For providers not in the Teladoc network, the applicable cost share applies (unless COVID-19 related). For more information about HSAs, eligibility, and the laws current provisions, you should ask your financial or tax adviser, or check with your HSA administrator for more details. For more information about HSAs, eligibility, and the laws current provisions, you should ask you financial or tax adviser, or check with your HSA administrator for more details. The modifier should be 95 or GT. Independence Blue Cross(Independence) is implementing the Biden administrations over-the-counter (OTC) testing program finalized earlier this month. Members should call the number on the back of their ID card. Screening tests for domestic travel are covered for most plans. This applies to both diagnostic and screening tests. Learn about what coverage and care you can receive through your Blue Shield, Blue Shield Promise Medicare Advantage, or Medicare Supplement benefits. Bill as if you are performing an in-person service, using the revenue and HCPCS/CPT code combinations that you would normally bill on a facility claim. Diagnosis Codes: B97.29 Z03.818 Z20.822 If you are interested in a rewarding position helping Michiganders apply today! What virtual care options does my plan cover? All information below is required. Blue Cross Blue Shield of Massachusetts covers the following drugs when usedoutside a clinical trialfor patients who are in aninpatienthospital setting and require treatment beyond respiratory support, at the discretion of their treating provider: Please note that standard inpatient payment policy rules apply. Reimbursement Process Link or Description: What's the difference between the booster shot and the additional dose? Please submit the vaccine administration procedure code and vaccine/toxoid code on the same claim. Those payments will now go directly to the provider. What should I do with it? Also, there are some limitations to the number of tests that can be reimbursed without a provider order. Retroactive to March 6, 2020, we waive member cost (copayments, deductible, co-insurance) for medically necessaryinpatient acute care hospital serviceswhen the claim includes a diagnosis of COVID-19. DIFS has surveyed health insurers operating in Michigan and prepared the information below to help Michiganders understand this benefit and how it will be offered. Blue Shield provides coverage for OTC COVID-19 at-home tests purchased prior to January 1, 2022, with a healthcare provider order. Please note that tests are currently in short supply and some retailers may impose limits on the number of tests you can purchase. Free at-home COVID-19 tests You will only be reimbursed for the maximum allowable tests per member per month for your plan. Ancillary and some behavioral health providers. Bill for ambulance transport
Feel free to ask your doctors office what safety steps they are taking to protect patients during the pandemic. You are now leaving the blueshieldca.com website, In-depth information about choices that affect you. Serologic testing for the presence of antibodies is not covered, Medicare HMO BlueSM and Medicare PPO BlueSM Members. California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. If you receive your health insurance through your employer, plan sponsor, or benefits administrator, review your Blue Shield member ID card for the letters ASO (Administrative Services Only) to learn if you are on a self-funded or self-insured plan. Since the vaccine is supplied free, we will not reimburse separately for the vaccine, regardless of the modifier. This page may have documents that can't be read by screen reader software. Licensed independent clinical social worker, Psychiatric and state psychiatric hospital. Learn moreabout potential out-of-pocket costs from out-of-network providers. Blue Cross Blue Shield of Massachusetts does not cover drugs under investigation through clinical trials that have not demonstrated improvement in patient outcomes in early studies or are not recommended for use outside of the clinical trial setting by the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), or Department of Public Health (DPH) guidelines. No, COVID-19 Testing Coverage Website: If you are currently seeing a mental healthcare provider, you can continue to see that provider virtually. Member cost still applies for an in-person, outpatient visits and for inpatient and residential services. These amounts not paid by the plan may be the responsibility of the member. *The CDC has created an interim set of ICD-10 CM official coding guidelines, effective February 20, 2020. Y0118_22_338A1_C 09272022 Have more questions about testing coverage? Contact the company for the latest information. 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. If you use the online form, you must file a separate digital claim for each member and for each receipt. This will enable us to pay you the same rate we pay you for in-person visits. That form will be replaced on Jan. 23 once the insurer develops . Does my plan cover COVID-19 screening and testing? Members can call our dedicated coronavirus help line at 1-888-372-1970. After the vaccine: what to expect. