| 5/2/2022 | Coverage of the COVID-19 Vaccination for AmeriHealth Members (Updated May 2, 2022) | 0.1 | | The purpose of this communication is to provide notice regarding information and procedure codes related to the coverage of SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) vaccines and administration of the vaccines for AmeriHealth members. | Coverage of the COVID-19 Vaccination for AmeriHealth Members (Updated May 2, 2022) | cb1cfab2-0501-4d60-9d3d-fe5793de137e |
| 3/31/2022 | 04/01/2022 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products | 0.1 | | The intent of this document is to communicate Medicare Advantage Product coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 04/01/2022, unless otherwise noted.
For more information related to these services, please refer to specific policies when applicable.
| 04/01/2022 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products | 323cf94c-642b-4c76-875a-58fd5d2db3f6 |
| 3/7/2022 | Preventive Coverage of Recombinant zoster vaccine (Shingrix), 15-Valent Pneumococcal Conjugate Vaccine, and 20-Valent Pneumococcal Conjugate Vaccine for AmeriHealth Members | 0.1 | | The purpose of this communication is to provide notice regarding the expanded preventive coverage criteria for recombinant zoster vaccine (Shingrix), 15-Valent
Pneumococcal Conjugate Vaccine, and 20-Valent Pneumococcal Conjugate Vaccine for AmeriHealth members effective January 21, 2022.
| Preventive Coverage of Recombinant zoster vaccine (Shingrix), 15-Valent Pneumococcal Conjugate Vaccine, and 20-Valent Pneumococcal Conjugate Vaccine for AmeriHealth Members | 9e15f350-0456-4178-a764-00d2008473fe |
| 2/18/2022 | Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for AmeriHealth New Jersey Members (Updated February 18, 2022) | 0.1 | | The purpose of this communication is to provide advance notice regarding information and procedure codes related to testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for AmeriHealth New Jersey members. | Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for AmeriHealth New Jersey Members (Updated February 18, 2022) | a880bb62-8bf9-40de-8334-c30bd9d5e9a0 |
| 2/18/2022 | Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) For AmeriHealth Pennsylvania Members (Updated February 18, 2022) | 0.1 | | The purpose of this communication is to provide advance notice regarding information and procedure codes related to testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for AmeriHealth Pennsylvania members. | Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) For AmeriHealth Pennsylvania Members (Updated February 18, 2022) | 76beb4d2-4ba5-433d-8e10-0d02ef11564a |
| 1/24/2022 | Extension of Coverage for Immune Prophylaxis for Respiratory Syncytial Virus (RSV) with palivizumab (Synagis) | 0.1 | | The purpose of this communication is to convey notification of coverage of additional doses for palivizumab (Synagis) for the expanded 2021-2022 RSV season.
| Extension of Coverage for Immune Prophylaxis for Respiratory Syncytial Virus (RSV) with palivizumab (Synagis) | cfe38afc-228a-42c5-b513-97ae3a2d13e8 |
| 12/31/2021 | ADUHELM™ (aducanumab-avwa) injection for Commercial Members (Updated January 1, 2022) | 0 | | The purpose of this communication is to provide notification of the Company's position for ADUHELM™ (aducanumab-avwa) injection for all Commercial Products effective as of June 7, 2021.
| ADUHELM™ (aducanumab-avwa) injection for Commercial Members (Updated January 1, 2022) | 6329e021-520f-4cad-8d97-5b61b3bf011b |
| 12/31/2021 | Telemedicine and Telehealth Services for AmeriHealth New Jersey Members (Updated January 1, 2022) | 0.1 | | The purpose of this document is to provide advance notice regarding coverage for telemedicine and telehealth services for our AmeriHealth New Jersey members during the coronavirus disease 2019 state of emergency.
This communication addressing telemedicine and telehealth services is effective through a period of 90 days following the end of the State of Emergency and Public Health Emergency as described in Executive Order 103 and supersedes Policy #00.10.42c Telemedicine and Telehealth (AmeriHealth New Jersey) during this time period.
