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.  

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Latest Updates

Indicates most recent updates 

Last Update Payers and Organizations Overview
6/15/2022 Aetna

Aetna OfficeLink Updates for June. Update to the Telehealth Place of Service (POS) Code. Telehealth continues to be an integral part of providing safe and convenient health care visits for Medicare Advantage beneficiaries. READ MORE 

>>>Click here to read past updates

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 

>>>Click here to read past updates

3/2/2022 Amerigroup

COVID-19 information (February 2022 update). READ MORE 

>>>Click here to read past updates

5/20/2021 Amerigroup Medicare Advantage Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQREAD 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 

7/15/2022 Anthem California

California Department of Managed Health Care All Plan Letter 22-017 on the coverage of COVID-19 therapeutics. READ MORE
On June 14, 2022, the California Department of Managed Health Care issued All Plan Letter (APL 22‑017) to provide guidance on how commercial health plans are expected to comply with requirements to cover COVID-19 therapeutics. This notification is to inform network providers that at Anthem Blue Cross (Anthem), COVID-19 therapeutics are covered services when medically necessary to treat an enrollee.

>>>Click here to read past updates

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

6/1/22 - Medicare News 6/1/22. Provider Notice for COVID-19 Testing. Evaluation and management services for COVID testing — professional. READ MORE 
Effective with dates of service on or after September 1, 2022, Anthem Blue Cross (Anthem) 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.

>>>Click here to read past updates

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 
Effective with dates of service on or after September 1, 2022, Anthem Blue Cross (Anthem) 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.

>>>Click here to read past updates

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

6/1/22 -Medicare News 6/1/22. Provider Notice for COVID-19 Testing. Medicare Advantage - This communication applies to the Commercial and Medicare Advantage programs from Anthem Blue Cross and Blue Shield (Anthem). READ MORE 

>>>Click here to read past updates

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

6/1/22 - Medicare News 6/1/22. Provider Notice for COVID-19 Testing. Medicare Advantage - This communication applies to the Commercial and Medicare Advantage programs from Anthem Blue Cross and Blue Shield (Anthem). READ MORE 

 >>>Click here to read past updates

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

6/1/22 - Medicare News 6/1/22. Provider Notice for COVID-19 Testing. Medicare Advantage - This communication applies to the Commercial and Medicare Advantage programs from Anthem Blue Cross and Blue Shield (Anthem). READ MORE 

>>>Click here to read past updates

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

6/1/22 - Medicare News 6/1/22. Evaluation and management services for COVID testing - professional. Effective with dates of service on or after September 1, 2022, AMH Health, LLC. 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.
READ MORE

>>>Click here to read past updates

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

6/1/22 - Medicare News 6/1/22. Evaluation and management services for COVID testing - professional. This communication applies to the Medicaid and Medicare Advantage programs for Anthem Blue Cross and Blue Shield (Anthem). READ MORE 

>>>Click here to read past updates

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

6/1/22 - Medicare News 6/1/22. Evaluation and management services for COVID testing - professional. This communication applies to the Medicaid and Medicare Advantage programs for Anthem Blue Cross and Blue Shield (Anthem). READ MORE 

>>>Click here to read past updates

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

6/1/22 - Medicare News 6/1/22. Evaluation and management services for COVID testing - professional. Effective with dates of service on or after September 1, 2022, Anthem 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. READ MORE 

>>>Click here to read past updates

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
Effective with dates of service on or after September 1, 2022, Empire 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.

Medicare News 6/1/2022. 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, Empire BlueCross BlueShield (Empire) 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.

