| 9/13/2021 | Pharmaceutical Treatments of COVID-19 for Independence Medicare Advantage Members (Updated September 13, 2021) | 0.1 | | The purpose of this document is to Communicate the Company's coverage position for Pharmaceutical Treatment of COVID-19 for the Company's Medicare Advantage products. | Pharmaceutical Treatments of COVID-19 for Independence Medicare Advantage Members (Updated September 13, 2021) | 5ee69a94-07f9-4b20-ae9f-7e069ed081b4 |
| 9/8/2021 | Coverage of COVID-19 Vaccination for Medicare Advantage Members (Updated September 8, 2021) | 0.1 | |
The purpose of this communication is to provide notice regarding information and procedure codes related to the coverage of SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) vaccines and administration of the vaccines for Medicare Advantage members.
This policy communication addressing COVID-19 vaccine for Medicare Advantage members has been updated retro-effective to August 12, 2021 as follows:
- The following HCPCS and CPT codes were added: M0201, 0003A, 0013A
| Coverage of COVID-19 Vaccination for Medicare Advantage Members (Updated September 8, 2021) | bc53842d-45c0-4401-b7ae-50bb5adc67d3 |
| 8/10/2021 | Aduhelm™ (aducanumab-avwa) injection for Medicare Advantage Members | 0.1 | | The purpose of this communication is to provide notification of the Company's position for Aduhelm™ (aducanumab-avwa) injection for all Medicare Advantage products effective June 7, 2021.
| Aduhelm™ (aducanumab-avwa) injection for Medicare Advantage Members | e11a6bd9-f0a5-4601-b5d2-0035c6482635 |
| 7/1/2021 | 7/1/2021 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | 0.1 | | The intent of this NewsFLASH is to communicate Medicare Advantage Product coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 7/1/2021, unless otherwise noted.
For more information related to these services, please refer to specific policies when applicable.
| 7/1/2021 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | e1958eb2-5a90-4cc1-b62a-fd496920d7d8 |
| 6/15/2021 | Notification of Upcoming Changes to Pharmacologic Nuclear Stress Testing in response to COVID-19 | 0 | | The purpose of this NewsFlash is to provide advance notice that medical necessity reviews will resume for new prior authorization requests on or after July 15, 2021 regarding the use of pharmacologic stress testing with nuclear imaging in lieu of exercise stress testing.
| Notification of Upcoming Changes to Pharmacologic Nuclear Stress Testing in response to COVID-19 | 872f2479-2690-4518-b8b8-e911e5749812 |
| 6/4/2021 | Notification of Upcoming Changes to Temporary COVID-19 Waivers of Certain Requirements Related to Respiratory Equipment and Related Supplies | 0.1 | | The purpose of this communication is to provide advance notice regarding the reinstatement of certain pre-PHE requirements/limits related to respiratory equipment/related supplies. | Notification of Upcoming Changes to Temporary COVID-19 Waivers of Certain Requirements Related to Respiratory Equipment and Related Supplies | f0cd547c-047a-4d87-9d85-8a03d1d77946 |
| 5/13/2021 | Telehealth Services for Medicare Advantage Members (updated May 13, 2021) | 0 | |
The purpose of this document is to provide advance notice regarding coverage for telehealth services for our Medicare Advantage members in response to Coronavirus Disease 2019 (COVID-19). | Telehealth Services for Medicare Advantage Members (updated May 13, 2021) | c0d96e81-2f34-47c0-a10b-58dfb8d678f8 |
| 4/20/2021 | Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for Independence Medicare Advantage Members (Updated April 20, 2021) | 0 | | The purpose of this communication is to provide advance notice regarding information and procedure codes related to testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for Independence Medicare Advantage members. This communication addressing Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) is effective from March 6, 2020 through the duration of the Federal Public Health Emergency.
Note: Information related to SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) is continuously evolving. The Company is closely monitoring the outbreak caused by the novel coronavirus, and will update our communications accordingly.
| Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for Independence Medicare Advantage Members (Updated April 20, 2021) | e987eedb-269d-43a9-85a5-218cbcc57730 |
| 4/1/2021 | 4/1/2021 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | 0.1 | | The intent of this article is to communicate Medicare Advantage Product coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 4/1/2021, unless otherwise noted.
| 4/1/2021 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | d2c73a29-4d27-43bb-be4a-15bcdcf54a84 |
| 1/4/2021 | 1/1/2021 CPT & HCPCS Annual Code Update Coverage Determinations for Medicare Advantage Products | 0 | | The intent of this document is to communicate Medicare Advantage Product coverage determinations for services identified through the Annual Code Update process.
| 1/1/2021 CPT & HCPCS Annual Code Update Coverage Determinations for Medicare Advantage Products | 83b993ed-7be0-47bc-983e-86d958abfdc6 |
| 12/31/2020 | Medicare Diabetes Prevention Program in Response to COVID-19 Outbreak (Updated March 25, 2021)
| 0 | | The purpose of this NewsFLASH is to provide advance notice regarding coverage for Medicare diabetes prevention program in response to Coronavirus Disease 2019 (COVID-19).This NewsFLASH addressing Medicare diabetes prevention program is effective for the duration of the public health emergency.
This policy communication addressing telehealth services for Medicare Advantage members has been updated January 1, 2021 to remove the requirement of a documented 5% weight loss.
| Medicare Diabetes Prevention Program in Response to COVID-19 Outbreak (Updated 12/31/2020) | 668d5e4b-58c4-42b2-bd67-219a209219e7 |
| 10/1/2020 | 10/1/2020 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | 0.1 | | The intent of this article is to communicate Medicare Advantage Product coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 10/1/2020, unless otherwise noted.