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. If you purchase a test at a retailer or pharmacy that is outside your insurer's preferred provider network, your insurance company will reimburse you up to $12 per test, or the cost of the test if less than $12. FEP and Blue Cross and Blue Shield (BCBS) companies are following CDC prevention guidelines and other federal recommendations and will continue to support and protect the health and well-being of its members, their families and the community. Anthem is waiving cost shares for COVID-19 treatment. Health plans are offered by Blue Shield of California. Feel free to ask your doctors office what safety steps they are taking to protect patients during the pandemic. Everyone qualifies. Blue Shield of California has neither reviewed nor endorsed this information. Please check yourEvidence of Coverageor plan policy documents to find out what is covered when traveling internationally. FEP will cover up to eight (8) over-the-counter COVID-19 tests per member on a contract per calendar month. Please note that Blue Shield does not offer tax advice for HSAs. Members who already have coverage for problem-focused exams (D0140) will have no cost share (deductible, copayment, or co-insurance).*. For members using the National Preferred Formulary (managed by Express Scripts, Inc.), there are new quantity limits for these medications. Reimbursement Process Link or Description: UnitedHealthcare (UHC) Payment for COVID-19 testing services on or after January 1, 2022. Your plan will provide this coverage through reimbursement to you. 1-800-316-BLUE (2583), Dental Network Management
Members can submit a direct member reimbursement claim to McLaren using the form found by following the link: https://www.mclarenhealthplan.org/community-member/materials-mhp/direct-member-reimbursement-7049. Rheumatological and dermatological use
See which plans cover screening tests for travel. Blue Cross will identify patients presenting for evaluation of possible COVID-19 using the below codes*: If your patient has previously confirmed COVID-19 illness or tests positive for COVID-19, use the code below. We extended existing authorizations through December 31, 2020. https://www.aetna.com/individuals-families/member-rights-resources/covid19/otc-in-home-test-faqs.html, https://www.ambettermeridian.com/coronavirus/covid-19-home-testing-kits.html, : https://www.ambettermeridian.com/coronavirus/covid-19-home-testing-kits.html, https://www.bcbsm.com/content/dam/public/shared/documents/coronavirus/covid-testing-member-reimbursement-form.pdf, https://covidtest.optumrx.com/covid-test-reimbursement, In Vitro Diagnostics EUAs - Antigen Diagnostic Tests for SARS-CoV-2 | FDA, COVID-19 Over-the-Counter (OTC) Test Kit Claim Form [PDF], https://www.hap.org/covid19-coronavirus/at-home-covid-19-rapid-testing-kits, https://www.humana.com/coronavirus/coverage-faqs, https://www.mclarenhealthplan.org/mhp/are-you-a-member, https://www.mclarenhealthplan.org/community-member/materials-mhp/direct-member-reimbursement-7049, https://www.molinamarketplace.com/Marketplace/MI/en-us/Coronavirus.aspx/, https://www.hioscar.com/at-home-covid-test-reimbursement, https://www.hioscar.com/search/facilities?specialty_id=3336C0003X&network_id=017&year=2022&zip_code=49444&searchUrl=https%3A%2F%2F, https://www.paramounthealthcare.com/news/reimbursement-for-over-the-counter-covid-19-at-home-test-kits, https://www.paramounthealthcare.com/covid-19/at-home-covid-testing-kits, https://www.phpmichigan.com/?id=175&sid=1, https://www.priorityhealth.com/covid-19/vaccine, https://www.uhc.com/health-and-wellness/health-topics/covid-19/coverage-and-resources/covid-19-at-home-testing-coverage, Life Insurance and Annuity Search Service (LIAS), Health Insurer FIS 322 Submission Application, Financial Education (Banking, Credit Union and Credit Information), Establishing a program to have tests mailed directly to you upon request, or. For example, if four people are covered by your health plan, you can get up to 32 tests per month. Visit covidtests.gov, and click the blue "Order Free At-Home Tests" button. For example, if you purchase a package with two tests inside, that counts as two separate tests. *UB-04 billers do not need to submit a place of service code. We have added these codes to our COVID-19 Temporary payment policy. They are basically the same. Annual exams can help you: These exams also help your primary doctor see any health issues early on. California Physicians' Service DBA Blue Shield of California 1999-2023. The web Browser you are currently using is unsupported, and some features of this site may not work as intended. Toll free: 800-462-3589, Reimbursement Process Link or Description: 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. National vaccine finder. Since the drug is supplied free, we will not reimburse separately for the drug regardless of modifier. What will BCBSIL cover for COVID-19? Claims for laboratory services including COVID-19 testing, On or after July 1, 2021, the ordering clinician NPI will be a required field on your claim to indicate that the lab test is medically necessary. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. We have plans to help keep you covered. However, if you fall ill with COVID-19 symptoms while traveling internationally, testing and treatment may be covered. California Physicians' Service DBA Blue Shield of California 1999-2023. Get the Kaiser Permanente at-home COVID test reimbursement claim form (will download PDF). 