>>>Click here to read past updates

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

6/1/22 - Medicare News 6/1/22. Evaluation and management services for COVID testing - professional. This communication applies to the Medicaid and Medicare Advantage programs for Anthem Blue Cross and Blue Shield (Anthem). READ MORE

>>>Click here to read past updates

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

6/1/22 - Provider notice for COVID-19 testing for Medicaid. Please note, this communication applies to Anthem HealthKeepers Plus, Medallion and Anthem HealthKeepers Plus, Commonwealth Coordinated Care Plus (Anthem CCC Plus) offered by HealthKeepers, Inc.
READ MORE 

Medicare news 6/1/22. Provider notice for COVID-19 testing. This communication applies to the Medicare Advantage program from Anthem Blue Cross and Blue Shield (Anthem). READ MORE 

>>>Click here to read past updates

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

6/1/22 - UPDATE - Medicaid News 6/1/22. Evaluation and management services for COVID testing - professional. This communication applies to the Medicaid and Medicare Advantage programs for Anthem Blue Cross and Blue Shield (Anthem). READ MORE 

Medicare News 6/1/22. Evaluation and management services for COVID testing - professional. This communication applies to the Medicaid and Medicare Advantage programs for Anthem Blue Cross and Blue Shield (Anthem). READ MORE

>>>Click here to read past updates

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

>>>Click here to read past updates

6/15/2021 Blue Cross Blue Shield
Arkansas

COVID-19 Update June 2022. Status of COVID-19 expanded benefits. READ MORE 
At the outset of the COVID-19 public health emergency, Arkansas Blue Cross and Health Advantage temporarily extended a number of voluntary, expanded COVID-19-related benefits and suspended some of our normal practices. Of course, those measures covered under federal mandates will remain in force until federal officials advise that they may be discontinued. 

>>>Click here to read past updates

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 

>>>Click here to read past updates

7/20/2022

Blue Cross Blue Shield
Florida

UPDATE - The Federal Public Health Emergency has been extended through October 13, 2022. READ MORE 

7/7/2022 - We have made updates to our monoclonal antibody coverage on the latest government guidance. READ MORE 
For Commercial plan patients, if your facility provides monoclonal antibody treatment for COVID-19, please bill Florida Blue for covered infusion therapy for the administration only using the appropriate CPT code. The drug should not be billed as it is provided by the government. Your Florida Blue patients will be responsible for their normal cost share. 


>>>Click here to read past updates

6/15/2022 Blue Cross Blue Shield
Illinois

We're Collecting Telehealth Information for Our Provider Directories. READ MORE 

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6/30/2022 Blue Cross Blue Shield
Massachusetts

Updated Payment Policies Now Available. Telehealth (Telemedicine) – Medical Services.
READ MORE 

>>>Click here to read past updates

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 

>>>Click here to read past updates

3/31/2022 Blue Cross Blue Shield
Nebraska

COVID-19 extensions are being extended through September 30, 2022. READ MORE 
Please be advised of the following: Temporarily suspending the requirement for a NE license if they are in good standing and free from disciplinary action in the state(s) where they are licensed. 

>>>Click here to read past updates

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 

>>>Click here to read past updates

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 

>>>Click here to read past updates

8/2/2022 Blue Cross Blue Shield
North Carolina

UPDATE - Blue Cross North Carolina Extends Telehealth Policy Through December 31, 2022. READ MORE 

7/29/2022 - Coding for Vaccine Counseling and Separate Vaccine Administration and Counseling Codes. READ MORE 

>>>Click here to read past updates

3/22/2022 Blue Cross Blue Shield
Texas

Not Covered: Testing for surveillance reasons is not eligible for coverage.
READ MORE 

Including:
• Return to Work
• School requirements
• Travel requirements
• Recreational requirements

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.

