The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. Testing sites: Not all testing sites are the same. We provide health insurance in Michigan. As of April 4, 2022, the Centers for Medicare & Medicaid Services (CMS) is covering up to eight free OTC COVID-19 at-home tests each calendar month at participating pharmacies and healthcare providers. Staying up to date with COVID-19 vaccinations protects against the worst outcomes of COVID-19. To learn more about treatments and medications, visit the Centers for Disease Control and Preventions web page. Your Guide to No-Cost Testing and Treatment as COVID-19 Surges 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. HSAs are offered through financial institutions. Please note that if you have previously visited an out-of-network provider and received a check payment from Blue Shield, our process has changed. Reimbursement for tests purchased before January 15, 2022: Bill all covered services that you render as if you are performing an in-person service using the codes that are currently on your fee schedule. You should follow existing claims reimbursement processes to obtain an at-home test reimbursement. Does BCBSIL cover at-home test kits? If you purchased an at-home test previously, you may be able to get paid back. HSAs are offered through financial institutions. These services can help you see if your symptoms may be related to COVID-19 or something else. We cover medically necessary telehealth services (COVID-19 and non-COVID-19-related) for in-network providers. They can obtain the tests from pharmacies, retailers and online vendors. How our department monitors insurance market practices, Insurance Company Contract and Rate Filings. 1-800-882-1178. FEP will waive copays for telehealth services related to COVID-19. https://www.hioscar.com/at-home-covid-test-reimbursement, Network of Preferred Providers: Members will be required to fill out a COVID-19 self-test claim submission sheet and submit it via us mail along with UPC packaging label and receipt. Losing your job doesnt have to mean losing your healthcare coverage. Under the rule, insurance providers are . This applies to both diagnostic and screening tests. I received a check from Blue Shield. bill the test on a separate claim from the rest of the services being rendered. 102811 1021R October 2021 COVID-19 Update as of Oct. 21, 2021 As we move forward during the COVID-19 pandemic, we support the work of providers, and the guidelines set forth by the Florida Department of Health and the Centers for Disease Control and Prevention (CDC). California Physicians' Service DBA Blue Shield of California 1999-2023. Feel free to ask your doctors office what safety steps they are taking to protect patients during the pandemic. *For the Federal Employee Program, benefits and cost share are applicable according to the members plan. See details on theState Medi-Cal websitefor how to submit a claim. Have more questions about testing coverage? Blue Cross and Blue Shield companies (BCBS) will also increase access to prescription drugs, enhanced telehealth and other clinical support . If you're diagnosed as having COVID-19, you won't have any out-of-pocket costs to pay if you get treatment for COVID-19 from doctors, hospitals, and other health-care professionals in your plan's network through May 31, 2020. Find out which COVID-19 tests are available to members and where to get tested. https://www.hioscar.com/at-home-covid-test-reimbursement, COVID-19 Testing Coverage Website: 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. For more information, read these FAQs:Frequently Asked Questions on the Revocation of the Emergency Use Authorization for Hydroxychloroquine Sulfate and Chloroquine Phosphate (PDF, 125 KB). FEP will determine coverage for the vaccine once it becomes available. You can have telehealth video or phone visits with children, adolescents, and adults. That form will be replaced on Jan. 23 once the insurer develops . COVID-19 testing for routine travel does not qualify as urgent or emergency care. Please note that tests are currently in short supply and some retailers may impose limits on the number of tests you can purchase. Two COVID-19 updates effective July 1, 2021: Change to telehealth cost share and authorization requirements, Update to bamlanivimab pharmaceutical treatment for COVID-19, Lab claims must include ordering clinician NPI starting July 1, Medicare sequestration suspended through December 31, 2021, Were committed to reducing health care inequities, Revised reimbursement for COVID-19 vaccination administration codes available, Monthly communications aim to reduce vaccine hesitancy, Updated coverage guidelines for COVID-19 testing, Medicare