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.
Vaccine News
- Philadelphia's COVID-19 Community Vaccination Program Request for Proposal (RFP)
- The City of Philadelphia is excited to share registration links for upcoming Vaccine Information Champion training sessions in English on April 5 at 1:00 p.m., and in Spanish on April 8 at 1:00 p.m. We understand that there are many questions about the COVID-19 vaccine, how to sign up for it, and what to expect when you go for your appointment. We hope this 90 minute training empowers you with the information you need to have meaningful conversations with your friends and neighbors.
COVID-19 Vaccine Administration
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 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 |
| $16.94* (1st Dose) $28.39* (2nd Dose) |
$0 Provider is required to bill CMS |
$16.94* (1st Dose) $28.39* (2nd Dose) |
$16.94* (1st Dose) $28.39* (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, |
$247.68 | $0
Provider is required to bill CMS |
$247.68 | $247.68 |
|
M0243 Regeneron intravenous infusion, casirivimab and |
$247.68 |
$0 |
$247.68 | $247.68 |
HPP Communications
- 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
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
- 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
Other Resources
- 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
- 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