Effective April 19, 2021, the following COVID-19 monoclonal antibody codes and corresponding administration codes were added to the Medicaid Management Information System (MMIS) and can be billed with the dates of service indicated . We partnered with findhelp, a social care network that connects you with local help. background-color: #7fcdbb; FEP will now reimburse up to 8 over-the-counter COVID-19 tests per member on a contract per calendar month. Additionally, our clinical team is actively monitoring external queries and reports from the Centers for Disease Control and Prevention to help us determine what, if any, action is necessary on our part to further support our stakeholders. Plus, we will keep you updated as things develop. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. The best way to prevent infection is to avoid being exposed to the virus. O|bW7{}OH>d_O }N]1W#oFPt#Qg: zM/_5+kL#w9>!:Oy}QqywW}?7yAy}<7G4b0HR=DY7p#K7mw.p'E++PJ"1%uOt_{;t:GU/6q 7+n[Vg tTsk9EEML2`S2UJbpzGoKQ""J_/RkGx\&!^xY?Ej Vf!Yf \GE,w y-sML5/792d.6NL-8zRT-]B[t-Z9zMK.% 5zOeGOOZ.5,f.kvVdQ[ehY0$h If you can't use soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol. Visit BCBS.com to see how BCBS companies are providing support to communities, providers and members during the COVID-19 pandemic. 2021copyright of Anthem Insurance Companies, Inc. Anthem Blue Cross and Blue Shield Healthcare Solutions is the trade name of Community Care Health Plan of Nevada, Inc., an independent licensee of the Blue Cross and Blue Shield Association. Are there any in-network or out-of-network limitations on these guidelines? Serving California. } If you have a Medicaid plan with us, you do not have to pay anything for the COVID-19 test or the doctor visit to get the test. How does my plan cover the over-the-counter test? We will waive cost sharing requirements for urgent care, telehealth and office visits to screen or determine whether COVID-19 testing is needed, when received from an in-network provider, or if no in-network provider is reasonably available, then from an out-of-network provider. If you have any questions, please contact the Provider Service number on the back of the members ID card, or your Provider Solutions contact on our Escalation Contact List. They also are for people who have no symptoms but know or suspect that they have recently been exposed to someone who has COVID-19. Similar to a cold or the flu. Cost share waiver extends to the end of the public health emergency. They are for people who have no symptoms of COVID-19 and no known or suspected exposure to people who have COVID-19. After that time, standard Medicare and Medicare Supplement cost sharing and coverage will apply. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. The cost of COVID-19 FDA-approved vaccines will initially be paid for by the government. margin-bottom: 40px; We are fielding questions about the outbreak from our customers, members, providers and associates. Learn more about COVID-19, including what you can do to prevent the spread of the disease and ways to stay healthy. Are there any prescription drugs that can be used to treat COVID-19? Arrive in 2 to 5 business days. What Are Your Thoughts On The Vaccines Against Covid-19? Heres everything you need to know about it. Findings. hb```e`` B@9 e'0w0i4bH) 3g2Ofaf~.j1* 30@vs10+|2 0 gV Good health habits can also help prevent and fight COVID-19. Reimbursement for COVID-19 testing performed in a participating hospital emergency room or inpatient setting is based on existing contractual rates inclusive of member cost share amounts waived by Anthem. COVID-19 vaccine administration and certain monoclonal antibody treatments: cost-sharing, coding, and billing This includes visits for behavioral health for our fully insured employer plans, individual and Medicaid plans, where permissible. We have established a team of experts to closely monitor developments and how they will impact our members and health care provider partners. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Healthcare Solutions. Stay six feet away from others, avoiding crowds and poorly ventilated spaces. HHS is also announcing an additional distribution of Provider Relief Funds to safety net hospitals: Anthem is closely monitoring COVID-19 developments and what it means for our customers and our health care provider partners. If an in-network provider is not reasonably available, the cost share waivers will include testing or screening for COVID-19 when received from an out-of-network provider. Pain or pressure in the chest that wont go away. This applies to all members, regardless of the type of health plan they have or which doctor or healthcare professional they choose to visit for COVID-19 vaccination. cost sharing for audio-only, in-network provider visits through January 11, 2023, for Medicare plans. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. Research shows the COVID-19 vaccination will help keep you from getting COVID-19. This is applicable for our employer-sponsored, individual, Medicare and Medicaid plan members. