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4/2/2024
Notification of Policy Update for 00.06.02ar: Preventive Care Services Applicable to AmeriHealth Commercial Members
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The purpose of this communication is to provide advance notice of updates to the frequency limits for breast cancer screening in Policy #00.06.02ar: Preventive Care Services, which will become effective on July 1, 2024.

 

In addition, effective July 1, 2024, for members subject to the NJ colorectal cancer screening state mandate, the colorectal cancer screening preventive coverage has been updated to align with the US Preventive Services Task Force (USPSTF) recommendations. 


Notification of Policy Update for 00.06.02ar: Preventive Care Services Applicable to AmeriHealth Commercial Members 7d785684-a9fa-4645-995c-9d58308f0590
2/12/2024
Coverage of the COVID-19 Vaccination for AmeriHealth Commercial Members (Updated February 12, 2024. Retroactively Effective to January 1, 2024.)
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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 Commercial Members (Updated February 12, 2024. Retroactively Effective to January 1, 2024.)b867f380-2802-4c99-b5c5-7d655d09d241
12/29/2023
1/01/2024 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 01/01/2024, unless otherwise noted. For more information related to these services, please refer to specific policies when applicable.​​​​​​​
1/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Productsba956e39-8e7b-45c6-aa3d-998b0e502521
12/15/2023
Coverage of Meningococcal ABCWY vaccine and Smallpox and Mpox Vaccine for AmeriHealth Commercial Members (Retroactively Effective to October 26, 2023)
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Retroactively effective to October 26, 2023, the purpose of this communication is to provide notice regarding the preventive coverage criteria for meningococcal groups A, B, C, W, and Y vaccine (Penbraya) and smallpox and mpox vaccine, live, non-replicating (Jynneos) vaccine for AmeriHealth Commercial members. 
Coverage of Meningococcal ABCWY vaccine and Smallpox and Mpox Vaccine for AmeriHealth Commercial Members (Retroactively Effective to October 26, 2023)662c4c0d-2185-42ab-813c-728259b069f6
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, 2023and 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
10/10/2023
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
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
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
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