You should follow existing claims reimbursement processes to obtain an at-home test reimbursement. Similarly, FEP will waive any copays or deductibles for diagnostic tests or treatment that are medically necessary and consistent with CDC guidance if diagnosed with COVID-19. COVID-19 test Note: Cost share waive for to COVID-19 treatment expires on 08/31/2021. Network of Preferred Providers: Note: Telephonic codes (98966-98968, 99441-99443) do not require the use of any telehealth modifier. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. The modifier should be 95 or GT. 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. Network of Preferred Providers: For HMO plans that do not have an out-of-network benefit, there is no coverage for non-emergency COVID-19 treatment received from out-of-network providers. Claim Forms - Blue Cross and Blue Shield's Federal Employee Program This helps make sure you dont have to pay more out-of-pocket. c I had COVID-19 symptoms. 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC, making use of high throughput technologies as described by CMS-2020-01-R. 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, Asymptomatic and without known COVID-19 contact, Contact with and (suspected) exposure to other viral communicable diseases, Symptomatic or has been exposed to COVID-19, Encounter for observation for suspected exposure to other biological agents ruled out, Encounter for screening for COVID-19 (Effective January 1, 2021), Contact with and (suspected) exposure to COVID-19 (Effective January 1, 2021), Other coronavirus as the cause of diseases classified elsewhere, SARS-associated coronavirus as the cause of diseases classified elsewhere, 2019-nCOV acute respiratory disease (Effective April 1, 2020), Pneumonia due to COVID-19 (Effective January 1, 2021), Multisystem inflammatory syndrome (Effective January 1, 2021), Other specified systemic involvement of connective tissue (Effective January 1, 2021), Diagnostic site (including COVID-19 testing) or therapeutic site (including dialysis; excluding physician office or hospital) to hospital, Residential, domiciliary, custodial facility (other than skilled nursing facility) if the facility is the beneficiarys home to hospital, Hospital to diagnostic site (including COVID-19 testing) or therapeutic site (including dialysis; excluding physician office or hospital), Hospital to residential, domiciliary, custodial facility (other than skilled nursing facility) if the facility is the beneficiarys home, Hospital to hospital (includes ASCs approved to provide hospital level of care), Hospital to alternative site for skilled nursing facility (SNF), Freestanding end-stage renal disease (ESRD) facility to skilled nursing facility, Skilled nursing facility to freestanding end-stage renal disease (ESRD) facility, Physician office to community mental health center, federally qualified health center, rural health center, urgent care facility, non-provider-based ambulatory surgical center or freestanding emergency center, or location furnishing dialysis services that is not affiliated with an end-stage renal facility, Physician office to residential, domiciliary, custodial facility (other than skilled nursing) if the facility is the beneficiarys home. up to $12 per test under the safe harbor (for plans that provide access to the tests . Click Reimbursement Form. Keep your purchase receipt(s) to submit for reimbursement. Some self-funded group plans may not cover all the costs when seeing an out-of-network provider. If you mistakenly receive reimbursement from an FSA, HSA, or HRA for at-home test costs covered by Blue Shield, you should contact the FSA, HSA, or HRA administrator. Cognitive impairments resulted from COVID-19 that was either clinically diagnosed or diagnosed through PCR/Antigen testing. 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. These may include fees for other tests or services. You can find a list of community-based testing sites here. UnitedHealthcare (UHC) 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. COVID-19 testing for routine travel does not qualify as urgent or emergency care. If you are currently seeing a mental healthcare provider, you can continue to see that provider virtually. If you have a Medi-Cal plan, your at-home tests will be covered by your pharmacy benefits. 24/7 access is provided at no cost. How to Submit Your At-Home COVID Test to Your Insurance - Health If you havent yet paid the provider, the check goes to the provider. 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. The updated COVID-19 vaccine boosters better protect against the most recent Omicron subvariants. Coverage varies by plan type. For help with these documents, please call 1-800-975-6314. . All rights reserved. Find out about COVID-19 vaccination, including side effectsand more. 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. Most diagnostic and screening tests are covered for the majority of Blue Shield members. How can I submit a claim form for my OTC COVID-19 at-home tests? Coverage for Medi-Cal and Cal MediConnect members Vaccine and vaccine administration codes for COVID-19. The screenshot below shows the correct way to enter modifiers. Member Reimbursement: If members purchased an OTC COVID-19 test on or after January 15, 2022, they can submit for a reimbursement of up to $12 per test. Or, contact our Clinical Pharmacy Operations area. We have added these codes to our COVID-19 Temporary payment policy. *Reimbursement for these codes is included in the payment for an evaluation or management (E/M) service if reported by the same provider on the same day, for the same member. COVID-19 | Blue Cross and Blue Shield of Illinois - BCBSIL Health Insurance Alabama | Blue Cross and Blue Shield of Alabama See details for how to submit a claim for reimbursement for covered testing. Licensees of the Blue Cross and Blue Shield Association. California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. Blue Shield of California PO Box 272540 Chico, CA 95927-2540 COVID-19 laboratory tests (PCR tests) If you paid out of pocket for a test that was sent to a laboratory, follow the steps below to file a reimbursement claim. Please be aware that this statement isnota bill. Others may need a boost due to the vaccine becoming less effective over time. For COVID-19-related diagnoses, they asked insurers to add quantity limits. To avoid paying any extra fees, please use. The federal government has officially launched a program requiring health insurance companies to cover the cost of at-home COVID-19 testing kits. If you have a Medicare Advantage Plan, you must have a healthcare provider order for your OTC at-home test purchases to be reimbursed by Blue Shield. We want to help ease stress during these uncertain times. This applies to all accounts except the Federal Employee Program (FEP). Bill for administration of first dose of CPT 91300 (Pfizer-BioNtech COVID-19 vaccine), Bill for administration of second dose of CPT 91300 (Pfizer-BioNTech COVID-19 vaccine), Bill for administration of first dose of CPT 91301 (Moderna-COVID-19 vaccine), Bill for administration of second dose of CPT 91301 (Moderna-COVID-19 vaccine), Bill for administration of CPT 91303 (Janssen COVID-19 Vaccine). 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. 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. Cost share is waived for members with a COVID-19 diagnosis, Cost share will apply to members without a COVID-19 diagnosis, Skilled nursing, rehab, and long-term acute care, Commercial HMO/POS and PPO (fully insured accounts). Registered Marks of the Blue Cross and Blue Shield Association. How can I get a free OTC COVID-19 test? Contact the company for the latest information. For Marketplace inquiries, please call 517-364-8567 or (toll-free) 866-539-3342. For in-network outpatient professional behavioral health providers, you should submit a claim to Florida Blue using one of the regular codes included in your fee schedule. Learn about what coverage and care you can receive through your Blue Shield, Blue Shield Promise Medicare Advantage, or Medicare Supplement benefits. Coronavirus (COVID-19) Updates | Blue Cross Blue Shield Important note: This information only applies to the ancillary and behavioral health specialties on this list.