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. Anthem.com and Anthems COVID-19 site (https://www.anthem.com/blog/member-news/how-to-protect/) are great resources for members with questions and are being updated regularly. On April 30, 2020, we hosted a webinar to share information and resources with network providers regarding opportunities to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19 on care providers that are also small employers. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. Anthems affiliated health plans will waive cost shares for our fully-insured employer, individual, Medicare and Medicaid plan membersinclusive of copays, coinsurance and deductiblesfor COVID-19 test and visits and services during the visit when the purpose of the visit is to be screened and/or tested for COVID-19, including telehealth visits. If your doctor isnt available for some reason, well help you find alternate care. If their symptoms get worse, call their doctor. No. In addition, Anthems telehealth provider, LiveHealth Online, is another safe and effective way for members to see a physician to receive health guidance related to COVID-19 from home via a mobile device or computer with a webcam. CMS has provided the Medicare guideline to use the CS modifier: Error! Symptoms may appear 2-14 days after being around someone who has COVID-19. Check the CDC website at cdc.gov/coronavirusfor up-to-date information. Anthem is committed to helping our members gain timely access to care and services in a way that places the least burden on the health care system. Diagnostic tests are for people who have symptoms of COVID-19. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), whichunderwrites or administersthe PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare Health Services Insurance Corporation (Compcare) underwritesor administers the HMO policies and Wisconsin Collaborative Insurance Company (WCIC) underwrites or administers Well Priority HMO or POS policies. FEP will increase access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications. The protection of your privacy will be governed by the privacy policy of that site. Heres what the Centers for Disease Control and Prevention says about wearing a facemask. Call 911 if you see emergency warning signs like the below. However, to assist providers our COVID-19 Vaccination Roster Billing Form provides a default Z23 diagnosis code. Mild to severe fever, cough and shortness of breath. The over-the-counter tests give results within 30 minutes. Anthem is committed to working with and supporting our contracted providers. Administrative. Call our 24/7 NurseLine 24 hours a day, 7 days a week, at the number on your ID card. Coronavirus is a type of virus that causes respiratory illness an infection of the airways and lungs. All Rights Reserved. Here are some additional ways Horizon BCBSNJ members can receive advice and support: The Blue Cross and Blue Shield Association is a national federation of 34 independent, community-based and locallyoperated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. Members can check their symptoms and connect with a doctor right from their phone. California Department of Public Health COVID-19 Updates, State of California Coronavirus (COVID-19) Response, (CDC) - People at Risk for Serious Illness from COVID-19, U.S. Department of State, Travel Advisories, World Health Organization (WHO), Coronavirus, Members with Cal MediConnect plans (Los Angeles County), Members with Cal MediConnect plans (Santa Clara County), vaccination prevents severe illness, hospitalizations, and death, cdc.gov/coronavirus/2019-ncov/about/index.html. No, prior authorization is not required for diagnostic services related to COVID-19 testing. Do you have medicines you take regularly? Telemedicine not only helps members get the care they need, but helps reduce the spread of the coronavirus protecting the health of our members and the doctors and nurses who care for them. In Kentucky: Anthem Health Plans of Kentucky, Inc. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. If theres an epidemic, how will you ensure that the doctors in my plan can still provide care? Submit telehealth with the CPT code for the service rendered, place of service (POS) 02 or 10, and append either modifier 95 or GT. Avoid close contact with people who are sick. If you have employer coverage, or an individual or family plan, you can get over-the-counter COVID-19 tests for diagnosing COVID-19 through your BCBSIL/Prime Therapeutics pharmacy benefits. It also lets you notify the CDC of any side effects you may experience. In general, it is recommended people get tested if they have symptoms including fever, cough, shortness of breath, chills, muscle pain, new loss of taste or smell, vomiting or diarrhea, and/or sore throat. If you have specific questions about the medicine you take, call the pharmacy services number on your member ID card.