For members of Medicaid plans, Medicaid state-specific rate and other state regulations may apply. Attention Provider Types 12 (Hospital, Outpatient) and 43 (Laboratory, Pathology Clinical): Rate Change for COVID-19 Testing Codes U0003 and U0004. Anthem is a registered trademark. COVID-19 vaccines for youth toolkit available. endstream endobj 112 0 obj <>/Metadata 8 0 R/Pages 109 0 R/StructTreeRoot 23 0 R/Type/Catalog/ViewerPreferences 133 0 R>> endobj 113 0 obj <>/MediaBox[0 0 612 792]/Parent 109 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 114 0 obj <>stream Wash your hands thoroughly and use hand sanitizer before and after touching or feeding someone, or touching any mobility devices or equipment. In addition to using a telehealth service, you can receive in-person or virtual care from your own doctor or another healthcare provider in your plan's network. Coronavirus is a type of virus that causes respiratory illness an infection of the airways and lungs. Anthem is a registered trademark. 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. Call your doctor if you develop a fever, have a cough, or have difficulty breathing. Check the CDC website at cdc.gov/coronavirusfor up-to-date information. Through May 31, all BCBS companies including the BCBS Federal Employee Program (FEP)are: Waiving cost-sharing for COVID-19 testing and treatment. Providers may submit the COVID-19 Vaccination Roster Billing Form to Availity at https://www.availity.com/ by signing in and submitting the form electronically to the Anthem health plan. Focusing solely on testing symptomatic patients may not be sufficient to prevent further transmission of COVID-19. In Connecticut: Anthem Health Plans, Inc. Based on standard AMA and HCPCS coding guidelines, for participating hospitals with a lab fee schedule, Anthem will recognize the codes 87635 and U0002, and will reimburse drive thru COVID-19 tests according to the lab fee schedule inclusive of member cost-share amounts waived by Anthem. Clean and disinfect items and surfaces you touch . 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. COVID-19 Coverage Expanded to Include Over-the-Counter Kits for Diagnostic Tests. If you have questions about your COVID-19 benefits, please call the Member Services number on your ID card. COVID-19 is a new strain of coronavirus. Each state will decide how and when to distribute vaccines. cost sharing for telephonic-only in-network visits from March 19, 2020, through January 11, 2023, for fully-insured employer-sponsored, individual and Medicaid plans. Anthem covers COVID-19 diagnostic tests for all members with no out-of-pocket costs. Anthem will waive associated cost shares for in-network providers only except where a broader waiver is required by law. Here are some tips: Washing your hands is the best way to avoid getting sick: Wash often with soap and water for at least 20 seconds. 2023 Blue Cross Blue Shield Association. The Act expands existing federal loan programs, creates new tax credits, postpones employment tax payments, and includes additional tax relief. Waiving all prior authorization requirements for COVID-19 testing and related covered services. Submit telehealth with the CPT code for the service rendered, place of service (POS) 02 or 10, and append either modifier 95 or GT. Independent licensees of the Blue Cross and Blue Shield Association. Call our 24/7 Nurse Line for COVID-related health questions and advice. Webinar recording available from Anthem BlueCross and BlueShield for network providers on SBA loans and other federal relief programs in response to COVID-19, Federal resources available for health care providers and employers in the federal CARES Act, Hydroxychloroquine and Chloroquine Diagnosis Requirements on Prescriptions (March 20, 2020). You should try to see your PCP or a doctor in your plan. The type of plan you have determines whether youre eligible to order an at-home test kit from Anthem. Blue Shield and Blue Shield Promise will cover most COVID-19 tests at no out-of-pocket cost to you for specified plans noted below. 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 We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Cover a cough or sneeze with a tissue, throw the tissue in the trash, and wash your hands. 24/7 access is provided at no cost. People who are diagnosed with COVID-19 may have long-term symptoms. How does my plan cover the over-the-counter test? Many plans include telephone care benefits during this public health emergency. How can a provider submit Anthems Roster Billing claim form? Check the. When are COVID-19 tests covered? Use Psych Hub's resources to help you manage and cope in stressful times. Anthem does not cover telephonic-only services today (with limited state exceptions) but we are providing this coverage effective from March 19, 2020, through January 11, 2023, to reflect the concerns we have heard from providers about the need to support continuity of care for Plan members during extended periods of social distancing. cost sharing for audio-only, in-network provider visits through January 11, 2023, for Medicare plans. cost sharing for COVID-19 diagnostic tests as deemed medically necessary by a healthcare clinician who has made an assessment of a patient, including serology or antibody tests, for members of our employer-sponsored, individual, Medicare and Medicaid plans. Lets look at the latest information on COVID-19 and how your health care plan can help. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. Cost sharing will be waived for members using Anthems authorized telemedicine service, LiveHealth Online, as well as care received from other providers delivering virtual care through internet video + audio services. To ensure you have access to the right care at the right time, FEP is waiving cost shares and prior authorization to support members care for COVID-19. Kaiser found: 7 insurers (Anthem, Blue Cross Blue Shield of Michigan, Blue Shield of California, Care First, Cigna, CVS Group/Aetna, and Kaiser Permanente) are currently relying only on . This includes covered visits for mental health or substance use disorders and medical services, for our fully-insured employer plans, individual plans and Medicaid plans, where permissible. What can I do to keep from running out of medication? Members can check their symptoms and connect with a doctor right from their phone. What codes would be appropriate to consider for a telehealth visit with a patient who wants to receive health guidance during the COVID-19 crisis? font-size: 50px; Call 911 if you see emergency warning signs like the below. The waiver of member out-of-pocket costs for COVID-19 treatment, which is not required by law, has been extended for an additional three months through March 31, 2021. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. If you cant use soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol. Anthem will cover the COVID-19 vaccine. This modifier should be used for evaluation and testing services in any place of service including a physicians office, urgent care, ER or even drive-thru testing once available. administered as part of determining the need for COVID-19 testing, the provider should submit the established codes appropriate for such testing. Visit BCBS.com to see how BCBS companies are providing support to communities, providers and members during the COVID-19 pandemic. Individuals with Intellectual and Developmental Disabilities, Individuals with Mental Health and Substance Use Needs, Individuals Who Need Long-term Services and Support, U.S. Department of State China Travel Advisory, CDC, People at Risk for Serious Illness from COVID-19, Administration for Community Living, Coronavirus, CMS Press Release: President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak. While a test sample cannot be obtained through a telehealth visit, the telehealth provider can help you get to a provider who can do so. Does Anthem expect any slowdown with claim adjudication because of COVID-19? Blue Cross and Blue Shield Companies Cover COVID-19 Testing and Treatment, I listened: A nurse case manager on addressing vaccine hesitancy, Meeting the challenge - BCBS companies are supporting Americans during COVID-19, COVID-19 vaccines: six ways were part of the solution, Blue Cross and Blue Shield of Kansas City, Horizon Blue CrossBlue Shield of New Jersey, Blue Cross and Blue Shield of North Carolina, Blue Cross and Blue Shield of North Dakota. Medicaid members in California and Nevada: You can also see a doctor from your smartphone or tablet through LiveHealth Online. Anthem will process the claim as if there is no member cost sharing, as it does, for example, with preventive health services. %%EOF 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. 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. Call your doctor if you develop a fever, have a cough, or have difficulty breathing. In compliance with California state law, some Anthem plans cover COVID-19 screening with no out-of-pocket costs. 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. 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. Wash your hands often with soap and water for at least 20 seconds. 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 in this document to Nevada Medicaid by the provider types listed. The U.S. Department of Health and Human Services (HSS) announced the distribution of approximately $15 billion from the Provider Relief Fund to eligible providers who participate in state Medicaid and the Children's Health Insurance Program (CHIP): On June 9, 2020, the Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced additional distributions from the Provider Relief Fund to eligible Medicaid and Childrens Health Insurance Program (CHIP) providers who participate in state Medicaid and CHIP programs. We use cookies on this website to give you the best experience and measure website usage. In Maine: Anthem Health Plans of Maine, Inc. Members can use Anthems Sydney Health mobile app for a quick and easy way to evaluate symptoms and see a doctor from home. They are for people who have no symptoms of COVID-19 and no known or suspected exposure to people who have COVID-19. Please note this coverage does not apply to LiveHealth Online visits. Treatment that's safe and convenient Members can rest assured that if they do fall ill with COVID-19, they will not need to pay any out-of-pocket costs or get a prior authorization for their treatment. Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. We're here to make sure you have the resources and care you need to keep yourself safe and well. During the COVID-19 crisis, care providers are working to keep the country running while navigating the financial impact it is having on them: Effective March 20, 2020, hydroxychloroquine and chloroquine prescriptions will require a diagnosis code on the prescription. If you are, youll be able to place an order. 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. For members of Medicare Advantage plans, CMS issued guidance that the COVID-19 vaccine administration should be billed by providers to the CMS Medicare Administrative Contractor (MAC) using product-specific codes for each vaccine approved. What is changing regarding prior authorization requirements? 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. 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. Were sharing information about how you can protect yourself and the people you care about. 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. These trials show the FDA whether a vaccine is safe and effective. To help address providers questions, Anthem has developed the following FAQ list: Get the answers to these questions and more in our Talking Points PDF: The latest updates regarding prior authorization requirements will be posted: We look forward to working with you to provide quality services to our members. Washing your hands is the best way to avoid getting sick: Wash often with soap and water for at least 20 seconds. What codes would be appropriate for COVID-19 lab testing? This is also for . To learn where you can obtain a test visit the State of New Jerseys. Here is what the CDC recommends. Use of the Anthem websites constitutes your agreement with our Terms of Use. In addition to using a telehealth service, you can receive in-person or virtual care from your own doctor or another healthcare provider in your plan's network. According to the CDC, vaccination prevents severe illness, hospitalizations, and death. Member Discounts Take advantage of member-only discounts on health-related products and services. 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 . Horizon Blue Cross Blue Shield of New Jersey, Your Guide to No-Cost Testing and Treatment as COVID-19 Surges, COVID-19 Information Hub section on testing, Site-Neutral Payments Would Save Nearly $500 Billion Over 10 Years, Blue Cross Blue Shield Association Statement on Medicare Advantage Risk Adjustment Validation Rule, Blue Cross Blue Shield Association Policy Solutions Could Lower Health Care Costs by $767 Billion, Blue Cross Blue Shield Companies Form Synergie Medication Collective, a New Venture to Radically Improve Affordability and Access to Costly Medications for Millions of Americans, Congress Passes Meaningful Changes to Expand Mental Health Support, Improve Maternal Health, and Lower Costs for Consumers, Blue Cross and Blue Shield of Louisiana Offers Services to Members Affected by Hurricane Ida, Blue Cross Of Idaho And The Blue Cross Of Idaho Foundation For Health Commit To Expanding Health Equity Across Idaho, Blue Cross Blue Shield of Wyoming Announces New Board Member, James G. Springfield Named President of Blue Cross and Blue Shield of Texas. The app will remind you when to get your second dose. What modifier is appropriate to waive member cost sharing for COVID-19 testing and visits related to testing? For more information, view our privacy policy. As we announced on March 6, 2020, Anthem will waive cost shares for members of our fully-insured employer-sponsored, individual, Medicare, Medicaid and self-funded plan membersinclusive of copays, coinsurance and deductiblesfor COVID-19 test and visits to get the COVID-19 test. Commercially insured members: 1-888-624-3096, Members covered through Medicaid plans: 1-800-711-5952, SHBP/SEHBP members: 1-800-414-SHBP (7427), Horizon Chat for Care may be available to some members at no cost through the companys free Horizon Blue app and. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. Claims for COVID-19 diagnostic testing procedure code 87426 (Infectious agent antigen detection by immunoassay technique) are not required to be billed with procedure code 87301. Does Anthem require a prior authorization on the focused test used to diagnose COVID-19? An airway and lung infection, similar to a cold. Dont stop taking your medicines as prescribed, and get your refills on time. Anthem will cover the administration of COVID-19 vaccines with no cost share for in- and out-of-network providers, during the national public health emergency, and providers are not permitted under the federal mandate to balance-bill members. We will pay for care you get from doctors outside your plan (called out of network) as long as the services are medically needed. Additionally, members who have a pharmacy plan that includes a 90-day mail-order benefit should talk to their doctor about whether changing from a 30-day supply to a 90-day supply of their prescriptions is appropriate. Our clinical team is actively monitoring external queries and reports from the Centers for Disease Control and Prevention (CDC) to help us determine what action is necessary on our part. Clean and disinfect frequently touched objects and surfaces like phones, keyboards, and doorknobs. Effective April 3, 2020, and for the duration of and consistent with Colorados emergency orders, Anthem will cover the additional services outlined in those orders. hb```e`` B@9 e'0w0i4bH) 3g2Ofaf~.j1* 30@vs10+|2 0 gV The cost-sharing waiver includes copays, coinsurance and deductibles. In case of mass pandemic, how can you ensure that your contracted providers can still provide services? Heres what the Centers for Disease Control and Prevention says about wearing a facemask. Members can also talk with your in-network doctor or get care through telemedicine services without incurring any out-of-pocket costs. For out-of-network providers, Anthem waived cost shares from March 17, 2020, through June 14, 2020. Find free videos and tools that address topics like depression and anxiety in a helpful, sympathetic way. Administrative. Steps you can take to protect yourself and others from COVID-19: Its best to follow the CDCs recommendations for using a facemask. No. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Providers who request to enroll with Nevada Medicaid to administer the COVID-19 vaccine must submit an initial application using the following resources. Get the latest news and information from the CDC at Please log in and update your communication preferences to make sure you receive the latest information. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Our actions are intended to support the protective measures taken across the country to help prevent the spread of COVID-19 and reduce barriers to seeing a doctor, getting tested and maintaining adherence to medications for long-term health issues. Call us at 888-832-2583 to explore your options. padding: 0.6rem; COVID-19 diagnostic tests, including serology or antibody tests, and visits to get the test, for the duration of the public emergency. 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. Members can call the Pharmacy Member Services number on their health plan ID card to learn more. Talk to your doctor to see if a 90-day supply would work for you. Cover your cough or sneeze with a tissue, and throw away the tissue. As of November 8, 2022, THIS DOCUMENT WILL NO LONGER BE UPDATED. After that time, standard Medicare and Medicare Supplement cost sharing and coverage will apply. An attending health care provider may order a test. If you're not sure whether your plan covers COVID-19 screening, please call the Member Services number on your ID card. We are fielding questions about the outbreak from our customers, members, providers and associates. 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 . 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. If theres an epidemic, how will you ensure that the doctors in my plan can still provide care? Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. Learn more about COVID-19, including what you can do to prevent the spread of the disease and ways to stay healthy. COVID-19 testing remains an important part of keeping our families and communities safe. Johns Hopkins University has resources to help you learn more about the disease. Do a video or phone visit with a doctor or therapist from home. How can I find a COVID-19 testing location? Anthem is monitoring COVID-19 developments and what they mean for our associates and those we serve. Will Anthem cover telephonic-only services in addition to telehealth via video + audio? The guidance here can make it easier for you to refer your patients to high-quality, lower-cost COVID-19 testing sites, find Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem)-contracted laboratories and identify the proper CPT codes to use. Effective May 1, 2021, for members of our fully-insured employer and individual plans, as well as self-funded plans, Anthem will reimburse for the administration of COVID-19 FDA-approved vaccines at a rate of $40 per administration. You'll need to submit them when you apply for reimbursement. Only visit the ER or call 911 if you're experiencing life-threatening symptoms. