Priority Health - COVID 19 Updates

March 23, 2020

COVID-19 update for providers


We're actively working to monitor the new Coronavirus disease—COVID-19—and its impacts to make sure we provide our members the care they need when they need it while supporting our providers.

Rest assured that we have business continuity plans in place. We’ll continue to serve you and your patients online and over the phone.

This is a rapidly developing situation. We’re updating information and policies frequently.

Check our provider news for ongoing updates

Coverage for our members
We'll cover the cost of medically necessary COVID-19 tests, waiving copays and deductibles. Other services related to diagnostic testing and the administration of the test such as office visits, blood draws, or specimen handling are now also covered 100%, with no member cost sharing applied. The effective date of coverage will be retroactive to February 4, 2020. 

Our members’ plan benefits apply for any care received while in treatment for COVID-19. Learn more or share cost information with your patients using our COVID-19 FAQ page.

Virtual visits billing and coverage
As we have for many years, we cover virtual visits and are encouraging members to use virtual care if they believe they have symptoms. Priority Health covers the cost of virtual care for all members and starting April 19, 2020 will temporarily waive costs before deductible for health savings account (HSA) plan members, through April 30, 2020 (not including behavioral health visits).

As a reminder of the options available for billing virtual visits, see telephone visits, e-visits and hosted visits. You’ll also find details about the providers and qualified health professionals who can bill telehealth codes.

Billing for COVID-19 lab tests
The Centers for Medicare and Medicaid Services (CMS) released two codes for COVID-19 lab tests that can be used starting Apr. 1, 2020 for dates of services starting Feb. 4, 2020. Labs can use HCPCS code U0001 when using the Centers for Disease Control and Prevention (CDC) 2019 Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel. Labs and health care facilities using other techniques for testing can bill U0002. For more information, see the CMS FAQ.

The American Medical Association has also released a CPT code: 87635. This code is effective immediately to report lab testing services that diagnose the presence of the novel coronavirus. See the AMA’s website for more information.

Thank you
We appreciate all you’re doing to serve our communities. Thank you for your partnership and patience as we work together through this rapidly evolving situation.