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COVID-19 resource center | Mass General Brigham Health Plan
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widget-type-cell dnd-column" style="" data-widget-type="cell" data-x="0" data-w="12"> <div class="row-fluid-wrapper row-depth-1 row-number-2 dnd-row"> <div class="row-fluid "> <div class="span12 widget-span widget-type-custom_widget dnd-module" style="" data-widget-type="custom_widget" data-x="0" data-w="12"> <div id="hs_cos_wrapper_widget_1706542681625" class="hs_cos_wrapper hs_cos_wrapper_widget hs_cos_wrapper_type_module" style="" data-hs-cos-general-type="widget" data-hs-cos-type="module"><div class="cm-cwbi-wrapper" id=""> <div class="field__item"> <section class="row cta-block" style="background-image:url('https://massgeneralbrighamhealthplan.org/hubfs/MGBHP%20Rebrand/Rebrand%20images/iStock-1320082881.jpg'); background-position:center center;"> <h1 class="cta-block__title large-7"> COVID-19 information and resources </h1> <div class="cta-block__text large-7"> </div> <div class="cta-block__links large-7"> </div> </section> </div> </div> </div> </div><!--end widget-span --> </div><!--end row--> </div><!--end row-wrapper --> </div><!--end widget-span --> </div><!--end row--> </div><!--end row-wrapper --> </div><!--end widget-span --> </div> </div> </div> <div class="container-fluid home-row2"> <div class="row-fluid-wrapper"> <div class="row-fluid"> <div class="span12 widget-span widget-type-cell " style="" data-widget-type="cell" data-x="0" data-w="12"> <div class="row-fluid-wrapper row-depth-1 row-number-1 dnd-section"> <div class="row-fluid "> <div class="span12 widget-span widget-type-cell dnd-column" style="" data-widget-type="cell" data-x="0" data-w="12"> <div class="row-fluid-wrapper row-depth-1 row-number-2 dnd-row"> <div class="row-fluid "> <div class="span12 widget-span widget-type-custom_widget dnd-module" style="" data-widget-type="custom_widget" data-x="0" data-w="12"> <div id="hs_cos_wrapper_widget_1671210236127" class="hs_cos_wrapper hs_cos_wrapper_widget hs_cos_wrapper_type_module widget-type-rich_text" style="" data-hs-cos-general-type="widget" data-hs-cos-type="module"><span id="hs_cos_wrapper_widget_1671210236127_" class="hs_cos_wrapper hs_cos_wrapper_widget hs_cos_wrapper_type_rich_text" style="" data-hs-cos-general-type="widget" data-hs-cos-type="rich_text"><div> <div> <div data-widget-type="custom_widget" data-x="0" data-w="12"> <h2>Our latest COVID-19 updates</h2> </div> </div> </div> <div> <div data-widget-type="cell" data-x="0" data-w="7"> <div data-widget-type="custom_widget" data-x="0" data-w="12"> <p><span>Throughout the COVID-19 pandemic, Mass General Brigham Health Plan was committed to ensuring timely access to high-quality healthcare services for our members. Following the end of the COVID-19 Public Health Emergency on May 11, 2023, this commitment remains a top priority. We have aligned our COVID-19 coverage policies based on public health recommendations and regulatory guidance.</span></p> </div> </div> </div></span></div> </div><!--end widget-span --> </div><!--end row--> </div><!--end row-wrapper --> </div><!--end widget-span --> </div><!--end row--> </div><!--end row-wrapper --> </div><!