to 12 Years of Age or Older. This is an update to the article titled ”COVID-19 Vaccine Administration Procedure Codes 0041A and 0042A Are Now Benefits” that was published on August 3, 2022. READ MORE 9/13/2022 - Reimbursement Rate Updates Implemented for COVID-19 Vaccine Administration Procedure Codes. Beginning August 25, 2022, for dates of service between March 11, 2021, and March 14, 2021, and for dates of service on or after March 15, 2021, the reimbursement rates for COVID-19 vaccine administration procedure codes for dental providers will be implemented for Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program. READ MORE 8/30/2022 - COVID-19: HHSC Publishes In-Home Day Habilitation Information for Program Providers (Replaces IL 2022-36). HHSC is temporarily waiving certain requirements in Section 3710, 4381.3, 4381.7(6) and 4381.7(7) of the HCS Billing Guidelines and TxHmL Guidelines because of COVID-19 and to provide access to needed day habilitation services. READ MORE 8/30/2022 - Reimbursement Rate Updates for Procedure Codes M0220 and M0221 Effective December 8, 2021. Starting January 18, 2022, for dates of service on or after December 8, 2021, reimbursement rates for COVID-19 Administration Codes M0220 and M0221 will be implemented for Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program. READ MORE 8/13/2022 - Reimbursement Rate Updates Implemented for COVID-19 Vaccine Administration Procedure Code 0041A and 0042A. READ MORE Beginning August 11, 2022, for dates of service on or after March 10, 2022, the reimbursement rates for COVID-19 vaccine administration procedure codes D1708-D1714, for dental providers, will be implemented for Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program. READ MORE Beginning June 23, 2022, for dates of service on or after May 17, 2022, the reimbursement rates for COVID-19 vaccine administration procedure code 0074A will be implemented for Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program. READ MORE Beginning August 11, 2022, for dates of service on or after July 13, 2022, reimbursement rates for COVID-19 vaccine administration procedure codes 0041A and 0042A will be implemented for Texas Medicaid, the Children with Special Health Care Needs (CSHCN) Services Program, Healthy Texas Women (HTW), and the Family Planning Program (FPP). 8/9/22 - Reimbursement Rate Updates for COVID-19 Vaccine Administration Procedure Code 0094A. READ MORE 8/4/22 - Effective June 17, 2022, Reimbursement Rate Updates Implemented for COVID-19 Vaccine Administration Procedure Codes. READ MORE 8/4/22 - American Rescue Plan Act (ARPA) Home and Community-Based Services (HCBS) Provider Retention Payments. READ MORE 8/3/22 - COVID-19 Vaccine Administration Procedure Codes 0041A and 0042A are now Benefits. Effective for dates of service on or after July 13, 2022, in accordance with the U.S. Food and Drug Administration’s Emergency Use Authorization, COVID-19 vaccine administration codes 0041A and 0042A are benefits of Medicaid, Healthy Texas Women (HTW), the Family Planning Program (FPP), and the Children with Special Health Care Needs (CSHCN) Services Program for the administration of the first and second dose of the primary series of the Novavax COVID-19 vaccine to individuals 18 years of age and older. READ MORE 8/3/2022 - Update to Provider Enrollment Revalidation Extensions to End Due to COVID-19 PHE. This is an update to the article titled “Provider Enrollment Revalidation Extensions to End on February 28, 2022,” which was posted on this website on November 1, 2021. READ MORE 8/1/2022 - This is an update to the article titled “Suspension of Payment for Not Submitting the Required SB 809 Rider 143 Reports” that was posted on this website on July 20, 2022. The suspension of payment will not begin on August 12, 2022, as was previously communicated.
|
| 6/24/2022 | Tricare East |
UPDATE: TRICARE updated its telemedicine Place of Service (POS) codes for dates of service on or after Jan 1, 2022, and included adding POS 10 to the telehealth codes. READ MORE 3/29/2022 - Provider News 4/1/22. COVID-19 Test to Treat Initiative. READ MORE |
| 8/31/2022 | Tricare West |
UPDATE - Temporary Program Changes in Response to COVID-19 Pandemic. In 2020, in response to the COVID-19 pandemic, the Department of Defense (DOD) implemented many temporary changes to the TRICARE benefit, ranging from increased reimbursement for COVID-19 inpatient stays to covered audio-only office visits to copayment/cost-share waivers for covered telehealth services. The DOD has since published updates to the TRICARE manuals that terminate, modify or keep in place some of the temporary changes. Regional contractors will be implementing these changes on Sept. 6, 2022. READ MORE 8/4/2022 - Tricare West Provider News August 2022. COVID-19 Updates: Billing Reminders and Boosters. READ MORE |
| 6/24/2022 | UnitedHealthcare (UHC) |
UHC News 6/24/22. Louisiana: Telehealth changes to COVID-19 temporary measures. The Louisiana Department of Health (LDH) revised the COVID-19 Informational Bulletin 20-5 on May 6, 2022. |
| 9/28/2020 | UMR | COVID-19 Vaccine Update. READ MORE |
| 3/16/2021 | UPMC Health Plan | UPMC Health Plan is covering the COVID-19 vaccine as a preventive service at no cost to members. READ MORE |
| 6/10/2022 | Washington State Medicaid/Apple Health |
Provider Alert 6/10/22. Audio-only behavioral health service codes. This message is intended as follow-up to the April 1, 2022 HCA Issue #29453 regarding HCA publishing audio-only telemedicine billing codes. READ MORE |
| 8/1/2020 | WellCare |
We intend to cover COVID-19 testing and screening services for Medicare members and are waiving all associated member cost share amounts for COVID-19 testing and screening. READ MORE |
| 3/16/2021 | Wellmark |
Wellmark BCBS will cover COVID-19 vaccinations with no member cost-sharing payments, deeming it a preventive service under the ACA. READ MORE |
| 6/27/2022 | WPS Government Health Administrators - J5 A/B, J8 A/B |
Increase in the COVID-19 Accelerated and Advance Payment (CAAP) Recovery Rate. READ MORE |