Covid-19 coverage support for providers
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You can also access this page by visiting healthpartners.com/providercovid19.
We are your partner and together we can keep our communities healthy amid COVID-19. Protecting the health, safety, and security of our patients, colleagues, providers, and our members is at the forefront of everything we do and it’s never been more important than right now.
Since January 2020, our COVID-19 Preparedness Team has actively partnered with public officials, state health departments, and care systems to develop effective emergency planning, research, clinical care, and operations.
We are well-equipped and dedicated to providing business continuity. We are ready to serve our members and patients through routine operations and expansions in coverage related to telemedicine and COVID-19 testing. As the COVID-19 Public Health Emergency rapidly evolves, we will update this page with new information when it comes available.
As a health solutions organization that operates health plans, care delivery, research and education, we are in a unique position to provide support and stability to all of our customers during this crisis. Our core functions and tools remain fully operational and effective without disruption. We’re here to assist our members and patients through online services, claims processing, phone consultations, telemedicine, and by providing referrals to a nearby provider. Below outlines the key highlights of our expanded medical and dental coverage.
HealthPartners waives cost-sharing.
HealthPartners, will waive member cost-sharing for all fully insured commercial, Medicare and Medicaid members for in network COVID-19 related treatment through December 31, 2020. We are actively working with our self-insured clients to make this option available for their employees and dependents.
- Waiving early medication refill limits on 30-day prescription authorizations and encouraging 90-day mail order benefits
- Allowing retail pharmacists at point of sale to override claim that is rejecting for ‘refill too soon'
- Removing prior authorization for COVID-19 diagnostic service
- Coverage of medically necessary tests
- Providing coverage for online care eligible to all HealthPartners members
- Expanding access to telehealth
HealthPartners recommends that providers submit the modifier CS on office visits associated with COVID-19 lab testing to aid in identifying COVID-19-related-claims. Note, however, that claims may be denied if the CS modifier is submitted on other lines of the claim or for services that are not related to the COVID-19 lab testing.
- A message to our dental community
- Tips for triaging dental patients
- Covid19 update for our dental partners
- Teledentistry Communication
- Dental PPE Provider communication
- Policy-Billing for Infection Control-PPE
Impacted products related to this information include:
- Fully insured commercial
- Self-Insured commercial
- Medicare Advantage Members
HealthPartners commercial products coverage
As your partner, protecting the health and safety of our members, patients, and providers is our top priority. We want to ensure our members and patients have access to the care, resources, and support they need during this trying time. That’s why we’ve broadened our telemedicine policy to help people address their health concerns without needing to leave their home, reducing their risk of exposure to the virus. Many routine issues can be assessed virtually without an in-person visit to a provider, whether it be assessment of a new condition or adjustments in treatment for an existing condition.
Temporary Telemedicine policy during the COVID-19 national health emergency
To encourage broader use of virtual services during the COVID-19 Public Health Emergency, HealthPartners has revised policies for the coverage of telephone and video visits and updated reimbursement for said services. These revised policies are intended to add clarity of coverage and to add additional eligible services for telehealth as follows:
- Physical Therapy, Occupational Therapy, and Speech Therapy services have been added.
- In accordance with actions taken by CMS, HealthPartners will allow non-HIPAA compliant audio-visual applications, such as Facetime and Skype, to be used for telehealth services.
- HealthPartners will waive the policy requirement of a visual component for telehealth, allowing for telehealth to be provided over the telephone.
- HealthPartners is temporarily suspending our policy requirement of telehealth and telephone services being provided only to established patients so that during the duration of the National Health Emergency related to COVID-19, telehealth and telephone visits can also be provided to new patients.
- Behavioral Health visits are described.
- In order to reduce the risk of spreading COVID-19, both the practitioner and the member can be located at their homes for telehealth and telephone visits.
- Please note that member responsibility will apply to telemedicine visits, E-visits and scheduled telephone visits per the member’s certificate of coverage.
- We will continue to evaluate our telemedicine policy for updates as the National Emergency Continues.
COVID-19 Vaccine and Monoclonal Antibodies Reimbursement
The Centers for Medicare & Medicaid Services (CMS) announced that Medicare payment for COVID vaccinations administered to Medicare Advantage and Medicare Cost beneficiaries during calendar years 2020 and 2021 will be reimbursed through the Medicare FFS program at no cost to beneficiaries. Beneficiaries can receive the vaccination through any FFS provider or supplier that participates in Medicare and is eligible to bill under Part B. Claims from providers should be submitted to the CMS Medicare Administrative Contractor (MAC) for payment. Review the CMS Memo-COVID-19 Vaccine-Significant Cost Determination for further information.
During the Public Health Emergency, HealthPartners will follow CMS reimbursement rates* and clams submission guidelines for COVID-19 Vaccines and Monoclonal Antibodies for Members in other HealthPartners Products as outlined here: www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies.
COVID-19 Diagnostic Testing and Specimen Collection Reimbursement
Unless specifically agreed otherwise, HealthPartners reimbursement rates for contracted and non-contracted providers, facilities and reference labs are based upon the Centers for Medicare and Medicaid Services (“CMS”) rates. As new codes are developed by CMS, HealthPartners will add those codes and the associated rates to its fee schedule(s). The current reimbursement rates are follows*:
- * Inclusion of the rates in the table above does not guarantee payment which is determined by the applicable certificate of coverage and your Agreement with HEALTHPARTNERS, INC.
- * COVID-19 diagnostic testing, antibody testing, PHE supplies and specimen collection codes are included in the reimbursement rates for inpatient services and will not be paid in addition to the DRG, per diem, or case rate payment.
- * As of 5/6/2021, HPI will follow CMS and geographically adjust the reimbursement for the Vaccine Administration and Monoclonal Antibody codes listed above. CMS geographically adjusted rates are posted in the website above.
- *** Code 99072 is considered part of the primary procedure being performed on the same day, and therefore, will not be separately reimbursed.
The rates outlined above, subject to any reimbursement changes made by CMS, apply to claims with dates of service on or after 1/1/2021. Click here to view the reimbursement rates for claims with dates of service prior to 1/1/2021.
If you have concerns regarding the reimbursement outlined above, please contact your HealthPartners contract manager.
- Vaccine and Treatment Frequently Asked Questions - updated 12/10/20
- HealthPartners frequently asked questions - updated 5/19/20
We continue to actively work with state departments of health to ensure we are providing the latest updates. Check these pages for the latest guidance.
- AUC Coronavirus (COVID-19) Updates
- Minnesota Department of Health – Healthcare Provider COVID-19 Updates
- Iowa Department of Health – Healthcare Provider COVID-19 Updates
- North Dakota Department of Health – Healthcare Provider COVID-19 Updates
- South Dakota Department of Health – Healthcare Provider COVID-19 Updates
- Wisconsin Department of Health – Healthcare Provider COVID-19 Updates<
Healthcare providers can receive the most recent updates about the national COVID-19 situation from the Centers for Disease Control and Prevention (CDC). We continue to monitor the situation in the real time and follow CDC guidance.