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10/15/2021
Coverage of the COVID-19 Vaccination for AmeriHealth Members (Updated October 15, 2021)
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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.​​​  This policy communication addressing COVID-19 vaccine for AmeriHealth members has been updated retro-effective to September 22, 2021.



Coverage of the COVID-19 Vaccination for AmeriHealth Members (Updated October 15, 2021)a388c4aa-1926-40d2-a282-3191759c4cd1
10/1/2021
Consumer Grade Pulse Oximetry Devices For Use In The Home Setting (Updated October 01, 2021)
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The purpose of this NewsFLASH is to provide advance notice during the COVID-19 outbreak related to the coverage of consumer grade pulse oximetry devices for use in the home setting.

The coverage of consumer grade pulse oximetry devices for use in the home setting is effective from June 1, 2020 and will be reevaluated for continuing applicability on December 31, 2021.

Consumer Grade Pulse Oximetry Devices For Use In The Home Setting (Updated October 01, 2021)08057418-c1e6-4887-a4df-19c0ac24188b
10/1/2021
10/1/2021 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products
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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 Productseea47e14-d8f5-4fad-b64f-cca234e83dc6
9/23/2021
Coverage of Speech Therapy Services Performed Through Telemedicine for AmeriHealth Members
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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 is effective from March 6, 2020 through January 1, 2022 and will be reviewed for continued coverage during the public health emergency.


​​Refer to the Telemedicine and Telehealth Services for AmeriHealth New Jersey Members (Updated March 19, 2021)​ communication for members enrolled in AmeriHealth New Jersey​ products.


Coverage of Speech Therapy Services Performed Through Telemedicine for AmeriHealth Membersf2b6c80f-17a1-4f5f-86d4-a62c964fca56
9/23/2021
Withdrawal of Advance Notification of Future Policy #00.10.41i: Telemedicine Services Scheduled to Become Effective 10/1/2021 for AmeriHealth Members
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The purpose of this communication is to provide notice of withdrawal of our Advance Notification of Future Policy #00.10.41i: Telemedicine Services (AmeriHealth), initially scheduled to become effective on October 1, 2021.  The current version of Policy #00.10.41h: Telemedicine Services (AmeriHealth), which became effective on July 1, 2021, will continue to communicate our telemedicine coverage position on behavioral health services at this time.  

Refer to Telemedicine and Telehealth Services for AmeriHealth New Jersey Members (Updated March 19, 2021)​ communication for members enrolled in AmeriHealth NJ products. 
Withdrawal of Advance Notification of Future Policy #00.10.41i: Telemedicine Services Scheduled to Become Effective 10/1/2021 for AmeriHealth Members3c662eea-e97b-4507-9128-fcd8c17788ae
9/17/2021
Preventive Coverage of Work-up and Follow-up Services for Pre-exposure Prophylaxis for the Prevention of HIV for AmeriHealth Members
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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 Memberscb45a059-776b-47e1-96f8-b10112b58900
9/13/2021
Pharmaceutical Treatments of COVID-19 for AmeriHealth Pennsylvania Members (Updated October 6, 2021)
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The purpose of this document is to communicate the Company's coverage position for Pharmaceutical Treatment of COVID-19 for AmeriHealth Pennsylvania members.


Pharmaceutical Treatments of COVID-19 for AmeriHealth Pennsylvania Members (Updated September 13, 2021)143ba3ae-92ab-45a6-8d3f-77945d954679
9/13/2021
Pharmaceutical Treatments of COVID-19 for ​AmeriHealth New Jersey Members (Updated October 6, 2021)
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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 Treatments of COVID-19 for ​AmeriHealth New Jersey Members (Updated September 13, 2021)bf989a9d-0996-40e2-8f1d-1e2aa6e262d2
8/19/2021
Expanded Coverage of Recombinant zoster vaccine (Shingrix) for AmeriHealth Members
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The purpose of this communication is to provide notice regarding the expanded coverage criteria for recombinant zoster vaccine (Shingrix)​ for AmeriHealth members effective July 26, 2021.