--end widget-span --> </div> </div> </div> <div class="container-fluid home-row3"> <div class="row-fluid-wrapper"> <div class="row-fluid"> <div class="span12 widget-span widget-type-cell " style="" data-widget-type="cell" data-x="0" data-w="12"> <div class="row-fluid-wrapper row-depth-1 row-number-1 dnd-section"> <div class="row-fluid "> <div class="span12 widget-span widget-type-cell dnd-column" style="" data-widget-type="cell" data-x="0" data-w="12"> <div class="row-fluid-wrapper row-depth-1 row-number-2 dnd-row"> <div class="row-fluid "> <div class="span12 widget-span widget-type-custom_widget dnd-module" style="" data-widget-type="custom_widget" data-x="0" data-w="12"> <div id="hs_cos_wrapper_widget_1682531324598" class="hs_cos_wrapper hs_cos_wrapper_widget hs_cos_wrapper_type_module widget-type-header" style="" data-hs-cos-general-type="widget" data-hs-cos-type="module"> <span id="hs_cos_wrapper_widget_1682531324598_" class="hs_cos_wrapper hs_cos_wrapper_widget hs_cos_wrapper_type_header" style="" data-hs-cos-general-type="widget" data-hs-cos-type="header"><h3>Effective on May 12, 2023</h3></span></div> </div><!--end widget-span --> </div><!--end row--> </div><!--end row-wrapper --> <div class="row-fluid-wrapper row-depth-1 row-number-3 dnd-row"> <div class="row-fluid "> <div class="span12 widget-span widget-type-custom_widget dnd-module" style="" data-widget-type="custom_widget" data-x="0" data-w="12"> <div id="hs_cos_wrapper_widget_1682531016041" class="hs_cos_wrapper hs_cos_wrapper_widget hs_cos_wrapper_type_module" style="" data-hs-cos-general-type="widget" data-hs-cos-type="module"><div class="accordion widget_1682531016041" id=""> <ul> <li class="accordion-item"> <a class="accordion-item__title" href="javascript:void(0)"> Commercial members </a> <div class="accordion-content"> <div class="accordion-item__body"> <p><span></span><span>COVID-19 tests and treatments* ordered by a provider, as well as COVID-19 vaccines will continue to be covered with no cost-sharing for members.</span></p> <p><span>*As of 1/1/2024, cost sharing applies to COVID-19 related services for HSA qualified health plans.</span></p> <p><span>Over-the-counter COVID-19 tests are no longer covered.</span></p> </div> </div> </li> <li class="accordion-item"> <a class="accordion-item__title" href="javascript:void(0)"> Mass General Brigham Accountable Care Organization (ACO) members </a> <div class="accordion-content"> <div class="accordion-item__body"> <p><span></span><span>In alignment with MassHealth requirements, the following will continue to be covered at no cost:</span></p> <ul> <li><span>COVID-19 tests and treatments when ordered by a provider</span></li> <li><span>COVID-19 vaccines</span></li> <li>Two over-the-counter tests every 28 days</li> </ul> </div> </div> </li> <li class="accordion-item"> <a class="accordion-item__title" href="javascript:void(0)"> Medicare Advantage members </a> <div class="accordion-content"> <div class="accordion-item__body"> <span></span><span>Medicare Advantage members can learn more about coverage for COVID-19 tests, treatments, and vaccines at </span><span><a href="https://www.medicare.gov/medicare-coronavirus" rel="noopener" target="_blank">Medicare.gov</a></span><span>.</span> </div> </div> </li> </ul> </div> </div> </div><!--end widget-span --> </div><!--end row--> </div><!--end row-wrapper --> </div><!--end widget-span --> </div><!--end row--> </div><!--end row-wrapper --> </div><!--end widget-span --> </div> </div> </div> <div class="container-fluid home-row4"> <div class="row-fluid-wrapper"> <div class="row-fluid"> <div class="span12 widget-span widget-type-cell " style="" data-widget-type="cell" data-x="0" data-w="12"> <div class="row-fluid-wrapper row-depth-1 row-number-1 dnd-section"> <div class="row-fluid "> <div class="span12 widget-span widget-type-cell dnd-column" style="" data-widget-type="cell" data-x="0" data-w="12"> <div class="row-fluid-wrapper row-depth-1 row-number-2 dnd-row"> <div class="row-fluid "> <div class="span12 widget-span widget-type-custom_widget dnd-module" style="" data-widget-type="custom_widget" data-x="0" data-w="12"> <div id="hs_cos_wrapper_widget_1683129447067" class="hs_cos_wrapper