 >>>Click here to read past updates

7/26/2022 BCBS Texas Medicaid

COVID-19 Moderna Vaccine Administration Codes 0011A, 0012A, and 0013A, for Ages 12 and Older. READ MORE 

>>>Click here to read past updates

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

>>>Click here to read past updates

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 

>>>Click here to read past updates

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 

 >>>Click here to read past updates

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 

>>>Click here to read past updates

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

  • Provider Type Impacted - Physicians, Lab
  • Claim Coding Impact - CPT codes 86408, 86409, 86413, 87426, 87811 and 0226U
  • MAC Action - The codes were updated
  • Provider Action - None Proposed
  • Resolution - A mass adjustment will be done for the claims that were processed incorrectly.
  • Status - Resolved
  • Date Resolved - 5/6/2022
  • Date Reported - 5/3/2022

>>>Click here to read past updates

7/21/2022 Centers for Medicare & Medicaid Services (CMS)

UPDATE - MLN Connects 7/21/22. COVID-19: Novavax Vaccine, Adjuvanted — New Codes. The FDA authorized emergency use of the Novavax COVID-19 vaccine, Adjuvanted for the prevention of COVID-19 disease in patients 18 years and older. READ MORE 

7/14/2022 - MLN Connects 7/14/22. COVID-19: FDA Authorizes Pharmacists to Prescribe PAXLOVID with Certain Limits. READ MORE 

7/14/2022 - COVID-19: Moderna Vaccines for Children as Young as 6 Months — New Codes. The FDA amended the Moderna COVID-19 vaccine emergency use authorization (PDF) to authorize use for all patients 6 months – 17 years old. READ MORE 

7/7/2022 - MLN Connects 7/7/22. Long COVID: Use ICD-10 Code U09.9. READ MORE

MLN Connect 7/7/22. Publications: Teaching Physicians, Interns, & Residents Guidelines — Revised. READ MORE

>>>Click here for past updates, MLN Newsletters, Webinar recordings, etc.

8/4/2022 Cigna

UPDATE - 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 

7/28/2022 - Cigna Policy Updates for July 2022. COVID-19 Interim Billing Guidelines - Reimbursement Policy R33. Update 7/12/2022 for the following changes/updates: Policy updated to include new COVID vaccine codes: 91308, 0081A-0083A, 91311, 0111A, 0112A. Removed end date of 03/13/2022 with reinstatement of reimbursement for virtual Urgent Care services. READ MORE 

7/1/2022 - The accelerated credentialing accommodation ended on June 30, 2022. Certain virtual care services that were previously covered on an interim basis as part of our COVID-19 guidelines are now permanently covered as part of our Virtual Care Reimbursement Policy. READ MORE 

7/1/2022 - Cigna Policy Updates June 2022. READ MORE 

>>>Click here to read past updates.

7/1/2022 Colorado Medicaid

Provider News Bulletin for July 2022 - Physician Services, All COVID-19 Vaccine Providers.
READ MORE 

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 
7/20/2022 Excellus BCBS New York

UPDATE - COVID-19 News/Regulatory Time Frames. READ MORE 

  • The Federal Public Health Emergency has been extended to 10/13/2022. This governs COVID-related telehealth services and testing/visits, out-of-network vaccine coverage, and the DRG reimbursement increase.
  • The NYS Emergency Regulation on Testing/Visits has been extended to 9/9/2022. This governs the cost-share waiver for testing, diagnosis, and office/emergency room visits, and telehealth when the purpose is to diagnose COVID-19.

7/14/2022 - Telemedicine and Telehealth Administrative Policy 22 Part III for All Providers. Excellus BlueCross BlueShield is updating the following administrative policy effective November 1, 2022, to further define coverage and billing guidelines under Telemedicine and Telehealth Part III. READ MORE 

7/6/2022 - Performant Outpatient Complex Chart Audit Program Update 7/6/22 for all Participating Providers and Facilities. READ MORE 

>>>Click here to read past updates

7/22/2022 First Coast Service Options - JN A/B

UPDATE - COVID-19 Vaccines and Administration -updated 7/22/22 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 

Fee Schedule News 7/22/22 for Part A & B Providers. 022 payment rates for COVID-19 vaccine and monoclonal administration. READ MORE 

7/15/2022 - COVID-19 Vaccines and Administration/Updated 7/15/22 for Part B Providers.
READ MORE 

>>>Click here to read past updates

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 
7/29/2022 Food and Drug Administration
(FDA)

