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Important Information Regarding COVID-19

AmeriHealth Caritas Pennsylvania has been closely monitoring the Centers for Disease Control and Prevention (CDC) for the latest information about COVID-19, and has been engaged in making the necessary plans based on guidance from the Centers for Disease Control and Prevention (CDC). AmeriHealth Caritas Pennsylvania recommends that providers follow CDC, Centers for Medicare and Medicaid Services, and state-specific guidance with regard to COVID-19 evaluation, testing, diagnosis, treatment, and reporting.

COVID-19 testing

AmeriHealth Caritas Pennsylvania will cover all medically necessary services required to facilitate testing and treatment of COVID-19 for its eligible members, in accordance with federal and state guidance. No prior authorization is required for COVID-19 testing. Coronavirus testing codes follow:

  • U0001: CDC 2019 Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel.
  • U0002: Coronavirus (COVID-19) for non-CDC laboratory tests for SARS-CoV-2/2019.

CDC links for more information:

If you suspect you or a patient has COVID-19

The CDC instructs providers to consult with local or state health departments to determine whether patients meet criteria for a Persons Under Investigation (PUI). Providers should immediately notify infection control personnel at their facility if they suspect COVID-19 in a patient. Please notify your state or local health department if a patient is classified as a PUI for COVID-19.

Providers should report recognized exposures, regularly monitor themselves for fever and symptoms of respiratory infection, and not report to work when ill. Providers in low-, medium-, or high-risk exposure categories who develop signs or symptoms compatible with COVID-19 are strongly encouraged to contact their established point of contact (public health authorities or their facility’s occupational health program) for medical evaluation prior to returning to work.

CDC links for more information:

Access and Availability to Care – Office Closures and Use of Telehealth during the COVID-19 response period

AmeriHealth Caritas Pennsylvania continues to monitor the latest information regarding COVID-19, and wants to help ensure that our members have access to care for their health care needs. To help accomplish that, we ask that any participating provider who will be closing their office for an extended period of time notify AmeriHealth Caritas Pennsylvania at 1-800-521-6007, and patients/members, and indicate whether virtual visits, telephonic consultation, and/or secure web-portal consultation will be available during this period.

AmeriHealth Caritas Pennsylvania covers telehealth visits for our members in accordance with State and Federal policy.  Similar to Medicare, many states are adopting expanded or interim policies related to the originating site, payment for telephonic visits, and expanded licensure.

If your office plans to close or limit on-site visits, and provide virtual, telephonic, or web-based support, please see updated guidance at Telemedicine care for coronavirus (COVID-19) (PDF). You can access recent telehealth guidance from the United States Department of Health and Human Services (HHS) Office for Civil Rights (OCR) here: https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html. AmeriHealth Caritas Pennsylvania will provide updates as we receive them.

If your office is closing for an extended period of time and not offering virtual, telephonic, or web-based visits, please direct your patients who are our members to contact AmeriHealth Caritas Pennsylvania Member Services at 1-888-991-7200. We have tools in place to connect members to alternate providers who can support their continued care. Members can also receive support by calling our 24/7 Nurse Call Line at 1-866-566-1513.

For more resources and guidance, please access the CDC COVID-19 homepage.