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10/16/2023
Coverage of Respiratory Syncytial Virus Immunizations for AmeriHealth Members (Updated October 16, 2023; Retroactively Effective October 6, 2023)
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The purpose of this communication is to provide notice regarding the coverage criteria for respiratory syncytial virus (RSV) immunization for AmeriHealth Commercial members. ​

Thi​s​ policy communication, addressing RSV immunization for AmeriHealth Commercial members, replaces the version that was published on September 28, 2023, and includes the following update: 
  • Retroactively effective to October 6, 2023, the following codes were added as eligible as preventive: 96380, 96381​​

Coverage of Respiratory Syncytial Virus Immunizations for AmeriHealth Members (Updated October 16, 2023; Retroactively Effective October 6, 2023)fc098339-37dd-4d6b-b7a6-0b5f5d100b62
10/12/2023
Coverage of the COVID-19 Vaccination for AmeriHealth Members (Updated on October 12, 2023. Retroactively Effective to October 3, 2023.)
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This communication provides 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 that have been granted US Food and Drug Administration (FDA) approval and/or have received an Emergency Use Authorization​ (EUA). Coverage of SARS-CoV-2 vaccines granted an EUA shall remain in effect during the applicable EUA declaration, unless the specific EUA for a SARS-CoV-2 vaccine has been terminated and/or revoked. 

Coverage of the COVID-19 Vaccination for AmeriHealth Members (Updated on October 12, 2023. Retroactively Effective to October 3, 2023.)7d37cd51-f187-495f-8c1d-8ed683b9a08b
10/10/2023
Expanded Coverage of 20-Valent Pneumococcal Conjugate Vaccine for AmeriHealth Members (Retroactively Effective June 27, 2023)
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Retroactively effective to June 27, 2023, the purpose of this communication is to provide notice regarding the expanded preventive coverage criteria for 20-valent pneumococcal conjugate vaccine for AmeriHealth members. ​​
Expanded Coverage of 20-Valent Pneumococcal Conjugate Vaccine for AmeriHealth Members (Retroactively Effective June 27, 2023)ea45858c-3771-45fd-adfe-61cd4d91759e
9/28/2023
10/01/2023 CPT & HCPCS Quarterly 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 Quarterly Code Update process. The procedure codes that represent these services will become effective on 10/01/2023, unless otherwise noted. For more information related to these services, please refer to specific policies when applicable.​​​​​​​​
10/01/2023 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products81901f79-7df5-4c99-b57a-25bcc704db36
9/11/2023
Nutritional Counseling/Medical Nutrition Therapy for AmeriHealth Members
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The purpose of this communication is to provide notice regarding the coverage of nutritional counseling/medical nutrition therapy for AmeriHealth members.
​
Nutritional Counseling/Medical Nutrition Therapy for AmeriHealth Members1132cfed-56ea-4e4f-bd6d-fdc51a056fb9
6/30/2023
7/01/2023 CPT & HCPCS Quarterly 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 Quarterly Code Update process. The procedure codes that represent these services will become effective on 7/01/2023, unless otherwise noted. For more information related to these services, please refer to specific policies when applicable.​​​​​​​
7/01/2023 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products889f8c34-c8bc-4af2-9b58-4cea289a2381
5/12/2023
Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) For AmeriHealth Pennsylvania Members (Updated May 12, 2023)
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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. Additionally, this Company document identifies when coverage is provided for clinical purposes, and the nonco​vered instances such as public health surveillance and screening. 


Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) For AmeriHealth Pennsylvania Members (Updated May 12, 2023)8e6011b3-4c59-4ed2-920c-c5d19a50e6d8
5/12/2023
Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for AmeriHealth New Jersey Members (Updated May 12, 2023)
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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. Additionally, this Company document identifies when coverage is provided for clinical purposes, and the nonco​vered instances such as public health surveillance and screening. ​

Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for AmeriHealth New Jersey Members (Updated May 12, 2023)d4d08b64-c6d0-4f16-8a95-0038faf1febb
4/1/2023
4/01/2023 CPT & HCPCS Quarterly 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 Quarterly Code Update process. The procedure codes that represent these services will become effective on 04/01/2023, unless otherwise noted. For more information related to these services, please refer to specific policies when applicable.​​​​​​​​
4/01/2023 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Productsbeae40b0-d40d-4181-a2d8-4ea8d3f88344
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
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
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)
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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 December 15, 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