UPDATE - FDA Roundup 7/29/22. The FDA updated the FAQs on Testing for SARS-CoV-2 to note that no tests remain on the commercial manufacturer serology test notification list described in the FDA’s Policy for Coronavirus Disease-2019 Tests. All tests previously on the commercial manufacturer serology test notification list have either been issued an Emergency Use Authorization or should no longer be distributed, marketed, or offered. READ MORE 

7/26/2022 - FDA Roundup 7/26/22. COVID-19 testing updates. READ MORE 

7/19/2022 - The FDA updated the device shortage list and the device discontinuance list on the web page for Medical Device Shortages During the COVID-19 Public Health Emergency. In addition, the FDA is providing information about devices that have been removed from the device shortage list at this time. READ MORE 

The FDA updated its Supplies of Medical Devices for COVID-19: Frequently Asked Questions web page to provide information about how the FDA determines to remove product codes from the device shortage list and what the FDA is doing to help medical device manufacturers with the global shortage of semiconductor chips. READ MORE 

7/15/2022 - The FDA updated the SARS-CoV-2 Viral Mutations: Impact on and COVID-19 Tests web page to include information about genotyping tests authorized for the identification and differentiation of specific SARS-CoV-2 mutations, lineages or variants. READ MORE 

The FDA authorized another over-the-counter (OTC) at-home COVID-19 antigen test. The Genabio COVID-19 Rapid Self-Test is an OTC COVID-19 antigen diagnostic test that shows results in 15 minutes. READ MORE 

The FDA authorized another over-the-counter (OTC) at-home COVID-19 antigen test. The Watmind Speedy Swab Rapid COVID-19 Antigen Self-Test is an OTC COVID-19 antigen diagnostic test that shows results in 15 minutes. READ MORE 

7/8/2022 - COVID-19 Update 7/13/22. The U.S. Food and Drug Administration issued an emergency use authorization (EUA) for the Novavax COVID-19 Vaccine, Adjuvanted for the prevention of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in individuals 18 years of age and older. READ MORE 

The FDA approved COMIRNATY (COVID-19 Vaccine, mRNA) for active immunization to prevent Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in individuals 12 through 15 years of age. READ MORE 

The FDA will continue hosting virtual town halls for test developers for SARS-CoV-2 on July 27 and August 24 from 12:05 p.m. – 1 p.m. ET. Registration is not required. During the virtual town hall, the FDA will share information and answer questions about the development and validation of tests for SARS-CoV-2. Recordings and transcripts will be available online for viewing after the live event. READ MORE 

7/6/2022 - COVID-19 Update 7/6/22. Today, the U.S. Food and Drug Administration revised the Emergency Use Authorization (EUA) for Paxlovid (nirmatrelvir and ritonavir), to authorize state-licensed pharmacists to prescribe Paxlovid to eligible patients, with certain limitations to ensure appropriate patient assessment and prescribing of Paxlovid. READ MORE 

>>>Click here to read past updates

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

>>>Click here to read past updates

4/22/2022 Hawaii Medical Service Association (HMSA) BCBS

COVID-19 FAQ and coding guideREAD MORE

8/3/2022 Department of Health & Human Services (HHS)

UPDATE - Biden-Harris Administration Releases Two New Reports on Long COVID to Support Patients and Further Research. READ MORE 

7/29/2022 - The U.S. Department of Health and Human Services (HHS), in collaboration with the U.S. Department of Defense (DOD), today announced an agreement to purchase 66 million doses of Moderna’s bivalent COVID-19 vaccine booster candidate for potential use in the fall and winter. This contract announcement follows a recommendation by the FDA last month that vaccine manufacturers update their existing COVID-19 vaccines to create a bivalent booster that can target BA.4 and BA.5 Omicron subvariants. READ MORE 

7/19/2022 - Statement from HHS Secretary Xavier Becerra on the Authorization of Protein-Based Novavax COVID-19 Vaccine. READ MORE 