Advantage telehealth cost share & COVID-19 vaccine billing, Updates to vaccine and pharmaceutical treatment codes for COVID-19, Blue Cross Blue Shield of Massachusetts joins national effort to help vaccinate seniors in underserved communities, Were helping to fund free rides for COVID-19 vaccine access, Provider reimbursement for COVID-19 vaccination administration codes are available, Facts may help patients understand and embrace COVID-19 vaccine, COVID-19 Information page updates: Cognitive rehab, testing coverage, and diagnosis codes, Updated billing guidelines and fees for COVID-19 lab testing codes, Telehealth and telephonic codes billing reminder, Updates to COVID-19 vaccine administration codes and pharmaceutical treatment, COVID-19 - Authorization requirements waived until March 31, Vaccines and pharmaceutical treatment for COVID-19, Updates to Medicare Advantage services effective Jan 1, Claims with COVID diagnoses require positive test in chart, COVID-19: Inpatient acute care auth requirements waived until Dec 31, COVID-19: Use appropriate diagnoses when billing for COVID testing, COVID-19: Coverage guidelines for laboratory tests, COVID-19: Coverage guidelines for pharmaceutical treatments, COVID-19: Auths extended; non-emergent transport modifiers, Dental Blue will offer assistance for PPE costs for dentists, Telehealth & online digital codes for FEP & Medicare Advantage, New supports for our members mental health, COVID-19: Continued coverage for early intervention services, COVID-19: Resuming provider audits and claim reviews, Increased fees for COVID-19 lab & specimen collection codes, COVID-19-We're extending our prior authorization waiver, Dental care strategies in the age of COVID-19, How were helping during COVID-19 emergency, COVID-19 payment policy, lab testing codes, claim reminders, COVID-19: APR-DRG Grouper ICD-10 code update, Patients with asthma can get early refill of their controller med, COVID-19: Extending authorizations for specific services, COVID-19: Expedited credentialing process; provider audits on hold, Non-emergency ground ambulance transports covered temporarily, COVID-19: How to bill for drive-through testing, Medicare Advantage reimbursement will be temporarily adjusted, Blue Cross Blue Shield of Massachusetts Telehealth Claims Skyrocket During Coronavirus Pandemic, Member costs waived for inpatient COVID-19 services, Chloroquine, hydroxychloroquine coverage update, Coverage for dental telephone or video consultations, Dentists and oral surgeons: How were helping during COVID-19 emergency, the original hydroxychloroquine policy still applies, Frequently Asked Questions on the Revocation of the Emergency Use Authorization for Hydroxychloroquine Sulfate and Chloroquine Phosphate (PDF, 125 KB), Massachusetts Standard Form for Medication Prior Authorization Requests, Medical Policy 660: Cognitive Rehabilitation, Notification of Enforcement Discretion for telehealth, 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, Serologic testing for the presence of antibodies for known or suspected current or prior COVID-19 infection, Public Health Emergency Credentialing Application, Contact your local plan. Learn about what coverage and care you can receive through your Blue Shield, Blue Shield Promise Medicare Advantage, or Medicare Supplement benefits. However, at-home COVID-19 tests are not qualified medical expenses when the costs are reimbursed by Blue Shield. Provider Hub | Independence Blue Cross - IBX Some plans may also have access to Teladoc or NurseHelp 24/7 as other options for virtual care. Claim Forms | Plan Documents | bcbsm.com How to get reimbursed for COVID-19 tests | Blue Shield of CA 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. Ancillary and some behavioral health providers. If you plan to provide a previously approved service under an authorization that expired on December 31, 2020 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. Medi_22_194_LS_IA_092722 Federal Employee Program (FEP) members Log in to find out if you have access. Health insurance products are offered by Blue Shield of California Life & Health Insurance Company. Will it be covered? Members may have out-of-pocket costs for unrelated fees, depending on their plan benefits. 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. 