02.09.2021 — Updated information on coverage of antibody testing.
02.04.2021 — Updated information on coverage of home tests for COVID-19.
02.01.2021 — Updated COVID-19 Testing, Treatment, and Vaccine Grid to include latest vaccine codes and information on the use of U07.1 COVID-19 diagnosis code and certain ICD-10 Z codes with regard to cost sharing.
01.04.2021 — Updated information on monoclonal antibody treatment and telemedicine/telehealth reimbursement. Extended prior authorization suspension on elective admissions for Massachusetts commercial products to March 31, 2021.
12.23.2020 — Extended date ranges on new and existing authorizations for elective inpatient services, remaining valid through March 31, 2021. Update to telehealth parity language.
12.14.2020 — Added information on COVID-19 vaccines and coverage of monoclonal antibody treatment and home tests for COVID-19.
We’re here to support you, our members, and employers during the COVID-19 public health crisis. We’re continually assessing and adapting our policies and business operations to support our members in receiving the care they need, including any necessary testing and treatment for COVID-19, and to aid our provider partners in ensuring that patients can safely access the care they need. Please review the following information — which applies to our fully insured, Medicare Advantage, Medicare Enhance, and Medicare Supplement plans, unless otherwise noted — to learn more.
With the COVID-19 vaccine given Emergency Use Authorization (EUA), Harvard Pilgrim offers the following guidance for providers on administering the vaccine. Harvard Pilgrim understands the urgency of getting vaccines administered swiftly and effectively and is committed to supporting providers in this important work. We are also conducting education and outreach to our members to educate them about the known safety of COVID-19 vaccines and the importance of getting vaccinated (consistent with state and federal guidelines on availability of the vaccine and populations who should receive vaccinations first).