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COVID-19 Resources for Providers

Health Partners Plans (HPP) is committed to the health and wellbeing of all our members, providers and the communities we serve. HPP is closely monitoring the spread of the COVID-19 virus (coronavirus), and we’re frequently communicating with local and federal officials to learn the most up-to-date information.

This page is updated frequently and includes resources and information to assist our provider network.

COVID-19 Vaccine Administration - Updated April 23, 2021

As promised in previous communications, we continue to monitor and update pricing related to COVID-19 vaccine administration. In response to a recent Pennsylvania Department of Human Services (DHS) Medical Assistance Bulletin released on April 19, 2021, we have increased our reimbursement for COVID-19 vaccine administration to align with that bulletin. The new rates are reflected in the table below. The cost of these vaccine serums will be paid for by the U.S. government.

HPP will continue to follow both the Centers for Medicaid & Medicare Services (CMS) and the Pennsylvania Department of Human Services (DHS) policies related to coding and reimbursement.

It is important to note that the reimbursement detailed in this communication is applicable to all provider types and places of service.

Note for Urgent Care Centers - Vaccine administration should not be billed as an urgent care visit. Urgent Care Centers will require a contract amendment for the vaccine administration codes and will receive additional communication.

Medicaid Medicare CHIP Non-Par Providers
Medicaid & CHIP
$40.00*
(1st Dose)

$40.00*
(2nd Dose)		 $0
Provider is required
to bill CMS		 $40.00*
(1st Dose)

$40.00*
(2nd Dose)		 $40.00*
(1st Dose)

$40.00*
(2nd Dose)

*May be updated by DHS

COVID-19 Antibody Therapy Administration

Please see the table below for the appropriate procedure codes to be used when billing Health Partners Plans (HPP) for COVID-19 antibody therapy administration to HPP members and the reimbursements applicable to those codes. HPP will follow both the Centers for Medicaid & Medicare Services (CMS) and the Pennsylvania Department of Human Services (DHS) policies related to coding and reimbursement.

It is important to note that the coding and reimbursement detailed in this communication are applicable to all provider types and the outpatient place of service.

Monoclonal Antibody Therapy Code Administration Code Medicaid Medicare Par and Non-Par CHIP Non-Par Providers Medicaid & CHIP

M0239

Eli Lilly and Company

intravenous infusion, bamlanivimabxxxx,
includes infusion and post
administration monitoring

 $247.68 $0

Provider is required to bill CMS

 $247.68 $247.68

M0243

Regeneron

intravenous infusion, casirivimab and
imdevimab includes infusion and post-administration monitoring

 $247.68

$0
Provider is required to bill CMS

 $247.68 $247.68

HPP Launches COVID Vaccine Report

Health Partners Plans (HPP) is pleased to announce the creation of the “COVID Vaccine Report.” This report will be posted every Tuesday on NaviNet and can assist you in identifying your patients who have received their vaccination.

Please take the time to visit the NaviNet portal. You can locate this report via Workflow>Practice Documents> HPP COVID_Vaccine.

Thank you for your ongoing support to continually improve the health outcomes of our members. We look forward to the opportunity to PartnerUp with our providers to make meaningful change.

HPP Communications

HPP Policy Changes

Cost Sharing
HPP is waiving all member cost sharing for services related to testing, screening and diagnosis to treat for COVID-19.

Prior Authorization
HPP is waiving all prior authorization requirements for services related to testing, screening and diagnosis to treat for COVID-19.

Telehealth Services Policy
In order to make needed medical care accessible to our members, HPP is encouraging providers to make telehealth more widely available. HPP is lifting some of the requirements of our telehealth policy; all other criteria of the policy are in-force at this time.

Until further notice, the criteria of our policy have been temporarily modified as follows:

  • Telehealth services, when appropriate, do not have to be completed via a video connection
  • Monthly reporting is not required, as long as the provider is submitting a valid claim, with appropriate and valid coding, to HPP
  • A member’s consent for telehealth services prior to the service being rendered is not required

If you are unable to assist members via telehealth services, we encourage you to recommend members contact Teladoc.

DHS Resources

CMS Resources

Other Resources

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