Anthem Blue Cross Blue Shield

Nevada Providers

COVID-19 Information from Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem)


Anthem is committed to helping our members gain timely access to care and services in a way that places the least burden on the health care system. We have established a team of experts to closely monitor developments and how they will impact our members and health care provider partners. Our actions are intended to support the protective measures taken across the country to help prevent the spread of COVID-19 and reduce barriers to seeing a doctor, getting tested and maintaining adherence to medications for long-term health issues.

COVID-19 Updates

Get the latest news and information from the CDC at www.cdc.gov/coronavirus.

Medicaid Bulletins

Monoclonal Antibodies Approved for Treatment of COVID-19 Infection (June 7, 2021)

Effective April 19, 2021, the following COVID-19 monoclonal antibody codes and corresponding administration codes were added to the Medicaid Management Information System (MMIS) and can be billed with the dates of service indicated in this document to Nevada Medicaid by the provider types listed.

New COVID-19 Vaccine Codes and Vaccine Administration Codes

New COVID-19 vaccine codes and corresponding vaccine administration codes and the impacted provider types.

New COVID-19 Vaccine Codes and Vaccine Administration Codes

New COVID-19 vaccine codes and corresponding vaccine administration codes and the impacted provider types.

Medicaid Services Manual Chapter 400 Updated (April 29, 2021)

The following Medicaid Services Manual (MSM) chapter has been updated and posted to the Division of Health Care Financing and Policy (DHCFP) website.

Attention All Providers Performing COVID-19 Diagnostic Testing with Procedure Code 87426 (April 28, 2021)

Claims for COVID-19 diagnostic testing procedure code 87426 (Infectious agent antigen detection by immunoassay technique) are not required to be billed with procedure code 87301.

Maximizing efficient, high quality COVID-19 screenings (April 4, 2021)

Identifying the most appropriate COVID-19 testing codes, testing sites and type of test to use can be confusing. The guidance here can make it easier for you to refer your patients to high-quality, lower-cost COVID-19 testing sites, find Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem)-contracted laboratories and identify the proper CPT® codes to use.

Encounter-Based Providers and COVID-19 Vaccine Billing (March 8, 2021)

All encounter-based providers (including but not limited to: Federally Qualified Health Centers, Rural Health Clinics, Indian Health Services and Tribal Clinics, etc.) who seek reimbursement for the administration of a COVID-19 vaccine must do so by using their encounter code and the COVID-19 vaccine administration Current Procedural Terminology (CPT) codes.

DHCFP COVID-19 covered services, vaccines, and vaccination prioritization lanes information for members (February 18, 2021)

The Division of Health Care Financing and Policy (DHCFP) has created three flyers to provide information to Nevada Medicaid recipients on COVID-19 covered services, COVID-19 vaccines, and COVID-19 vaccination prioritization lanes. The DHCFP is asking for Nevada Medicaid providers to assist with providing these flyers to Nevada Medicaid recipients. Page one is in English and page two is in Spanish for each flyer. Providers can print double-sided or email these flyers to Nevada Medicaid recipients.

Rate Change for COVID-19 Testing Codes U0003 and U0004 (February 18, 2021)

Attention Provider Types 12 (Hospital, Outpatient) and 43 (Laboratory, Pathology Clinical): Rate Change for COVID-19 Testing Codes U0003 and U0004

Attention Providers Who Wish to Enroll with Nevada Medicaid to Administer the COVID-19 Vaccine (January 5, 2020)

Providers who request to enroll with Nevada Medicaid to administer the COVID-19 vaccine must submit an initial application using the following resources.

COVID-19 Vaccine Administration Coverage and Billing (January 5, 2020)

On December 11, 2020, the U.S. Food and Drug Administration (FDA) approved the Pfizer COVID-19 vaccine for individuals aged 16 years and older for emergency use authorization (EUA). On December 18, 2020, the FDA also approved the Moderna vaccine for EUA for individuals aged 18 years and older.

What Are Your Thoughts On The Vaccines Against Covid-19?

Researchers from UNR Med, in partnership with the NV Department of Health and Human Services and Immunize NV, are conducting a survey to learn about the public's knowledge about the COVID-19 vaccines.

