For telehealth services rendered by a facility provider, report the CPT/HCPCS code with the applicable revenue code as would normally be done for an in-person visit, and also append either modifier 95 or GT. 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. Anthems affiliated health plans are committed to help our members gain timely access to care and services in a way that places the least burden on the healthcare system. How is Anthem reimbursing participating hospitals that perform COVID-19 diagnostic testing in an emergency room or inpatient setting? 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 members have access to telehealth 24/7 through LiveHealth Online. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Get Reimbursed for Over-the-Counter COVID-19 Tests. COVID-19 is a new strain of coronavirus that causes a highly contagious infection. If you are traveling, visit cdc.govfor the CDCs most current travel guidelines. As of November 8, 2022, THIS DOCUMENT WILL NO LONGER BE UPDATED. Members can check their symptoms and connect with a doctor right from their phone. Call 911 if you see emergency warning signs like the below. 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. For members of Medicaid plans, Medicaid state-specific rate and other state regulations may apply. Effective March 17, 2020, through September 30, 2020, unless a longer period is required by law, Anthems affiliated health plans will waive member cost share for telehealth (video + audio) in-network visits, including visits for behavioral health, for our fully-insured employer plans and individual plans. Symptoms may appear 2-14 days after being around someone who has COVID-19. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. Reimbursement is available only during the COVID-19 public health emergency. 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. The expansion covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020. You'll need to submit them when you apply for reimbursement. div.treatment-testing-cont div.motif-icon.motif-syringe:before, Leading the way in health insurance since 1929. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. It also lets you notify the CDC of any side effects you may experience. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. 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. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. The CARES Act provides financial relief to lessen the impact of the COVID-19 crisis. 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. Members can access LiveHealth Online at https://livehealthonline.com/ or download the LiveHealth Online app from the App Store or Google Play. Researchers from UNR Med, in partnership with the NV Department of Health and Human Services and Immunize NV, are conducting a survey to learn about the public's knowledge about the COVID-19 vaccines. Anthem is a registered trademark. margin-bottom: 40px; Medicaid members in California and Nevada: You can also see a doctor from your smartphone or tablet through LiveHealth Online. This extension applies to Horizon BCBSNJs fully insured members, including those covered through Medicaid, Medicare Advantage, Individual and Small Group policies. div.treatment-testing-cont div.motif-icon.motif-marker:before { These products are restricted from coverage through the pharmacy point-of-sale (POS) system. Heres what the Centers for Disease Control and Prevention says about wearing a facemask. How can I find a COVID-19 testing location? Providers who currently submit electronic claims are encouraged to do so. 111 0 obj <> endobj 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. Through May 31, all BCBS companies including the BCBS Federal Employee Program (FEP)are: Waiving cost-sharing for COVID-19 testing and treatment. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. All Rights Reserved. Administrative. 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. Your member ID card is your key to using your medical plan benefits. Members can see an in-network doctor or use Horizon BCBSNJs telemedicine platform (HorizonCareOnline) for any covered purpose including diagnosis or treatment of COVID-19 and even for routine care or mental health care. 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. We are waiving your costs for telehealth visits with your doctor through January 31, 2021. 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. To help care providers navigate the resources available to them, Anthem has compiled information on programs we have learned about that could provide additional financial relief during this crisis. The cost-sharing waiver includes copays, coinsurance and deductibles. What member cost-shares will be waived by Anthems affiliated health plans for virtual care through internet video + audio or telephonic-only care? This information can be found in theFederal Resources Available for Care Providers and Employers in the Federal CARES Actarticle in AnthemProvider News. For non-COVID-19 tests (like flu, RSV, etc.) Cover your cough or sneeze with a tissue, and throw away the tissue. Find free and reduced-cost support for food, transportation, housing, health and more. performed during a provider visit that results in an order for, or administration of, diagnostic testing for COVID-19. Screening tests show whether or not someone has COVID-19. Are COVID-19 tests covered? Were working closely with the doctors and other health care professionals in our plans to prepare for more calls and visits. 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. who seek reimbursement for the administration of a COVID-19 vaccine must do so by using their encounter code and the COVID-19 vaccine administration Current Procedural Terminology (CPT) codes. 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. Anthem has a business continuity plan for serious communicable disease outbreaks, inclusive of pandemics, and will be ready to deploy the plan if necessary. 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. 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. Our actions should reduce barriers to seeing a physician, getting tested and maintaining adherence to medications for long-term health issues. Its part of the same family of coronaviruses that includes the common cold. 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. Cover your coughs and sneezes with tissues; discard the tissues. -moz-border-radius: 50%; independent licensees of the Blue Cross and Blue Shield Association. Some Anthem health plans include LiveHealth Online. Increasing access to prescription medications. 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. Ordering at-home test kits from Anthem. Arrive in 2 to 5 business days. Serving California. What is changing regarding prior authorization requirements? FEP will also encourage members to use the 90-day mail order benefit, if available through your health plan.If you are having difficulty paying for your treatment, contact the retail pharmacy phone number on the back of your ID card for assistance. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. 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