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1/20/2023
Coverage of the COVID-19 Vaccination for AmeriHealth Members (Retroactively effective to December 8, 2022. Updated January 20, 2023)
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​This policy communication, addressing COVID-19 vaccine for AmeriHealth members, replaces the version that was issued on November 2, 2022. The following procedure codes have been added to this document in accordance with the FDA Emergency Use Authorization (EUA). These codes are retroactively effective to December 8, 2022: 91316, 0164A, 91317, 0173A​.

Coverage of the COVID-19 Vaccination for AmeriHealth Members (Retroactively effective to December 8, 2022. Updated January 20, 2023)e4a87c20-8129-48cd-ac89-912d2f33f259
12/30/2022
01/01/2023 CPT and HCPCS Quarterly 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 01/01/2023, unless otherwise noted. For more information related to these services, please refer to specific policies when applicable.​​​​​​​

01/01/2023 CPT and HCPCS Quarterly Update Coverage Determinations for Commercial Productsfe87127b-c8ab-4e5b-96a4-706b67fe3175
12/15/2022
Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for AmeriHealth New Jersey Members (Updated December 15, 2022)
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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 & screening. 
Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for AmeriHealth New Jersey Members (Updated December 15, 2022)45fe37cc-b42f-474c-8af8-191f822043d1
12/15/2022
Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) For AmeriHealth Pennsylvania Members (Updated December 15, 2022)
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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 & screening. 
Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) For AmeriHealth Pennsylvania Members (Updated December 15, 2022)a8d9f545-697f-4371-b69b-11c282023621
11/7/2022
Laboratory Testing, Vaccination, and Treatment for Monkeypox for AmeriHealth Members (Updated November 7, 2022)
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The purpose of this document is to communicate the Company's coverage positions for laboratory testing, vaccination, and treatment for monkeypox.
Laboratory Testing, Vaccination, and Treatment for Monkeypox for AmeriHealth Members (Updated November 7, 2022)43fa7913-ddd2-4177-a501-bf8af89f0635
10/31/2022
Expanded Preventive Coverage of Pneumococcal 15-valent Conjugate Vaccine for AmeriHealth Members (Retroactively Effective 06/22/2022)
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The purpose of this document is to provide notice regarding the expanded preventive coverage of pneumococcal 15-valent conjugate vaccine​ for our AmeriHealth members.
Expanded Preventive Coverage of Pneumococcal 15-valent Conjugate Vaccine for AmeriHealth Members (Retroactively Effective 06/22/2022)700e2906-44c0-4464-bf5a-25a106075e16
6/29/2022
07/01/2022 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 07/01/2022, unless otherwise noted.

For more information related to these services, please refer to specific policies when applicable.​​​​​​​

07/01/2022 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products3880f868-82a3-4fc4-a644-0c8eaf0140e8
6/14/2022
Preventive Coverage of Colonoscopy Following a Positive Non-invasive Stool-based Screening Test or Direct Visualization Test for AmeriHealth Members
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The purpose of this communication is to convey our current coverage position regarding coverage of a screening colonoscopy following a positive non-invasive stool-based screening test or direct visualization test for AmeriHealth members. 
Preventive Coverage of Colonoscopy Following a Positive Non-invasive Stool-based Screening Test or Direct Visualization Test for AmeriHealth Members ddcac080-29fb-4c97-8298-006d721edda6
5/31/2022
Preventive Coverage of FDA-Approved Contraceptive Mobile Applications for Amerihealth Members
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The purpose of this communication is to provide notice regarding the preventive coverage of FDA-approved contraceptive mobile applications​​ for AmeriHealth members effective June 1, 2022. 
Preventive Coverage of FDA-Approved Contraceptive Mobile Applications for Amerihealth Members0b153087-ba23-49b1-8f25-b37b13f4b059
3/31/2022
04/01/2022 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products
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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 Products323cf94c-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
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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 Members9e15f350-0456-4178-a764-00d2008473fe
12/31/2021
Coverage of Speech Therapy Services Performed Through Telemedicine for AmeriHealth Members (Updated January 1, 2022)
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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 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)
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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 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)
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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
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
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
1/4/2021
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
10/22/2020
Pharmaceutical Prophylaxis and Treatments of COVID-19 for AmeriHealth Pennsylvania Members (Updated August 25, 2022)
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The purpose of this document is to communicate the Company's coverage position for Pharmaceutical Prophylaxis and Treatments of COVID-19 for AmeriHealth Pennsylvania members. 

Pharmaceutical Prophylaxis and Treatments of COVID-19 for AmeriHealth Pennsylvania Members (Updated August 25, 2022)b0770177-5954-47cf-a02d-00c63821535b
10/22/2020
Pharmaceutical Prophylaxis and Treatments of COVID-19 for AmeriHealth New Jersey Members (Updated August 25, 2022)
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The purpose of this document is to communicate the Company's coverage position for Pharmaceutical Prophylaxis and Treatments of COVID-19 for AmeriHealth New Jersey members. 

Pharmaceutical Prophylaxis and Treatments of COVID-19 for AmeriHealth New Jersey Members (Updated August 25, 2022)766a77b6-f85a-4994-bd97-4beb6b435c9b
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
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