| 10/15/2021 | Coverage of the COVID-19 Vaccination for AmeriHealth Members (Updated October 15, 2021) | 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. 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) | 0.1 | |
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 | 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 |
| 9/23/2021 | Coverage of Speech Therapy Services Performed Through Telemedicine for AmeriHealth Members | 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 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 Members | f2b6c80f-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 | 0.1 | | 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 Members | 3c662eea-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 | 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 |
| 9/13/2021 | Pharmaceutical Treatments of COVID-19 for AmeriHealth Pennsylvania Members (Updated October 6, 2021) | 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 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) | 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 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 | 0.1 | |
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 Members | 3131e35a-b388-42a3-8ef8-92909e78b169 |
| 8/12/2021 | ADUHELM™ (aducanumab-avwa) injection (for Commercial Members) | 0.1 | | 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 | 0.1 | | 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 Members | 2966a7ce-5d7b-4652-9390-b8b25f8c192c |
| 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 |
| 4/20/2021 | Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) For AmeriHealth Pennsylvania Members (Updated October 6, 2021) | 0 | | 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.
| 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 | 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 |
| 1/25/2021 | Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for AmeriHealth New Jersey Members (Updated October 6, 2021)
| 0 | |
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 | 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 |
| 10/1/2020 | 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 October 6, 2021)
| 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 March 19, 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 October 7, 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 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)
| 1 | | 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 Members | 4CC21DED3CAC6D35852585520045435C |
| 4/1/2020 | 4/1/2020 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products (revised 05/04/2020) | 1 | | 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 | 1 | | 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 Products | 878452BEE2294FD4852584DD004BB52E |
