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.
Billing Update for 2022 COVID-19 Vaccine and Monoclonal Antibodies
The Centers for Medicare & Medicaid Services (CMS) has instructed Health Partners Plans that effective for dates of service on and after January 1, 2022, COVID-19 vaccines and monoclonal antibodies provided to patients enrolled in a Medicare Advantage plan are to be billed and reimbursed by the plan.
If you have any questions, please contact our Provider Services Helpline at 1-888-991-9023, Monday – Friday, 9 a.m. – 5:30 p.m.
DHS Bulletin: Provider Revalidation Requirements
As described in MA Bulletin 99-21-01, effective June 1, 2021, the Department reinstated provider revalidation requirements as applicable prior to the COVID-19 public health emergency (PHE). This means, for revalidations due on and after June 1, 2021, providers must submit revalidation applications by the due dates indicated in their 90-day and 30-day revalidation notices. If your revalidation application is received prior to your revalidation date and remains active, you will not close.
PLEASE NOTE: Failure to submit your revalidation application by the revalidation due date specified in the revalidation notices will result in closure of the provider service locations in PROMISe. Once a closure occurs, you must complete a reactivation application to be reenrolled.
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 & CHIP
Provider is required
to bill CMS
*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|
Eli Lilly and Company
intravenous infusion, bamlanivimabxxxx,
Provider is required to bill CMS
intravenous infusion, casirivimab and
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.
- March 16, 2020: Telehealth Services
- March 22, 2020: COVID-19 Updates
- March 24, 2020: Tri-Tech Announcement
- March 25, 2020: Maternity Blood Pressure Cuffs
- March 26, 2020: Shift Care
- March 27, 2020: Facility UM Appeals Change
- April 2, 2020: Electronic Claims Submission
- April 9, 2020: Authorization Process Changes
- April 17, 2020: Process Changes from HPP
- April 29, 2020: Medical Day Care Centers Update
- May 12, 2020: Authorization Process Update
- Dec. 19, 2020: Year End Provider Check In
- Dec. 21, 2020: COVID-19 Vaccine Information
- Jan. 4, 2021: COVID-19 Antibody Therapy Administration
- Jan. 28, 2021: COVID-19 Vaccine Administration – Updated Information Based on DHS Changes
- Jan. 29, 2021: COVID-19 Vaccine Administration by Pharmacies
- Feb. 22, 2021: Participating Laboratory COVID-19 Testing Update
- Feb. 22, 2021: Non-Participating Laboratory COVID-19 Testing Update
- April 23, 2021: Vaccine Administration Updates
- June 1, 2021: Authorization Process Changes
- December 17, 2021: Authorization Process Changes
- January 7, 2022: Authorization Process Changes
HPP Policy Changes
HPP is waiving all member cost sharing for services related to testing, screening and diagnosis to treat for COVID-19.
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 Bulletin on Provider Revalidation Requirements: Full DHS Bulletin
- DHS Bulletin on Adminsitration of Vaccine and Monocolnal Antibody THerapy: Corrected - Expansion of Providers for the Administration of SARS-CoV-2 Vaccines and Monoclonal Antibody Therapy
- DHS Bulletin on Vaccination for Pregnant People: COVID-19 Vaccination for Pregnant People to Prevent Serious Illness, Deaths, and Adverse Pregnancy Outcomes from COVID-19
- DHS Alerts
- Billing Guidance for Alternative Screening Sites Related to COVID-19
- COVID-19 Vaccine Resources
- Medicare Provider Enrollment Relief Frequently Asked Questions
- Current Emergencies
- General Provider Telehealth and Telemedicine Tool Kit
- Adult Elective Surgery and Procedures Recommendations
- Minimizing Face-to-Face Contact for Medication Delivery or Dispensing
- ESRD Provider Telehealth and Telemedicine Tool Kit
- CMS Clinician Letter
- Fact Sheet: Expansion of the Accelerated and Advance Payments Program for Providers and Suppliers During COVID-19 Emergency
- Increasing Vaccine Confidence Through Communication and Community Engagement, presentation by the Montgomery County Immunization Council
- The Montgomery County Office of Public Health has announced that the Pfizer COVID-19 vaccine is now available for people aged 12-15 at its County-run vaccine clinics. Click here to view the flyer.
- Centers for Disease Control and Prevention - Coronavirus (COVID-19)
- AMA quick guide to telemedicine in practice
- Finding the Right Words About COVID-19
Community & Food Resources
- COVID-19 Vaccine Provider Quicksheet from the City of Philadelphia (PDF)
- Philadelphia COVID Vaccine Center
- CMS OMH COVID-19 Vaccine Resources for Vulnerable Populations Webpage
- City of Philadelphia: Where to find free, nutritious food during COVID-19
- Community Resource Connects: Find community services to support families, such as help with food, utilities, transportation and more.
- Connect4Health: Find food, health care, housing, and other services in and around Philadelphia