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. Coverage for out-of-network testing will change when the public health emergency ends. My Turn Virtual visits are covered. Call us at 877-352-5830 with questions about COVID-19 testing sites, navigating health care plans or for help connecting to local community resources for finding food, utility and rent assistance, and many other types of relief programs. Your claim represents your attestation that you provided the service to the patient via telehealth. We will share additional information when available. Providing Support During the COVID-19 Pandemic Communities Leading through a public health crisis All 35 Blue Cross and Blue Shield companies are fighting against COVID-19, investing more than $12.8 billion in the nation's recovery. Get reimbursed for your over-the-counter COVID-19 tests OTC tests purchased at retail locations cost, on average, $12 for a single test and $24 for a double test kit. This is at the discretion of the prescriber and/or dispensing pharmacist. If you plan to provide a previously approved service to a patient in 2021, please call our. Coverage should always be confirmed with your plan prior to purchasing any tests. You can bill all services for which you are contracted using the telehealth codes with the telehealth modifier. As announced on April 6, Blue Cross will also waive cost share for COVID 19 related inpatient care at both in- and out-of-network acute care facilities for our fully insured members. News & updates Reverse transcription-polymerase chain reaction (RT-PCR) or antigen testing to detect the presence of SARS-CoV-2 for the diagnosis of COVID-19 is covered 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. Over-the-counter tests for things like return to work or school, travel and recreational event requirements may not be covered unless you have symptoms or have been exposed. Reimbursement Process Link or Description: If you need to get tested or seek treatment for COVID-19, well help you know exactly what your plan covers. Symptoms consistent with COVID-19, such as fever, cough, shortness of breath, chills, muscle pain, sore throat, anosmia, and gastrointestinal distress, Asymptomatic patients with direct exposure and/or close contact to another individual with a confirmed case of COVID-19, Close contact is defined by the CDC as someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period* starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated, Asymptomatic patients who have been identified by contact tracing, Symptomatic or asymptomatic patients who require testing prior to a medical procedure or surgery, Admission to a facility including but not limited to a hospital operated or licensed by the Department of Public Health or Mental Health, a long-term acute care hospital, or a skilled nursing facility, The patients home (using a testing kita patient self-swab), For public health or surveillance purposes, For periodic or serial testing of asymptomatic high-risk individuals (examples include congregate housing and occupational safety), Tests that have been denied FDA approval, an Emergency Use Authorization from the FDA, or laboratories that have not submitted an Emergency Use Authorization request within a reasonable timeframe, Member transportation to or from testing sites (unless the member meets requirements for ambulance services), for public health or surveillance purposes, for periodic or serial testing of asymptomatic individuals (examples include congregate housing such as dormitories and residential facilities, and occupational safety), For tests that have been denied FDA approval, an Emergency Use Authorization from the FDA, or laboratories that have not submitted an Emergency Use Authorization request within a reasonable timeframe, For member transportation to or from testing sites (unless the member meets requirements for ambulance services), To screen for eligibility to donate plasma, pre-surgical testing for elective and non-elective procedures, We extended existing authorizations issued for the first six months of 2020 to December 31, 2020. Once a COVID-19 vaccine has EUA or approval from the FDA, Blue Cross will accept this vaccine CPT code and administrative codes. Member costs are being waived for all Teladoc visits (COVID-19 and non-COVID-19) during this emergency period. Note: Telephonic codes (98966-98968, 99441-99443) do not require the use of any telehealth modifier. However, insurers may choose to reimburse consumers for these tests. When you provide any services by phone, do not bill the specific telephonic CPT codes. Yes. See the Notification of Enforcement Discretion for telehealth. COVID-19 Vaccine Information | CareFirst BlueCross BlueShield At-Home Rapid Tests Are Now Covered Over-the-counter COVID-19 tests are now covered for qualifying members. In Massachusetts, call, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted, for intramuscular use, Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted; first dose, Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted; second dose, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage; first dose, Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage; second dose, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5x10, Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5x10, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative free, 5x10, Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative free, 5x10, Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring, Injection, casirivimab and imdevimab, 2400 mg, Injection, bamlanivimab and etesevimab, 2100 mg, Blue Cross Blue Shield of Massachusetts is temporarily allowing reimbursement for this code for drive-through testing specimen collection*, Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), any specimen source*, CDC 2019 novel coronavirus (2019-ncov) real-time