Expanded Coverage of Recombinant zoster vaccine (Shingrix) for AmeriHealth Members3131e35a-b388-42a3-8ef8-92909e78b169
8/12/2021
ADUHELM™ (aducanumab-avwa) injection (for Commercial Members)
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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)5d1b9fc9-5339-4a64-b5d5-f68745dde812
7/26/2021
Preventive Coverage of Colorectal Cancer Screening for AmeriHealth Members
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The purpose of this document is to provide advance notice regarding preventive coverage for colorectal cancer screening for our AmeriHealth members.

Preventive Coverage of Colorectal Cancer Screening for AmeriHealth Members2966a7ce-5d7b-4652-9390-b8b25f8c192c
6/15/2021
Notification of Upcoming Changes to Pharmacologic Nuclear Stress Testing in response to COVID-19
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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-19b84b1f63-d93c-4135-a044-dfb6ae36d3dd
4/20/2021
Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) For AmeriHealth Pennsylvania Members (Updated October 6, 2021)
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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.
 
This communication addressing Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) is effective from March 6, 2020 through December 31, 2021, or the duration of the Public Health Emergency.​

 
Note: Information related to SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) is continuously evolving. The Company is closely monitoring the outbreak caused by the novel coronavirus, and will update our communications accordingly. ​

 
  • This document replaces the version published on March 19, 2021.

  • Language in the section for SPECIMENS COLLECTED BY A MEMBER was revised for clarity.​

Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) For AmeriHealth Pennsylvania Members (Updated June 16, 2021)bc970482-65d0-4097-8cf3-a4cc2fce4192
4/1/2021
4/1/2021 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products
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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 Productsd9abbf7e-c97e-4b3a-9663-b4c1f5718349
1/25/2021
Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for AmeriHealth New Jersey Members (Updated October 6, 2021)
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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 June 16, 2021)ed926941-fa2e-4d39-9eac-bb629c419742
1/4/2021
1/1/2021 CPT & HCPCS Annual Code Update Coverage Determinations for Commercial Products
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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 Productse9ec2c0c-fb3f-4dc8-ba77-76f1d77bff75
10/1/2020
10/1/2020 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products
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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 Productsc1c57826-12dd-47cc-b303-2102ee13691a
7/17/2020
​Respiratory Equipment and Related Supplies (Updated April 16, 2021)
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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
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7/1/2020 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products5D38243F686BE26685258598006308EB
5/19/2020
​Telemedicine and Telehealth Services for AmeriHealth New Jersey Members (Updated October 6, 2021)​
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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 March 19, 2020)B804E29A492DDB848525856D0044CCE4
5/12/2020
Pharmacologic Nuclear Stress Testing in Response to COVID-19 (Updated June15, 2021)
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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 October 7, 2021)
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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 June 16, 2021)CE6C7792C6B95201852585590043BD99
4/22/2020
Coverage of Preventive Well Visits through Telemedicine in Response to COVID-19 for AmeriHealth New Jersey Members (Updated October 7, 2021)
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The purpose of this News Article is to provide advance notice regarding coverage for preventive well visits through telemedicine for our AmeriHealth New Jersey members in response to Coronavirus Disease 2019 (COVID-19).
Coverage of Preventive Well Visits through Telemedicine in Response to COVID-19 for AmeriHealth New Jersey Members4CC21DED3CAC6D35852585520045435C
4/1/2020
4/1/2020 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products (revised 05/04/2020)
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The intent of this news 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 4/1/2020.
4/1/2020 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products (revised 05/04/2020)7826A7FDF85578D38525855E004A1326
12/27/2019
1/1/2020 CPT & HCPCS Annual Code Update Coverage Determinations for Commercial Products
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The intent of this article is to communicate Commercial Product coverage determinations for services identified through the Annual Code Update process. The procedure codes that represent these services will become effective on 1/1/2020.
1/1/2020 CPT & HCPCS Annual Code Update Coverage Determinations for Commercial Products878452BEE2294FD4852584DD004BB52E
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