Temporary Medicaid Plan Waivers Expiring for Applicable COVID-19 Treatment and Telehealth Services on June 1, 2021
As we continue to address the COVID-19 pandemic, we want to update you on important changes for our Medicaid plans. Last year, we instituted temporary prior authorization waivers for select services to ensure critical care could be quickly delivered to our members during a time of heightened need. On June 1, 2021, these temporary waivers will expire and our members' Medicaid plan benefits will be reinstated for the following services:
COVID-19 Treatment Related Services
- COVID-19 treatment related services (those billed with a confirmed ICD-10 diagnosis code) will continue to be eligible for coverage at this time, in accordance with the member's plan benefits.
- Beginning June 1, 2021, prior authorization will be required for COVID-19 treatment related services, in accordance with CMS guidance and plan benefits.
Telehealth Services
- Any services that can be delivered virtually will continue to be eligible for telehealth coverage at this time.
- Beginning June 1, 2021, prior authorization requirements will be reinstated for applicable services delivered via telehealth.
- Providers should reflect telehealth care on their claim form by following standard telehealth billing protocols in their state.
- For further coding guidance for telehealth services, we recommend following what is being published by:
Prior authorization requirements will continue to be waived for COVID-19 testing, screening services and vaccinations.
We continue to work in close partnership with state, local and federal authorities to serve and protect our members and communities during the COVID-19 pandemic, including ensuring that our providers have relevant and up-to-date information. We value your partnership during these unprecedented times.
This guidance is in response to the current COVID-19 pandemic and may be retired at a future date.