Only to be reported with use of high-throughput technologies. Log in to find out if you have access. https://www.phpmichigan.com/?id=175&sid=1. California Physicians' Service DBA Blue Shield of California 1999-2023. During the federal public health emergency, Blue Shield will continue to waive out-of-pocket costs for copays, coinsurance, and deductibles for: There are no prior approvals needed for COVID-19 screenings, evaluations, or testing. Or purchase in-store at an in-network pharmacy counter with their Humana ID card as outlined in the FAQ. Log in to blueshieldca.com (Engagement Point users at engagementpoint.com) Choose "Claims" Select "File a claim" They include: As Americans continue to monitor the coronavirus outbreak, one thing they should not be concerned with is whether Blue Cross and Blue Shield will be there for them, saidWilliam A. Breskin, senior vice president of government programs for the Blue Cross Blue Shield Association. For more information, visit https://www.phpmichigan.com/?id=175&sid=1. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Test kit cost $ Standard office visit copay may apply. Learn more about the COVID-19 vaccine booster. Learn more about the different types of tests. H0148_22_161_C_IA_092722. Contact the company for the latest information. Member cost will be the same as an in-person office visit, and cost will not be waived for a COVID-19 diagnosis. To meet this requirement, insurers may choose to provide direct coverage for tests by: If your insurer does not provide direct coverage, or if you purchase tests outside of your insurer's preferred provider network, you can request reimbursement for some or all of your out-of-pocket expense. Independence Blue Cross is a subsidiary of Independence Health Group, Inc. independent licensees of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania. Reimbursement Process Link or Description: Blue Cross members with a COVID-19 diagnosis will be protected against balance billing. For example: 8 At-Home Rapid tests per 30 days. You may also submit a digital claim online with a copy of your receipt. https://www.humana.com/coronavirus/coverage-faqs. Blue Cross and Blue Shield of Illinois (BCBSIL) is closely monitoring activity around the Novel Coronavirus 2019 (COVID-19). BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. The Massachusetts Division of Insurance (DOI) issued aMarch 26, 2020 Bulletinaddressing this topic. These may include fees for other tests or other services unrelated to the COVID-19 test. COVID-19 Testing Coverage Website: Update: BCBSTX Approach to OTC COVID-19 Testing Coverage - COVID 19 Producers | Blue Cross and Blue Shield of Texas This page may have documents that can't be read by screen reader software. Access to COVID-19 testing is critically important as we work to limit the spread of COVID-19 variants. 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. For Commercial/HMO inquiries, please call 517-364-8500 or (toll-free) 800-832-9186. We want to help ease stress during these uncertain times. For eligible plans, you can fill out and mail a paper claim form. Contact the company for the latest information. Reimbursement Process Link or Description: You do not need health insurance to receive your free tests. These tests are available without out-of-pocket cost at locations specified by your insurance company. https://www.aetna.com/individuals-families/member-rights-resources/covid19/otc-in-home-test-faqs.html. Your health is our priority. Claims submission and reimbursement for all COVID-19 testing. To request reimbursement for a fully self-administered FDA authorized test purchased from a non-preferred pharmacy or other retailer between January 15, 2022 and January 31, 2022, submit this form: The authorization process will officially resume for all products effective July 1, 2021. We have shared the following July 1, 2021 changes with our providers: Blue Cross Blue Shield of Massachusetts follows federal and state-mandated requirements for COVID-19 treatment coverage. There are no additional credentialing or contracting processes you need to follow to offer telehealth services. Claims for over-the-counter COVID-19 tests submitted for reimbursement will be reimbursed up to $12 per test. Click Forms. Members covered through Medicaid plans: 1-800-711-5952. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. Independence does not cover tests that are needed for return to work, a condition of employment, return to school, or travel. * Login to find out what options are available to you. Federal Employee Program (FEP) members
For example: Find out what your coverage is for OTC at-home tests. Yes, but coverage for testing varies by plan. 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. Not all plans have access to these services. You have a few options for where to get a test: Diagnostic testing performed by out-of-network health care providers is also covered at no cost to members during thepublic health emergency. We are following guidelines from the Blue Cross Blue Shield Association regarding coverage for Federal Employee Program members. Use the diagnosis codes below for patients presenting for evaluation of suspected COVID-19. Network of Preferred Providers: They have their own payment policy for telehealth services. Get an in-person test at a Washington or Alaska testing location . These services can help you see if your symptoms may be related to COVID-19 or something else. How to maintain coverage If you have any questions, call the number on the back of your Blue Cross ID . You can get up to eight at-home COVID-19 tests per month for every person covered on your health plan. 100748 0521 R3 Page 1 . These changes, which have been approved by the Office of Personnel Management, will ensure that nearly 6 million federal employees, retirees and their families have comprehensive, accessible care.