This policy communication addressing telemedicine and telehealth services has been revised to address a new place of service, 10, and a new modifier, FQ.
| Telemedicine and Telehealth Services for AmeriHealth New Jersey Members (Updated January 1, 2022) | d30bb96e-f3ed-4abb-815d-6bf95cf7bdeb |
| 12/31/2021 | Coverage of Speech Therapy Services Performed Through Telemedicine for AmeriHealth Members (Updated January 1, 2022) | 0.1 | | The purpose of this communication is to provide notice regarding coverage for speech therapy services performed through telemedicine for our AmeriHealth members during the coronavirus disease 2019 public health emergency.
This communication addressing coverage of speech therapy services performed through telemedicine shall remain in effect until further notice is provided
Refer to the Telemedicine and Telehealth Services for AmeriHealth New Jersey Members communication for members enrolled in AmeriHealth New Jersey products.
This policy communication addressing coverage of speech therapy performed through telemedicine has been revised to address a new place of service, 10.
| Coverage of Speech Therapy Services Performed Through Telemedicine for AmeriHealth Members (Updated January 1, 2022) | a7ca986f-be03-4cfa-b282-1dbd4a51cf2c |
| 12/31/2021 | 1/01/2022 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products (Updated January 7, 2022) | 0.1 | | The intent of this document is to communicate Commercial Product coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 01/01/2022, unless otherwise noted. | 1/01/2022 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products (Updated January 7, 2022) | 09f459f7-2a55-468a-a1d7-4a8e19ec7108 |
| 12/29/2021 | Coverage of Preventive Well Visits Performed Through Telemedicine Response to COVID-19 for AmeriHealth New Jersey Members (Updated December 29, 2021) | 0.1 | | The purpose of this document is to communicate that coverage of preventive well visits performed through telemedicine is addressed in the Telemedicine and Telehealth Services for AmeriHealth New Jersey Members communication.
| Coverage of Preventive Well Visits Performed Through Telemedicine Response to COVID-19 for AmeriHealth New Jersey Members (Updated December 29, 2021) | 185069d1-3c94-4b61-a69f-dbf2b733aff5 |
| 12/1/2021 | Expiration of Coverage for Consumer Grade Pulse Oximeters Effective January 1, 2022 for Commercial Members | 0.1 | | The purpose of this communication is to provide advance notification of our position on consumer grade pulse oximetry devices for use in the home setting, which will expire January 1, 2022 for Commercial members.
| Expiration of Coverage for Consumer Grade Pulse Oximeters Effective January 1, 2022 for Commercial Members | 11414b6a-5ef4-485e-b9e9-9a901752274d |
| 10/1/2021 | 10/1/2021 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products | 0.1 | | The intent of this article is to communicate Commercial Product coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 10/1/2021, unless otherwise noted.
For more information related to these services, please refer to specific policies when applicable. | 10/1/2021 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products | eea47e14-d8f5-4fad-b64f-cca234e83dc6 |
| 9/17/2021 | Preventive Coverage of Work-up and Follow-up Services for Pre-exposure Prophylaxis for the Prevention of HIV for AmeriHealth Members | 0.1 | | The purpose of this communication is to provide notice regarding the preventive coverage of services received by an individual prior to beginning pre-exposure prophylaxis for the prevention of HIV and on-going follow-up and monitoring for AmeriHealth members.
| Preventive Coverage of Work-up and Follow-up Services for Pre-exposure Prophylaxis for the Prevention of HIV for AmeriHealth Members | cb45a059-776b-47e1-96f8-b10112b58900 |
| 6/15/2021 | Notification of Upcoming Changes to Pharmacologic Nuclear Stress Testing in response to COVID-19 | 0 | | The purpose of this NewsFlash is to provide
advance notice that medical necessity reviews will resume for new prior authorization requests on or after July 15, 2021 regarding the use of pharmacologic stress testing with nuclear
imaging in lieu of exercise stress testing.
| Notification of Upcoming Changes to Pharmacologic Nuclear Stress Testing in response to COVID-19 | b84b1f63-d93c-4135-a044-dfb6ae36d3dd |
| 4/1/2021 | 4/1/2021 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products | 0.1 | | The intent of this article is to communicate Commercial Product coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 4/1/2021, unless otherwise noted.