*. You can get 90-day supplies of most prescription medicines, depending on your plans pharmacy benefits. Please review the Medicare and Medicaid specific sites noted below for details about these plans. This extension applies to Horizon BCBSNJs fully insured members, including those covered through Medicaid, Medicare Advantage, Individual and Small Group policies. Check the. Please visit VaccineFinder to find COVID-19 vaccines by ZIP Code, vaccine brand, and availability status. Johns Hopkins University has resources to help you learn more about the disease. We're here to make sure you have the resources and care you need to keep yourself safe and well. As the number of COVID-19 cases in New Jersey moves in the wrong direction, Horizon Blue Cross Blue Shield of New Jersey will continue to do whats right for our members and communities. Clean and disinfect frequently touched objects and surfaces like phones, keyboards, and doorknobs. Payment for COVID-19 testing services on or after January 1, 2022. Anthem is a registered trademark. People at most risk of contracting COVID-19 or developing complications of illness are scheduled to receive vaccinations first. To help reduce the burden on the states health care facilities and ensure members get the care they need when they need it, the cost-sharing waiver also applies totelemedicine visits, includingtelephonic visits. If you are, youll be able to place an order. All encounter-based providers (including but not limited to: Federally Qualified Health Centers, Rural Health Clinics, Indian Health Services and Tribal Clinics, etc.) As there is a heightened awareness of COVID-19 and more cases are being diagnosed in the United States, LiveHealth Online is increasing physician availability and stands ready to have physicians available to see the increase in patients, while maintaining reasonable wait times. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. Anthem is a registered trademark. hk%@Z^ pp>ZV]X~ fE#E2y$IFD*r\Rtk^u_e,~tIG*aJ*h'URWjRJ=W*L)CCCBTjJ4Oo~x|~y|?x~|.o._=w_~w_{?G=o1q}w?\ZNwuw?Kw|/vCyvIY7?}Ngw}&UG-&F-w_=_,_=aUq+uK[W--kVtkKU=V5|Zq:4o]{u\Z-UCC5PqiU#]Eyfk]WJnv?/u]s9n'#~rk]f2x7-,}_[-mjeh5j7 o~L}5wQVeu,OkA4oSS3.U Identifying the most appropriate COVID-19 testing codes, testing sites and type of test to use can be confusing. Screening tests show whether or not someone has COVID-19. For COVID-19 treatments via telehealth visits, Anthems affiliated health plans will cover telehealth and telephonic-only visits from in-network providers and will waive cost shares through January 31, 2021. Medicare Advantage and Medicare GRS plans are waived through February 28, 2021. cost sharing for telehealth services not related to the treatment of COVID-19 from Anthem's telehealth provider, LiveHealth Online, from March 17, 2020, through May 31, 2021, for our fully-insured employer, individual, and where permissible, Medicaid plans. Anthem is encouraging providers to bill with codes U0001, U0002, U0003, U0004, 86328, 86769, or 87635 based on the test provided. Taking care of your emotional health is important during this stressful time. Visit the CDC website for the most up-to-date testing guidance. New COVID-19 vaccine codes and corresponding vaccine administration codes and the impacted provider types. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. This is also for . Hyperlink reference not valid.. Anthem also looks for the CS modifier to identify claims related to evaluation for COVID-19 testing. We have resources and partners to help you handle not just everyday needs, but extra ones you may be facing in this outbreak. The State Health Benefits Program (SHBP) and School Employees Health Benefits Program (SEHBP) have also agreed to administer benefits consistent with these changes. Diagnostic tests, under the direction of a medical clinician, show whether or not someone has COVID-19. This modifier should be used for evaluation and testing services in any place of service including a physician's office, urgent care, ER or even drive-thru testing once available. Through May 31, all BCBS companiesincluding the BCBS Federal Employee Program (FEP)are: It is important that our members feel safe and secure during these unprecedented times, said Scott P. Serota, current president and CEO of the Blue Cross Blue Shield Association. CMS has provided coding guidelines related to COVID-19 vaccines:https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies. Reimbursement is available only during the COVID-19 public health emergency. Many options exist for test including for those without a prescription and who will be paying out-of-pocket for their test. 111 0 obj <> endobj Find free videos and tools that address topics like depression and anxiety in a helpful, sympathetic way. Anthem will waive associated cost shares for in-network providers only except where a broader waiver is required by law. Call our 24/7 NurseLine 24 hours a day, 7 days a week, at number... 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