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August 5, 2020

COVID-19 Testing: What's Covered?

Federal law requires most employer-sponsored group health plans and private health insurance plans to pay for medically appropriate testing to detect or diagnose COVID-19 in an individual. If a physician believes a test is medically appropriate for an individualized diagnosis, it is proper to bill Blue Cross for the test and the patient’s record should reflect the medical appropriateness.

Federal government guidance on this legislation issued June 23, 2020, states that group health plans and insurers are not required to pay for COVID-19 tests that are ordered for surveillance purposes. Surveillance testing for returning to school or for workplace screening is not covered by insurance in most cases.

August 4, 2020

Updated: Codes Not Subject to EAPG Pricing

CPT codes 87426 and 0224U and HCPCS code G2024 have been added to the list of codes not subject to EAPG pricing on our COVID-19 Testing page. 

July 30, 2020

Dispensing Limits on Hydroxychloroquine, Chloroquine and Azithromycin Discontinued

Dispensing limits on these drugs will be discontinued as of August 1, 2020. For more information, see our COVID-19 Treatment page.

July 29, 2020

Attention Blue Advantage^® Providers: Use Appropriate Codes for Telehealth E/M Services

Providers must use correct codes to indicate whether audio and video equipment or audio only was used when performing evaluation and management (E/M) services via telehealth for Blue Advantage patients. Refer to our Telehealth Coverage Guidelines page for details.

July 28, 2020

CPT Code 99211 Added to Specimen Collection Codes

CPT code 99211 has been added to the list of approved codes related to specimen collection. Refer to our COVID-19 Testing page for a complete list of approved testing and specimen collection codes and fees.

July 28, 2020

DME Update: Oxygen Therapy

In response to the ongoing COVID-19 Public Health Emergency, the suspension of the oxygen saturation requirement for both certification and recertification has been extended to September 1, 2020. Refer to our COVID-19 Treatment page for additonal treatment information.

July 24, 2020

Update: COVID-19 Testing Code 87426

We are adding CPT code 87426 to the Preferred Medical Doctor (PMD) Agreement - Exhibit I (Physician In-Office Laboratory Procedures). We will reprocess claims submitted with this code going back to the code's effective date of June 25, 2020. Refer to our COVID-19 Testing page for a full list of approved testing and specimen collection codes and fees.

July 20, 2020

COVID-19 Testing Code 0224U Added

CPT code 0224U has been added to the list of approved COVID-19 testing procedure codes. Refer to our COVID-19 Testing page for a full list of approved testing and specimen collection codes and fees.

July 16, 2020

Important Telehealth Coverage Update

In response to the ongoing COVID-19 pandemic, we have extended our telehealth services through December 31, 2020. We will continue to evaluate to determine whether a further extension is needed.

Telehealth services for Blue Advantage^® will continue through the Public Health Emergency, which the U.S. Department of Health and Human Services extended for 90 days effective July 25, 2020.

Please note that for most Blue Cross members, the cost-sharing waiver for telehealth services filed with a non-COVID-19-related diagnosis code will end July 31, 2020.

Because benefits can vary depending on a member’s plan, it’s important to always check eligibility and benefits through ProviderAccess or your practice management system to confirm coverage and cost-sharing details.

Click here to see How to View COVID-19 and Telehealth Benefits on ProviderAccess.

July 16, 2020

Fee Increased for COVID-19 Testing Code 87426

The fee for COVID-19 testing CPT code 87426 has been increased to $31.02. We will reprocess claims submitted with this code going back to the code's effective date of June 25, 2020. Refer to our COVID-19 Testing page for a full list of approved testing and specimen collection codes and fees.