In a statement, Blue Cross Blue Shield said, "We are also working on . The use of reverse transcription-polymerase chain reaction (RT-PCR) or antigen testing to detect the presence of SARS-CoV-2 for a diagnosis of COVID-19 infection is covered for FDA-approved tests when ordered by any healthcare professional authorized under state law. (Medical and Mental Health) Network Management and Credentialing Services WASHINGTON The Blue Cross and Blue Shield Federal Employee Program (FEP) announced today that it will waive cost-sharing for coronavirus diagnostic testing, waive prior authorization requirements for treatment and take other steps to enhance access to care for those needing treatment for COVID-19 to ensure its members can swiftly access the right care in the right setting during the outbreak. Establishing a network of preferred providers that will enable you to go directly to a designated pharmacy or retailer to obtain free tests. These actions will apply to all FEP members of the 36 U.S. and Puerto Rico-based BCBS companies, including those members located overseas, when applicable. To make sure the associated costs for getting diagnostic tests are covered by your BCBSIL plan: However, insurers may choose to reimburse consumers for these tests. Some self-funded group plans may not cover all the costs when seeing an out-of-network provider. Once a COVID-19 vaccine has EUA or approval from the FDA, Blue Cross will accept this vaccine CPT code and administrative codes. Test kit cost $ Contact the company for the latest information. 2Tests obtained for employment purposes, return to school, or sports are those requested at the direction of an employer, school, or sports league/facility or are for group testing rather than for individual assessment. An attending health care provider may order a test. bill the test on a separate claim from the rest of the services being rendered. Chloroquine and hydroxychloroquine (Plaquenil), On June 5, 2020, the FDA revoked the Emergency Use Authorization (EUA) for hydroxychloroquine and chloroquine for the treatment of COVID-19 because the benefits of using them outweigh the known and potential risks for authorized use. When reporting modifier GT, 95, G0, or GQ, you are attesting that services were rendered to a patient via synchronous/asynchronous telehealth audio and/or video telecommunications systems. Several drugs are under investigation as potential treatments for COVID-19 that have shown early benefit in clinical trials. If you purchase a test outside of your preferred network, your insurance company can cap your reimbursement fee at $12meaning that even if your COVID test costs upwards of $30, you will. Contact the company for the latest information. Members should call the number on the back of their ID card. For our commercial products (managed care HMO and POS, PPO, and Indemnity), we will accept the following CPT codes for treatment for COVID-19 infection. Purchase a COVID-19 at-home test kit and submit a claim through the paper-based OTC test claim form. https://www.mclarenhealthplan.org/mhp/are-you-a-member. Your Blue Cross and Blue Shield of Texas (BCBSTX) health plan gives you access to the care you need during the COVID-19 pandemic. What virtual care options does my plan cover? This update also includes the ICD-10 vaping-related disorder code. Please note that Blue Shield does not offer tax advice for HSAs. The web Browser you are currently using is unsupported, and some features of this site may not work as intended. Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique, making use of high throughput technologies as described by CMS-2020-01-R. Reimbursable for dates of service on or after April 14, 2020. Medicare members can get up to eight OTC COVID-19 home tests each calendar month. We will mail you an explanation of benefits that outlines what Blue Shield paid and what remaining balance you may owe, if any. Centers for Medicare and Medicaid Services FAQ. Per state mandate Chapter 260 of the Acts of 2020 Patients First Act, cognitive rehabilitation for cognitive impairment resulting from COVID-19 is covered in the outpatient setting.1. My at-home test comes with more than one test per package. There are new codes for these boosters. Feel free to ask your doctors office what safety steps they are taking to protect patients during the pandemic. As of January 1, 2022, most members can get reimbursed for up to eight OTC at-home tests per member per month without a provider order. Please follow the billing instructions outlined in our COVID-19 Temporary payment policy. Where can I go for more details about COVID-19? For thehigh-technology radiologyandsleep testing and treatment servicesthat require prior authorization with AIM Specialty Health, during the public health emergency, we authorized new requests for 180 days to allow time to have services performed. Log in to find out your costs and if you have access. Network of Preferred Providers: Screening tests for domestic travel are covered for most plans. Or, contact our Clinical Pharmacy Operations area. Standard out-of-pocket costs will apply for treatments received. Blue Cross and Blue Shield companies (BCBS) will also increase access to prescription drugs, enhanced telehealth and other clinical support . HSAs are offered through financial institutions. You can also log in to your online account to learn what benefits your plan covers or call the customer service number at the number on your ID card. Refund Management | Blue Cross and Blue Shield of Illinois Refund Management The following information does not apply to government programs (Medicare Advantage, Illinois Medicaid). Please be advised that, while awaiting further guidance from the Department of Managed Health Care (DMHC)/ Department of Health Care Services (DHCS) regarding SB510, Anthem Blue Cross will pay Medi-Cal claims for COVID-19 testing incurred on or after January 1, 2022, according . Effective for claims with discharge dates or dates of service on or after April 1, 2020, for all commercial products, we have updated our APR-DRG grouper with the ICD-10 diagnosis codes below. Viral testing Health plans are offered by Blue Shield of California. COVID-19 Testing Coverage Website: Most diagnostic and screening tests are covered for the majority of Blue Shield members. https://www.ambettermeridian.com/coronavirus/covid-19-home-testing-kits.html. No. Leading the way in health insurance since 1929. You are now leaving the blueshieldca.com website, Your coverage for COVID-19 | Blue Shield of CA. If you plan to provide a previously approved service to a patient in 2021, please call our Clinical Intake Department at the appropriate number and we will create a new authorization or update the existing one. 11Medicare members can get up to eight OTC COVID-19 home tests each calendar monththrough the Centers for Medicare and Medicaid Services. Annual exams can help you: These exams also help your primary doctor see any health issues early on. Yes, CVS Caremark Pharmacies, Reimbursement Process Link or Description: Many Americans can now get home Covid-19 tests at no cost through their private insurance. Some may choose to cover screening tests for employment purposes, return to school, or sports. The Federal Employee Program (FEP) covers COVID-19 testing and antibody testing with no member cost share, regardless of provider status, including testing for: Note: There are no limits on frequency of testing. Learn how to get free OTC at-home teststhrough the federal program. https://www.phpmichigan.com/?id=175&sid=1. Network of Preferred Providers: There are no age limits for members who need care through telehealth or phone services. Outside of an emergency situation, you should seek care from in-network providers to save money. It is provided as a general resource to providers regarding the overpayment recovery process that may be available for commercial claims. https://www.hioscar.com/at-home-covid-test-reimbursement, Network of Preferred Providers: See our COVID-19 Temporary payment policy, Do not bill 87635 and U0002 on the same day for the same patient. COVID-19 Testing Coverage Website: Patient symptoms are expected to improve with cognitive rehabilitation. Should I still postpone preventive visits/routine checkups or specialist care? According to the CDC, serologic testing: * Detection of specific antibody in serum, plasma, or whole blood that indicates new or recent infection provides presumptive laboratory evidence of COVID-19 illness, according to the Council of State and Territorial Epidemiologists (CSTE) interim case definition for COVID-19. To avoid paying any extra fees, please usenetwork locationsfor testing. FEP will waive prior authorizations for diagnostic tests and for covered services that are medically necessary and consistent with Centers for Disease Control and Prevention (CDC) guidance if diagnosed with COVID-19. For example: Choose your plan type to learn more about the available no-cost options Individual & Family Medicare Medicaid Stay Healthy and Informed . Reimbursement Process Link or Description: Blue Shield and Blue Shield Promise cover these types of tests: 1Tests ordered by a healthcare provider means that a licensed and authorized healthcare provider has requested that you obtain a test for COVID-19. This applies to tests purchased on or after January 15. Bill the same as you would for in-person visits, and include the following modifiers with the applicable place of service code*: modifier GT, 95, G0, or GQ via synchronous/asynchronous telehealth audio and/or video telecommunications systems to differentiate a telehealth (telemedicine) encounter from an in-person encounter with the patient. Find out which COVID-19 tests are available to members and where to get tested. In keeping with CMS guidance issued September 2, 2020 and for the duration of the COVID-19 public health emergency, Blue Cross will