For more information related to these services, please refer to specific policies when applicable.
| 10/1/2020 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | eaaa732d-9e1b-4325-a3d9-2891b122930a |
| 7/17/2020 | Consumer Grade Pulse Oximetry Devices For Use In The Home Setting (June 16, 2021)
| 1 | | The purpose of this News Article is to provide advance notice during the COVID-19 outbreak related to the coverage of consumer grade pulse oximetry devices for use in the home setting. | Consumer Grade Pulse Oximetry Devices For Use In The Home Setting | 6C97385C22DEF1EC852585A7007B19D5 |
| 7/1/2020 | 7/1/2020 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | 1 | | | 7/1/2020 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | BC325E22B96FD1D585258598006632FB |
| 6/30/2020 | Waiver of certain requirements during COVID-19 outbreak related to Durable Medical Equipment (DME), prosthetics, orthotics, and supplies for Medicare Advantage members (Updated March 24, 2021)
| 1 | | The purpose of this News Article is to provide advance notice regarding the temporary waiver of certain requirements for Durable Medical Equipment (DME), as well as prosthetics, orthotics, and supplies in response to Coronavirus Disease 2019 (COVID-19). | Waiver of certain requirements during COVID-19 outbreak related to Durable Medical Equipment (DME), prosthetics, orthotics, and supplies for Medicare Advantage members (Updated March 24, 2021) | 731A7A410AA02BF08525858B0060F43F |
| 5/12/2020 | Pharmacologic Nuclear Stress Testing in Response to COVID-19 for Medicare Advantage Members (Updated June 15, 2021)
| 1 | | The purpose of this News Article is to provide advance notice regarding the use of pharmacologic stress testing with nuclear imaging in response to the Public Health Emergency (PHE) for the COVID-19 pandemic. | Pharmacologic Nuclear Stress Testing in Response to COVID-19 for Medicare Advantage Members (Updated June15, 2021) | 6061365DEA093EF78525856500743BFA |
| 4/29/2020 | Direct Supervision Requirements for Incident to Services Performed by Certified Registered Nurse Practitioners (CRNPs) and Physician Assistants (PAs) in Response to COVID-19 (Updated March 24, 2021)
| 1 | | The purpose of this News Article is to provide advance notice regarding direct supervision requirements for Incident to services performed by Certified Registered Nurse Practitioners (CRNPs) and Physician Assistants (PAs) in response to Coronavirus Disease 2019 (COVID-19). | Direct Supervision Requirements for Incident to Services Performed by Certified Registered Nurse Practitioners (CRNPs) and Physician Assistants (PAs) in Response to COVID-19 | 4FDDC2AFA5B549C885258558007D7B93 |
| 4/14/2020 | Ground Ambulance Transport Services (Emergency and Nonemergency) for Medicare Advantage Members (Updated May 20, 2021)
| 0 | |
The purpose of this communication is to provide advance notice regarding the temporary expansion of the list of allowable destinations for ground ambulance transports AND to convey coverage criteria for medically necessary ground ambulance services without a transport in response to the Public Health Emergency (PHE) for the COVID-19 pandemic. | Ground Ambulance Transport Services (Emergency and Nonemergency) for Medicare Advantage Members (Updated May 20, 2021) | f43a2ed7-486a-48bf-bb49-fa849eb03cfb |
| 4/1/2020 | 4/1/2020 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products (revised 05/04/2020) | 1 | | The intent of this news article is to communicate Medicare Advantage Product coverage determinations for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 4/1/2020. | 4/1/2020 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products (revised 05/04/2020) | EDA9E7863A7A63E88525855E004ADE17 |
| 12/27/2019 | 1/1/2020 CPT & HCPCS Annual Code Update Coverage Determinations for Medicare Advantage Products | 1 | | The intent of this article is to communicate Medicare Advantage Product coverage determinations for services identified through the Annual Code Update process. The procedure codes that represent these services will become effective on 1/1/2020. | 1/1/2020 CPT & HCPCS Annual Code Update Coverage Determinations for Medicare Advantage Products | C8F40B977C70A150852584DD004C3F4E |
| 10/1/2019 | 10/1/2019 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | 1 | | The intent of this article is to communicate Medicare Advantage Product coverage positions for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 10/1/2019. | 10/1/2019 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | 8CD3C91BE7B054FF85258486004B5749 |
| 9/12/2019 | Coverage of Interprofessional Internet Consultation
| 1 | | The purpose of this communication is to provide notice regarding a change in coverage position from not covered to covered for interprofessional internet consultation, retroactively effective to January 1, 2019, for our Medicare Advantage members. | Coverage of Interprofessional Internet Consultation | 172BF5121B6AC21085258473004D0B45 |
| 8/8/2019 | Clinical Appropriateness Guidelines for Radiology to be updated for Medicare Advantage Members | 1 | | The purpose of this news article is to provide advance notice regarding upcoming AIM Clinical Appropriateness Guidelines for Radiology for Independence Medicare Advantage Members. | Clinical Appropriateness Guidelines for Radiology to be updated for Medicare Advantage Members | E33539CCEF30B304852584500071C202 |
| 7/1/2019 | 7/1/2019 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | 1 | | The intent of this article is to communicate Medicare Advantage Product coverage positions for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 7/1/2019. | 7/1/2019 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | EDB10E4310F313C98525842A006FD5EB |
| 5/14/2018 | Meniscal allograft transplantation performed in combination with treatment of focal articular cartilage lesions | 1 | | | Meniscal allograft transplantation performed in combination with treatment of focal articular cartilage lesions | 9F77C0D48113789B8525828D006DC3C2 |