7/15/2022 - Renewal of De​​termination That A Public Health Em​ergency Exists. READ MORE 

7/11/2022 - HHS News 7/11/22. The U.S. Department of Health and Human Services (HHS), in collaboration with the Department of Defense (DOD), today announced that it has secured 3.2 million doses of Novavax’s COVID-19 vaccine. READ MORE 

>>>Click here to read past updates

4/16/2021 HHS OIG (Office of Inspector General)

Coronavirus (COVID-19) Update: FDA Revokes Emergency Use Authorization for Monoclonal Antibody Bamlanivimab. READ MORE

>>>Click here to read past updates

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 

>>>Click here to read past updates

7/27/2022

Horizon Blue Cross Blue Shield
New Jersey

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.
READ MORE 

>>>Click here to read past updates

7/27/2022 HRSA -
Health Resources & Services Administration

UPDATE - Provider Relief Fund - Reporting News. Request to Report Late Due to Extenuating Circumstances. READ MORE 

Providers who experienced one or more extenuating circumstances that prevented them from submitting a completed Provider Relief Fund (PRF) Report in Reporting Periods 1 and/or 2 (RP1 and RP2) by the deadline had the opportunity to submit a Request to Report Late Due to Extenuating Circumstance. The opportunities to submit late reports for RP1 and RP2 have passed. Providers who did not submit an RP1 report by the deadline and returned funds prior to HRSA announcing the Request to Report Late Due to Extenuating Circumstances process have a one-time opportunity to have their RP1 PRF payment(s) reissued. The projected window for report submissions is August 22 to September 9, 2022.

7/14/2022 - Provider Relief Fund - Reporting Requirements and Auditing. Reporting Period 3 Is Open. READ MORE 

7/6/2022 - Provider Relief Fund - Reporting Requirements. Need Help With Reporting? We have detailed answers to common questions related to reporting requirements and auditing. Read the Reporting and Auditing FAQ. READ MORE 

>>>Click here to read past updates

8/3/2022

Humana

UPDATE - An important message regarding Humana’s COVID-19 response: COVID-19 VACCINE FAQs READ MORE 

7/27/2022 - An important message regarding Humana’s COVID-19 response: COVID-19 VACCINE FAQs READ MORE 

7/13/2022 - An important message regarding Humana’s COVID-19 response: COVID-19 VACCINE FAQs READ MORE 

>>>Click here to read past updates

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 
Subject: COVID-19 Vaccine
Published date: 12/23/2020
Policy number: CP2020004
Revision date: 09/10/2021
Related policies: COVID-19 Related Coding

Humana Claims Payment Policy. READ MORE 
Subject: COVID-19 Related Coding
Application: Medicare Advantage, Commercial and Medicaid Products
Published date: 07/2020
Policy number: CP2020001
Revision date: 09/2021
Related policies: COVID-19 Vaccine; Original Medicare Payment for Some COVID-19 Treatments; Telehealth and Other Virtual Services During the COVID-19 PHE.

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 

6/6/2022 Independence Blue Cross Pennsylvania

Change to Medicare Advantage Inpatient Hospital Readmission claim payment policy. READ MORE

>>>Click here to read past updates

7/1/2021 Indiana Medicaid

Indiana Health Coverage Programs Bulletin BT202152 7/1/2021: IHCP Rescinds Certain COVID-19 Policy Changes. READ MORE 

>>>Click here to read past updates

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 

8/3/2022 Medi-Cal

UPDATE - 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 

7/29/2022 - New Approval Messages for COVID-19 Uninsured Group User Guide. Effective August 3, 2022, the approval messages for individuals granted COVID-19 Uninsured Group (UIG) coverage will be updated. The update provides additional information for beneficiaries on ways to apply for full coverage and removes the reference to a 12-month limit for COVID UIG program eligibility.
READ MORE 

