COVID-19 Billing Guidance

To allow accurate and timely reimbursement for COVID-19 related services, please submit claims using specific codes that our payers’ claim systems will recognize. If these recommended codes are used it will facilitate proper payment and help avoid errors and reimbursement delays. Following are the links to recommendations for each payer.

Aetna:

https://www.aetna.com/health-care-professionals/provider-education-manuals/covid-faq.html.

Cigna:

COVID-19 provider web page on CignaforHCP.com.

Humana:

https://www.cdc.gov/nchs/data/icd/ICD-10-CM-Official-Coding-Gudance-Interim-Advice-coronavirus-feb-20-2020.pdf

Innovation Health: (same as Aetna)

https://www.aetna.com/health-care-professionals/provider-education-manuals/covid-faq.html.

Optima:

Telehealth must be billed using E&M codes or the telehealth codes 99441 - 99443 with a place code of 02. It is recommended that providers affix the modiifer 95 or GT to E&M codes billed, but it is not required. This applies to new or established patients. No pre-authorization required.

MedCost (formerly VHN)

https://www.medcost.com/providers

Medicare

https://www.medicare.gov/coverage/virtual-check-ins