cover, without a healthcare professionals order, the cost of one diagnostic test for COVID-19 and one diagnostic test each for influenza virus or similar respiratory condition for Medicare members when performed in conjunction with a COVID-19 test and needed to obtain a final COVID-19 diagnosis. Your plan includes COVID-19 tests, treatment, and care. FAQs abour medication and treatment, COVID-19 coverage for testing All Blue Cross Blue Shield of Massachusetts contracted doctors and health care providers can provide care remotely, using any technology, for medically necessary covered services (COVID-19 AND non-COVID-19 related) to our members. A direct link to the Ambetter provider search tool is given for members to find a pharmacy from the COVID-19 home test kit page: https://guide.ambetterhealth.com. Does my plan cover COVID-19 screening and testing? Reimbursement Process Link or Description: Or purchase in-store at an in-network pharmacy counter with their Humana ID card as outlined in the FAQ. Blue Cross Blue Shield of Massachusetts will reimburse telehealth covered claims that we receive through the BlueCard program. For example, if you purchase a package with two tests inside, that counts as two separate tests. c I had COVID-19 symptoms. https://www.paramounthealthcare.com/covid-19/at-home-covid-testing-kits, COVID-19 Testing Coverage Website: Subsequent tests will require the order of an authorized health care professional. We are here to support you as you care for your patientsour members. Similarly, for at-home tests paid for or reimbursed by Blue Shield, you should not seek reimbursement from an FSA, HSA, or HRA for the cost (or the portion of the cost). Call us toll-free Monday through Friday 8 a.m. to 5 p.m. at877-999-6442. Learn moreabout potential out-of-pocket costs from out-of-network providers. We've taken steps to lower costs and provide our members easier access to care related to COVID-19. Your plan will provide this coverage through reimbursement to you. These tests are available without out-of-pocket cost at locations specified by your insurance company. These may include fees for other tests or other services unrelated to the COVID-19 test. Vaccine and vaccine administration codes for COVID-19. Covered testing sites include (but are not limited to): Whats not covered How can I submit a claim form for my OTC COVID-19 at-home tests? If your tests cost more than $12 per test, you will not be reimbursed for the difference. Coverage for Medicare members. You will have to pay for your tests up front and should save your receipts and test boxes for submission to your insurance company for reimbursement. Effective March 16, 2020, Blue Cross and Blue Shield of Alabama is expanding telehealth coverage. La compaa cumple con las leyes de derechos civiles federales y estatales aplicables, y no discrimina, ni excluye ni trata de manera diferente a las personas por su raza, color, pas de origen, identificacin con determinado grupo tnico, condicin mdica, informacin gentica, ascendencia, religin, sexo, estado civil, gnero, identidad de gnero, orientacin sexual, edad, ni discapacidad fsica ni mental. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. I have a Medicare plan. New authorizations will be required for services deferred into 2021, and all other administrative requirements related to these services continue to apply. for tests purchased on or after January 15, 2022. The instructions and form are provided on the COVID-19 home test kit page: https://www.ambettermeridian.com/coronavirus/covid-19-home-testing-kits.html. Insurers may not apply deductibles, co-pays, or other cost sharing to at-home COVID-19 tests purchased under this new benefit. Serologic testing for the presence of antibodies for known or suspected current or prior COVID-19 infection is covered for FDA-approved tests when ordered by any healthcare professional authorized under state law. Serologic testing for the presence of SARS-CoV-2 IgM/IgG antibodies is covered for FDA and Emergency Use Authorization tests (as described above) when ordered by a health care provider who is making an individualized clinical assessment of the patient in accordance with current standards of medical practice, including the Centers for Disease Control (CDC) and Massachusetts Department of Public Health (DPH) guidelines. Verify your contact information. For assisted reproductive technology services listed in ourmedical policythat require prior authorization: Durable medical equipment Beginning January 15, 2022, and until the end of the Public Health Emergency, Independence will cover up to eight FDA approved OTC COVID-19 tests per calendar month as directed by the Biden administrations program. Licensing - Consumer Finance and Mortgage. The provider should mail you a refund check. Members will receive test kits from network pharmacies at no cost. Health insurance products are offered by Blue Shield of California Life & Health Insurance Company.