7/25/2022 - FDA Approves COVID-19 Vaccine for Children 6 Months and Up. Effective for dates of service on or after June 17, 2022, the U.S. Food and Drug Administration (FDA) amended the Emergency Use Authorizations (EUA) for the Pfizer-BioNTech and Moderna COVID-19 vaccines. READ MORE 

7/22/2022 - Coming Soon: Hospital and Skilled Nursing Facility COVID-19 Worker Retention Payments. On June 30, 2022, Governor Newsom signed legislation aimed at stabilizing and retaining California’s health care workforce and managing the COVID-19 pandemic, through the issuance of worker retention payments. As a result, many workers in qualifying facilities will soon be eligible to receive a retention payment. READ MORE 

7/19/2022 - Update: FQHC, RHC and Tribal FQHC Providers Claim Submission for COVID-19 Vaccine Administration. READ MORE
Medi-Cal has also extended the timeliness requirement waiver to October 14, 2022. For information, please refer to the original article “FQHC, RHC and Tribal FQHC Providers May Now Submit Claims for COVID-19 Vaccine Administration”, dated April 15, 2022.

7/14/2022 - PHE Telehealth Policy Clarification for Medication Abortion: HCPCS Code S0199.
READ MORE 

>>>Click here to read past updates

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

>>>Click here to read past updates

12/1/2021 Molina

Molina OH Provider Bulletin/December 2021. Post-acute Authorization Requirements (for Medicare network providers).  READ MORE

>>>Click here to read past updates

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 

>>>Click here to read past updates

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 

>>>Click here to read past updates

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 

>>>Click here to read past updates

7/21/2022 Noridian JE & JF

COVID-19 Novavax Vaccine, Adjuvanted New Codes. READ MORE

>>>Click here to read past updates

7/20/2022 Novitas Solutions - JH & JL

UPDATE - COVID-19 Vaccine: New product and administration codes for the Novavax vaccine.
READ MORE 

7/14/2022 - COVID-19 News 7/14/22. COVID-19 Vaccines - redosing update for EVUSHELD for COVID-19. READ MORE 

>>>Click here to read past updates

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 

>>>Click here to read past updates

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

>>>Click here to read past updates

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

7/20/22 - Important Reminder: Medicare FFS Claims Payment Adjustment (Sequestration) Resumes.
READ MORE 

>>>Click here to read past updates

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 

>>>Click here to read past updates

6/1/2022  Regence BCBS Utah

UPDATE - The Bulletin/Policy Updates. Reimbursement policies/Commercial - Changes effective June 1, 2022. READ MORE 

6/1/2022 - Connections Provider Newsletter/June 2022. COVID-19 updates. READ MORE 

>>>Click here to read past updates

10/6/2021 Select Health SC/First Choice 

Coronavirus Disease 2019 (COVID-19) Third Dose of Vaccine Administration Coverage. READ MORE 

>>>Click here to read past updates

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

>>>Click here to read past updates

8/9/2022 Texas Medicaid

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.
READ MORE 

7/29/2022 - COVID-19 Vaccine Administration Procedure Codes 0081A, 0082A, 0083A, 0111A, 0112A, and 0113A Are Now Benefits for Medicaid and CSHCN . Effective for dates of service on or after June 17, 2022, COVID-19 vaccine administration procedure codes 0081A, 0082A, 0083A, 0111A, 0112A, and 0113A are benefits of Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program. READ MORE 

7/28/2022 - American Rescue Plan Act (ARPA) Home and Community-Based Services (HCBS) Provider Retention Payments. The Texas Health and Human Services Commission (HHSC) implements American Rescue Plan Act (ARPA) Home and Community-Based Services (HCBS) Provider Retention payments. READ MORE 

7/28/2022 - COVID-19 Vaccine Administration Procedure Codes 0091A, 0092A, and 0093A Are Now Benefits. Effective for dates of service on or after June 17, 2022, in accordance with the U.S. Food and Drug Administration amendment to the Emergency Use Authorization, COVID-19 vaccine administration codes 0091A, 0092A, and 0093A are benefits of Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program for the administration of the Moderna COVID-19 vaccine to individuals 6 through 11 years of age. READ MORE 