hs_cos_wrapper_widget hs_cos_wrapper_type_module" style="" data-hs-cos-general-type="widget" data-hs-cos-type="module"><div class="advanced-contnt" id=""> <div class="page-center"> <div class="table-wrapper"> <div class="table-wrapper__inner"> <div class="contnt_box" style="background-color:rgba(177, 228, 227, 1.0);border-bottom: solid 2px rgba(0, 156, 166, 1.0);"> <h2>Information for providers</h2> <p><span><span dir="ltr">Please follow our standard policies and procedures as outlined in our <a aria-label="Link provider resources" title="https://massgeneralbrighamhealthplan.org/providers/provider-resources" href="https://massgeneralbrighamhealthplan.org/providers/provider-resources" rel="noreferrer noopener" target="_blank">provider resources</a> or your contract. </span></span><span><span dir="ltr">Our covered COVID-19 diagnosis codes are listed below.</span></span></p> </div> </div> </div> </div> </div> </div> </div><!--end widget-span --> </div><!--end row--> </div><!--end row-wrapper --> <div class="row-fluid-wrapper row-depth-1 row-number-3 dnd-row"> <div class="row-fluid "> <div class="span12 widget-span widget-type-custom_widget dnd-module" style="" data-widget-type="custom_widget" data-x="0" data-w="12"> <div id="hs_cos_wrapper_widget_1706210019146" class="hs_cos_wrapper hs_cos_wrapper_widget hs_cos_wrapper_type_module" style="" data-hs-cos-general-type="widget" data-hs-cos-type="module"><div class="accordion widget_1706210019146" id=""> <ul> <li class="accordion-item"> <a class="accordion-item__title" href="javascript:void(0)"> COVID-19 diagnosis codes </a> <div class="accordion-content"> <div class="accordion-item__body"> <div data-hs-responsive-table="true" style="overflow-x: auto; max-width: 100%; width: 100%; margin-left: auto; margin-right: auto;"> <table style="width: 100%; border-collapse: collapse; table-layout: fixed; border: 1px solid #99acc2; height: 166.542px;"> <tbody> <tr style="height: 23.7917px;"> <td style="width: 49.5575%; padding-top: 4px; padding-right: 4px; padding-bottom: 4px; height: 23.7917px;"><strong>Code</strong></td> <td style="width: 49.5575%; padding-top: 4px; padding-right: 4px; padding-bottom: 4px; height: 23.7917px;"><strong>Description</strong></td> </tr> <tr style="height: 23.7917px;"> <td style="width: 49.5575%; padding-top: 4px; padding-right: 4px; padding-bottom: 4px; height: 23.7917px;">U07.1</td> <td style="width: 49.5575%; padding-top: 4px; padding-right: 4px; padding-bottom: 4px; height: 23.7917px;">COVID-19</td> </tr> <tr style="height: 23.7917px;"> <td style="width: 49.5575%; padding-top: 4px; padding-right: 4px; padding-bottom: 4px; height: 23.7917px;">U09.9</td> <td style="width: 49.5575%; padding-top: 4px; padding-right: 4px; padding-bottom: 4px; height: 23.7917px;">Post COVID-19 condition, unspecified</td> </tr> <tr style="height: 23.7917px;"> <td style="width: 49.5575%; padding-top: 4px; padding-right: 4px; padding-bottom: 4px; height: 23.7917px;">M35.81</td> <td style="width: 49.5575%; padding-top: 4px; padding-right: 4px; padding-bottom: 4px; height: 23.7917px;">Multisystem inflammatory syndrome</td> </tr> <tr style="height: 23.7917px;"> <td style="width: 49.5575%; padding-top: 4px; padding-right: 4px; padding-bottom: 4px; height: 23.7917px;">Z01.81</td> <td style="width: 49.5575%; padding-top: 4px; padding-right: 4px; padding-bottom: 4px; height: 23.7917px;">Encounter for preprocedural examinations (please include 6th character for exam description)</td> </tr> <tr style="height: 23.7917px;"> <td style="width: 49.5575%; padding-top: 4px; padding-right: 4px; padding-bottom: 4px; height: 23.7917px;">Z11.52</td> <td style="width: 49.5575%; padding-top: 4px; padding-right: 4px; padding-bottom: 4px; height: 