| 4/1/2021 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products | d9abbf7e-c97e-4b3a-9663-b4c1f5718349 |
| 1/4/2021 | 1/1/2021 CPT & HCPCS Annual Code Update Coverage Determinations for Commercial Products | 0 | | The intent of this document is to communicate Commercial Product coverage determinations for services identified through the Annual Code Update process.
| 1/1/2021 CPT & HCPCS Annual Code Update Coverage Determinations for Commercial Products | e9ec2c0c-fb3f-4dc8-ba77-76f1d77bff75 |
| 10/22/2020 | Pharmaceutical Prophylaxis and Treatments of COVID-19 for AmeriHealth Pennsylvania Members (Updated April 28, 2022) | 0.1 | | The purpose of this document is to communicate the Company's coverage position for Pharmaceutical Treatment of COVID-19 for AmeriHealth Pennsylvania members.
| Pharmaceutical Prophylaxis and Treatments of COVID-19 for AmeriHealth Pennsylvania Members (Updated April 28, 2022) | 9d18c342-541c-4222-ab09-0a73f089212e |
| 10/22/2020 | Pharmaceutical Prophylaxis and Treatments of COVID-19 for AmeriHealth New Jersey Members (Updated April 28, 2022). | 0.1 | | The purpose of this document is to communicate the Company's coverage position for Pharmaceutical Treatment of COVID-19 for AmeriHealth New Jersey members.
| Pharmaceutical Prophylaxis and Treatments of COVID-19 for AmeriHealth New Jersey Members (Updated April 28, 2022). | 0cec2182-652c-4992-8689-10b814c7a120 |
| 10/1/2020 | 10/1/2020 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products | 1 | | The intent of this article is to communicate Commercial Product coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 10/1/2020, unless otherwise noted.
For more information related to these services, please refer to specific policies when applicable.
| 10/1/2020 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products | c1c57826-12dd-47cc-b303-2102ee13691a |
| 7/17/2020 | Respiratory Equipment and Related Supplies (Updated April 16, 2021)
| 1 | | The purpose of this News Article is to provide advance notice during the COVID-19 outbreak related to respiratory equipment and related supplies. | Respiratory Equipment and Related Supplies (Updated April 16, 2021) | 5B5700A06FC104F9852585A70077812F |
| 7/1/2020 | 7/1/2020 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products | 1 | | | 7/1/2020 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products | 5D38243F686BE26685258598006308EB |
| 5/19/2020 | Telemedicine and Telehealth Services for AmeriHealth New Jersey Members (Updated December 14, 2020)
| 1 | |
The purpose of this News Article is to provide advance notice regarding coverage for telemedicine and telehealth services for our AmeriHealth New Jersey members during the coronavirus disease 2019 state of emergency. | Telemedicine and Telehealth Services for AmeriHealth New Jersey Members (Updated December 14, 2020) | B804E29A492DDB848525856D0044CCE4 |
| 5/12/2020 | Pharmacologic Nuclear Stress Testing in Response to COVID-19 (Updated June15, 2021)
| 1 | | The purpose of this News Article is to provide advance notice regarding the use of pharmacologic stress testing with nuclear imaging in response to the Public Health Emergency (PHE) for the COVID-19 pandemic. | Pharmacologic Nuclear Stress Testing in Response to COVID-19 (Updated June15, 2021) | A5277AA82A838E708525856500751E28 |
| 4/29/2020 | Direct Supervision Requirements for Incident to Services Performed by Certified Registered Nurse Practitioners (CRNPs) and Physician Assistants (PAs) in Response to COVID-19 (Updated December 15, 2021)
| 1 | | The purpose of this News Article is to provide advance notice regarding direct supervision requirements for Incident to services performed by Certified Registered Nurse Practitioners (CRNPs) and Physician Assistants (PAs) in response to Coronavirus Disease 2019 (COVID-19). | Direct Supervision Requirements for Incident to Services Performed by Certified Registered Nurse Practitioners (CRNPs) and Physician Assistants (PAs) in Response to COVID-19 (Updated December 15, 2021) | CE6C7792C6B95201852585590043BD99 |