7/28/2022 - Screening of Staff and Visitors Entering Nursing Facilities to Continue. The nursing facility COVID-19 Response Emergency Rule expired on July 26, 2022. However, in accordance with CMS and CDC nursing facilities must continue to screen staff and visitors. READ MORE 

7/27/2022 - HHSC Issues NF Specific COVID-19 Reporting Guidance (PL 2022-16). HHSC has published Provider Letter 2022-16 - COVID-19 Reporting Guidance for Nursing Facility Providers (PDF). READ MORE 

7/25/2022 - Novavax COVID-19 Vaccine Coverage Update. Beginning July 13, 2022, the Texas Health and Human Services Commission (HHSC) covers the Novavax COVID-19 vaccine as a payable pharmacy benefit for Medicaid and Children’s Health Insurance Program (CHIP) clients who are 18 years of age or older. The Novavax COVID-19 vaccine is given as a two-dose primary series three weeks apart. READ MORE 

7/15/2022 - Telemedicine and Telehealth Services for the HTW and HTW Plus Programs. Effective September 1, 2022, benefit information for the Healthy Texas Women (HTW) program will be updated to identify services that will remain permanent benefits when delivered through telemedicine and telehealth. READ MORE 

7/15/2022 - Telehealth Services for the Early Childhood Intervention Program. Effective September 1, 2022, benefit information for the Early Childhood Intervention (ECI) program will be updated to identify services that will remain permanent benefits when delivered through telehealth. READ MORE 

7/15/2022 - HB4 PT, OT, ST and Related Durable Medical Equipment Services: Telehealth and Exclusions. Effective September 1, 2022, the Texas Health and Human Services Commission (HHSC) will transition certain COVID-19 flexibilities to permanent guidance in line with House Bill (H.B.) 4 (87th Legislature, Regular Session, 2019). This will include some physical therapy (PT), occupational therapy (OT), and speech therapy (ST) services delivered by synchronous audiovisual technology for adults and children. READ MORE 

7/13/2022 - Reminder: Senate Bill 809/COVID-19 Monthly Reporting Requirement. READ MORE 

7/11/2022 - Moderna COVID-19 Vaccine Administration Procedure Codes 0011A, 0012A, and 0013A Age Expansion. READ MORE 

7/11/2022 - HHSC Publishes Provider Communications Prior to the End of the COVID-19 PHE. READ MORE 

7/9/2022 - New Occurrence Span Code and Revenue Code for Acute Hospital Care at Home Program.  READ MORE 

7/9/2022 - HCS COVID-19 Reporting Requirements Changed. As of June 16, Home and Community-based Services program providers are no longer required to report COVID-19 cases to HHSC.
READ MORE 

7/1/2022 - HHSC Updates the NF COVID-19 Response Plan Document June 27th. HHSC Long-term Care Regulation updated the COVID-19 Response Plan document for nursing facilities. READ MORE 

7/1/2022 - Pediatric Updates for Moderna and Pfizer-BioNTech COVID-19 Vaccines. READ MORE 

>>>Click here to read past updates

3/29/2022 Tricare East  

Provider News 4/1/22. COVID-19 Test to Treat Initiative. READ MORE

>>>Click here to read past updates

8/4/2022 Tricare West

UPDATE - Tricare West Provider News August 2022. COVID-19 Updates: Billing Reminders and Boosters. READ MORE 

7/29/2022 - West Region Telehealth Options for Your Tricare Patients. Do you offer telemedicine (also referred to as telehealth)? Let us know by submitting an updated TRICARE Provider Roster. READ MORE 

>>>Click here to read past updates

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. READ MORE 

>>>Click here to read past updates

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

>>>Click here to read past updates

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 

>>>Click here to read past updates

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 

>>>Click here to read past updates

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 

>>>Click here to read past updates

 

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