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. For non-COVID-19 tests (like flu, RSV, etc.) Cant reach your doctor? LiveHealth Online is a 24/7 telehealth service that's free with Medicare Advantage plans. As we announced on March 6, 2020, Anthem will waive cost shares for members of our fully insured employer-sponsored, individual, Medicare, Medicaid and self-funded plan membersinclusive of copays, coinsurance and deductiblesfor COVID-19 test and visits to get the COVID-19 test. Visit the CDC website for the most up-to-date testing guidance. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. How is Anthem reimbursing participating hospitals that perform COVID-19 diagnostic testing in an emergency room or inpatient setting? Serving residents and businesses in the 28 eastern and southeastern counties of New York State. Findings. 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. If youre experiencing symptoms or if your doctor recommends a test, use our COVID-19 Test Site Finder to search your ZIP Code and find testing options near you. 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. No copays for telehealth services provided by Teladoc. What financial assistance is available for care providers during the COVID-19 crisis? Anthem is relaxing early prescription refill limits, where permitted, for members who have Anthem pharmacy benefits and wish to refill a 30-day supply of most maintenance medications early. We know how important it is to continue taking your prescriptions as directed by your doctor. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. The Division of Health Care Financing and Policy (DHCFP) has created three flyers to provide information to Nevada Medicaid recipients on COVID-19 covered services, COVID-19 vaccines, and COVID-19 vaccination prioritization lanes. We know these are challenging times, and want you to know that we remain deeply committed to supporting you to get care and protect your overall health and wellbeing. Arrive in 2 to 5 business days. Members can rest assured that if they do fall ill with COVID-19, they will not need to pay any out-of-pocket costs or get a prior authorization for their treatment. This will ensure that Medicare Advantage members will not have cost sharing for the administration of the vaccine. For members who arent feeling well, telehealth services are available so you can get care at home. 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. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. If you have a Medicare Advantage, Medicare Supplement or MMP plan, or Medicaid from us, your plan covers sick visits and tests. Can I visit the emergency room for a test? What is Anthem Doing to Help with Access to Care, Telehealth, and Cost Sharing? Serving California. Anthem members will receive the COVID-19 vaccination at no cost Coverage for COVID-19 testing COVID-19 treatment Visit a doctor from home Refill your prescription medication early Emotional and mental health support resources are available Sources Simply put, if your doctor determines that you should be tested for COVID-19, your out-of-pocket costs for testing will be waived. If your plan offers LiveHealth Online, just log in at anthem.com/ca to use it. There are no delivery charges for members who use Anthems Home Delivery Pharmacy. Anthem is committed to working with and supporting our contracted providers. Were monitoring developments in this area closely and will evaluate how benefits will cover treatments once treatments are approved. Eligible members can find an in-network doctorhereor access HorizonCareOnline through the Horizon Blue app,www.horizoncareonline.com, orwww.HorizonBlue.com. However, to assist providers our COVID-19 Vaccination Roster Billing Form provides a default Z23 diagnosis code. The CARES Act provides financial relief to lessen the impact of the COVID-19 crisis. The visit and test are covered whether you get care in a doctors office, urgent care center or emergency department. Wash your hands often with soap and water; use hand sanitizer when you cant wash. Clean and disinfect items and surfaces you touch often. Prior authorization is not required for COVID-19 testing. Anthem members will receive the COVID-19 vaccination at no cost, Anthem will help you coordinate COVID-19 care, Anthems alternative virtual care offerings, Prescription Medications and Pharmacy Services, Take advantage of emotional and mental health support. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. Stay six feet away from others, avoiding crowds and poorly ventilated spaces. To access your member services, please visit your BCBS company. That includes older adults, people living with disabilities, and those with chronic medical conditions like diabetes, and heart, lung or kidney disease. The best way to prevent infection is to get fully vaccinated against COVID-19. This applies to both diagnostic and screening tests. Were working closely with the doctors and other health care professionals in our plans to prepare for more calls and visits. 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