Nevada Department of Health and Human Services Director’s Office Urges Youth Screening (November 23, 2020)

The Nevada Department of Health and Human Services (DHHS) and its Divisions, including the Division of Health Care Financing and Policy (DHCFP), are concerned about the effect of the pandemic on rates of anxiety, depression and suicide among youth. The Department would like to bring to your attention the importance of the role you play as a provider in mental health screening and early identification of mental and behavioral health difficulties. The DHHS and its Divisions respectfully request that providers make an extra effort to screen all youth more frequently.

COVID-19 Information from Anthem — October 22, 2020

Anthem is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners. Click below for the latest information for providers:

Attention All Providers: New Phase 3 Provider Relief Funding Available (October 13, 2020)

The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has announced $20 billion in new funding for providers on the frontlines of the Novel Coronavirus (COVID-19) pandemic.

Deadline for Provider Relief Fund Has Been Extended to August 3, 2020 (July 23, 2020)

The U.S. Department of Health and Human Services (HSS) announced the distribution of approximately $15 billion from the Provider Relief Fund to eligible providers who participate in state Medicaid and the Children's Health Insurance Program (CHIP):

Department of Health and Human Services Announces Additional Distributions from the Provider Relief Fund to Eligible Medicaid and CHIP Providers (June 15, 2020)

On June 9, 2020, the Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced additional distributions from the Provider Relief Fund to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers who participate in state Medicaid and CHIP programs. HHS is also announcing an additional distribution of Provider Relief Funds to safety net hospitals:

COVID-19 Update: Guidance for Telehealth/Telephonic Care for Behavioral Health Services (June 9, 2020)

Anthem is closely monitoring COVID-19 developments and what it means for our customers and our health care provider partners. Our clinical team is actively monitoring external queries and reports from the CDC to help us determine what action is necessary on our part. We have made changes to how behavioral health providers can use and be compensated for telehealth (audio + video) and telephonic-only care with their patients.

Anthem Waives Cost Share for COVID-19 Treatment

Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. The expansion covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020.

Expansion of COVID-19 Testing Criteria

Focusing solely on testing symptomatic patients may not be sufficient to prevent further transmission of COVID-19. Testing expansion is urgently required to determine the impact of asymptomatic cases on viral spread.

COVID-19 Update: Anthem Suspends Select Prior Authorization Rules and Announces Significant Policy Adjustments in Response to Unprecedented Demands on Health Care Providers

Anthem recognizes the intense demands facing doctors, hospitals and all health care providers in the face of the COVID-19 pandemic. Today, unless otherwise required under state and federal mandates as detailed below, Anthem health plans will suspend select prior authorization (PA) requirements, member cost sharing, claims review and handling protocols to allow health care providers to focus on caring for patients diagnosed with COVID-19:

Listen Now! Webinar Recording Available from Anthem for Network Providers on SBA Loans and Other Federal Relief Programs in Response to COVID-19

We are committed to helping care providers learn how you can secure resources to support yourselves and your business during the COVID-19 crisis. On April 30, 2020, we hosted a webinar to share information and resources with network providers regarding opportunities to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19 on care providers that are also small employers.

Federal Resources Available for Health Care Providers and Employers in the Federal CARES Act

During the COVID-19 crisis, care providers are working to keep the country running while navigating the financial impact it is having on them:

Hydroxychloroquine and Chloroquine Diagnosis Requirements on Prescriptions (March 20, 2020)

Effective March 20, 2020, hydroxychloroquine and chloroquine prescriptions will require a diagnosis code on the prescription. Hydroxychloroquine and chloroquine will be covered only for FDA-approved indications:

Information on COVID-19 from the Division of Health Care Financing and Policy

Visit the Division of Health Care Financing and Policy website at http://dhcfp.nv.gov/covid19 and the Nevada Health Response website at https://nvhealthresponse.nv.gov for important updates related to COVID-19 and its impact on Nevada Medicaid recipients and providers.

FAQs

To help address providers’ questions, Anthem has developed the following FAQ list:

Get the answers to these questions and more in our Talking Points PDF:

Provider tools & resources

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