23.7917px;">Encounter for screening for COVID-19</td> </tr> <tr style="height: 23.7917px;"> <td style="width: 49.5575%; padding-top: 4px; padding-right: 4px; padding-bottom: 4px; height: 23.7917px;">Z20.822</td> <td style="width: 49.5575%; padding-top: 4px; padding-right: 4px; padding-bottom: 4px; height: 23.7917px;">Contact with and (suspected) exposure to COVID-19</td> </tr> </tbody> </table> </div> <p><strong><br>Covered diagnosis codes for COVID-19 evaluation and treatment</strong></p> <ul> <li>Evaluation for suspected Covid-19: <ul> <li>Asymptomatic individuals with actual or suspected exposure to COVID-19 or for symptomatic individuals with actual or suspected exposure to COVID-19 and the infection has been ruled out, or test results are inconclusive or unknown: <ul> <li>Facility claims use Z20.822 as the primary diagnosis</li> <li>Professional claims use Z20.822 pointed to the line for the related service<br><br></li> </ul> </li> </ul> </li> <li>Confirmed diagnosis for Covid-19: <ul> <li>Facility claims use U07.1 as the primary diagnosis</li> <li>Professional claims use U07.1 pointed to the line for the related service<br><br></li> </ul> </li> <li>Multisystem Inflammatory Syndrome for individuals with multisystem inflammatory syndrome (MIS) and COVID-19: <ul> <li>Facility claims use U07.1 as the primary diagnosis</li> <li>Professional claims U07.1 and M35.81 pointed to the claim line for the related service<br><br></li> </ul> </li> <li>Multisystem Inflammatory Syndrome due to post Covid-19 condition <ul> <li>For facility claims use U09.9 and M35.81 billed together</li> <li>For professional claims use U09.9 and M35.81 pointed to the line claim for the related service<br><br></li> </ul> </li> <li>Patients receiving preoperative evaluations only: <ul> <li>ICD-10-CM Coding Guidelines instruct to sequence first a code from subcategory Z01.81 (Encounter for preprocedural examinations)</li> </ul> </li> </ul> </div> </div> </li> </ul> </div> </div> </div><!--end widget-span --> </div><!--end row--> </div><!--end row-wrapper --> </div><!--end widget-span --> </div><!--end row--> </div><!--end row-wrapper --> <div class="row-fluid-wrapper row-depth-1 row-number-4 dnd-section"> <div class="row-fluid "> <div class="span12 widget-span widget-type-cell dnd-column" style="" data-widget-type="cell" data-x="0" data-w="12"> <div class="row-fluid-wrapper row-depth-1 row-number-5 dnd-row"> <div class="row-fluid "> <div class="span12 widget-span widget-type-custom_widget dnd-module" style="" data-widget-type="custom_widget" data-x="0" data-w="12"> <div id="hs_cos_wrapper_widget_1682531381308" class="hs_cos_wrapper hs_cos_wrapper_widget hs_cos_wrapper_type_module" style="" data-hs-cos-general-type="widget" data-hs-cos-type="module"><div id="" class="cm-features-wrapper column-count-"> <section class="content-grid page-center"> <h2 class="content-grid__title columns small-12"> COVID-19-related resources </h2> <div class="row small-12 field__items"> <div class="columns small-12 medium-6 field__item"> <a href="https://www.cdc.gov/coronavirus/2019-ncov/index.html" target="_blank" rel="noopener" class="paragraph" style="background-color:rgba(177, 228, 227, 1.0);"> <div class="content-grid-item__title"> </div> <div class="content-grid-item__content"> </div> <div class="content-grid-item__cta">Centers for Disease Control and Prevention</div> </a> </div> <div class="columns small-12 medium-6 field__item"> <a href="https://www.vaccines.gov/" target="_blank" rel="noopener" class="paragraph" style="background-color:rgba(177, 228, 227, 1.0);"> <div class="content-grid-item__title"> </div> <div class="content-grid-item__content"> 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