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. Coverage for COVID-19 testing | Blue Shield of CA Note: These changes do not apply to our Medicare Advantage members. If you did not receive a refund from your provider, please contact their office. Federal Agencies Extend Timely Filing and Appeals Deadlines - COVID 19 Producers | Blue Cross and Blue Shield of Illinois. Blue Cross Blue Shield of Massachusetts Announces New Resources for At Get an in-person test at a Washington or Alaska testing location . Quantity We are following guidelines from the Blue Cross Blue Shield Association regarding coverage for Federal Employee Program members. General Reimbursement Information | Blue Cross and Blue Shield of Texas Below are the codes for providers and laboratories to test patients for COVID-19. They can advise you on how to return the money back into your account. Please be aware that this statement isnota bill. If you plan to provide a previously approved service to a patient in 2021, please call our. https://www.priorityhealth.com/covid-19, Phone Number: If you purchased an OTC at-home test between March 11, 2021, and January 31, 2022, the Department of Health Care Services (DHCS) will reimburse beneficiaries the retail cost with a receipt. COVID-19 Provider Billing Guidelines - Florida Blue Blue Cross Blue Shield said it is also working on a system that would allow members to avoid the reimbursement process. *These modifiers do not apply to Federal Employee Program members. Log in to find out your costs and if you have access. Effective March 16, 2020, Blue Cross and Blue Shield of Alabama is expanding telehealth coverage. 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. https://covidtest.optumrx.com/covid-test-reimbursement. California Physicians' Service DBA Blue Shield of California 1999-2023. This makes it easier to treat and improve the outcome. 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. It is provided as a general resource to providers regarding the overpayment recovery process that may be available for commercial claims. FAQ - COVID-19 | Blue Cross and Blue Shield of Illinois - BCBSIL If a test reader is required, reimbursement is limited to $12. Your standard coverage and out-of-pocket costs apply. If you are submitting 1500 claims using Direct Data Entry in Online Services, please do not use separate fields for each character of the modifier. For more details, please see fepblue.org. Health plans are offered by Blue Shield of California. For our Medicare Advantage members, coverage is through original Medicare. 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. Network of Preferred Providers: For Federal Employee Program and Medicare Advantage members, coverage for these drugs remains the same at this time. Billing for partial hospitalization and intensive outpatient using telehealth. By doing this, we will be able to identify when members should receive the cost-share waiver for COVID-19 testing, and the claim will be . They apply to commercial, Federal Employee Program, and Medicare Advantage members. What virtual care options does my plan cover? Reimbursement for tests purchased before January 15, 2022 COVID-19 Update | Blue Cross and Blue Shield of Illinois - BCBSIL Please choose, Unrelated fees:These are other fees that may be charged for your visit, but are unrelated to the test itself. Individuals, Families, and Group customers with FutureScripts (OptumRx) can use this coverage in three ways: Independence and OptumRx do not control the supply of at-home tests. COVID-19 Home Test Kits - For members | Blue Cross Blue Shield - BCBSRI 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. What's Covered - COVID-19 | Blue Cross and Blue Shield of Texas - BCBSTX For Medicare Advantage plans, you must submit claims for COVID-19 vaccine and the administration of the vaccine to the CMS Medicare Administrative Contractor (MAC) for payment. FAQs about resuming "regular" care For neuropsychological testing services listed in ourmedical policythat require prior authorization, we typically give the member 365 days to complete the authorized services. Leading the way in health insurance since 1929. Effective March 10, 2020, we expanded the telehealth benefit and removed the member cost (copayments, co-insurance, and deductibles) for all COVID-19 related telehealth services, member cost will apply when billed with the appropriate modifiers. The web Browser you are currently using is unsupported, and some features of this site may not work as intended. No, COVID-19 Testing Coverage Website: Please submit the vaccine administration procedure code and vaccine/toxoid code on the same claim. 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 . Varies by plan. PDF COVID-19 Frequently Asked Questions - Blue Cross Blue Shield of Since the drug is supplied free, we will not reimburse separately for the drug regardless of modifier. H0148_22_161_C_IA_092722. Network of Preferred Providers: How To Get Your At-Home Covid Tests Reimbursed - Forbes Advisor What to do if you think you have COVID-19. https://www.hap.org/covid19-coronavirus/at-home-covid-19-rapid-testing-kits.