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4/1/2024
04/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage 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 04/01/2024, unless otherwise noted. For more information related to these services, please refer to specific policies when applicable.​​​​​​

04/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products9dae70d4-ef5c-4e1d-925e-e0e03dd2267e
3/4/2024
Expansion of Preventive Coverage of Diabetes Screening Tests for Medicare Advantage Members (Retroactively Effective 01/01/2024)
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Retroactively effective to January 1, 2024, the purpose of this document is to communicate the addition of hemoglobin A1c blood test to the preventive coverage of diabetes screening test and to update the frequency of the diabetes screening tests for Medicare Advantage members.​
Expansion of Preventive Coverage of Diabetes Screening Tests for Medicare Advantage Members (Retroactively Effective 01/01/2024)6174f35e-677a-411b-b7f8-fac2315327e2
2/26/2024
Coverage of the Administration at Home for Pneumococcal, Influenza, Hepatitis B, and COVID-19 Vaccination for Medicare Advantage Members (Retroactively Effective to 1/1/2024)
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To communicate the expansion of the administration at home procedure ​code to include additional vaccines (i.e., pneumococcal, influenza, hepatitis B) that can be administered in a home setting. ​
Coverage of the Administration at Home for Pneumococcal, Influenza, Hepatitis B, and COVID-19 Vaccination for Medicare Advantage Members (Retroactively Effective to 1/1/2024)34ff30ed-5e46-4ba9-a1e2-f3055f8fe34d
2/12/2024
Coverage of the COVID-19 Vaccination for Medicare Advantage 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 Medicare Advantage Members (Updated February 12, 2024. Retroactively Effective to January 1, 2024.)0b7dae7f-1f59-4e7f-b09c-ec13770e565c
1/26/2024
01/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products (Updated January 26, 2024; Retroactively Effective January 1, 2024)
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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. Procedure codes that represent these services are retroactively effective to 01/01/2024, unless otherwise noted. ​​ 
01/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products (Updated January 26, 2024; Retroactively Effective January 1, 2024)8f1996f4-a68b-4b48-984e-a9eca3898eaf
1/1/2024
Coverage of the COVID-19 Vaccination for AmeriHealth New Jersey Medicare Advantage Members (Effective 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 New Jersey Medicare Advantage Members (Effective January 1, 2024)6006d2ff-a3d6-478b-ae3e-923051aa5c61
1/1/2024
Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for AmeriHealth New Jersey Medicare Advantage Members (Effective January 1, 2024)
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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 Medicare Advantage members. Additionally, this Company document identifies when coverage is provided for clinical purposes, and the not co​vered instances such as public health surveillance and screening. 

Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for AmeriHealth New Jersey Medicare Advantage Members (Effective January 1, 2024)b25d7ade-ae82-4f8d-924e-02b7cf0c9cc0