January 2022 Health Policy Update
ASHA monitors health policy updates in both public and private health plans across the United States. Below are the latest updates that could impact you or those you serve.
Aetna:
- A policy update for hearing aid coverage was published adding language that specifically allows for coverage of hearing aids under plans that do not explicitly exclude its coverage.
- A policy update with coding changes for bone anchored hearing aids.
Aetna – Pennsylvania Medicaid: An updated policy regarding prosthesis for voice rehabilitation following total laryngectomy.
Amerihealth: An updated telehealth policy was published with new information regarding the use of modifiers for audio and video visits.
Anthem Connecticut [PDF], Maine [PDF], Missouri [PDF], Nevada [PDF], New Hampshire [PDF], and Ohio [PDF]: A provider bulletin was published for multiple states. It contains information related to the COVID-19 pandemic, coverage of medically necessary services via telehealth, and cost-sharing during the state of emergency.
BCBS Rhode Island
- An update was published with information on telephone and telemedicine visits [PDF].
- A plan update was published with coding and plan information on implantable bone-conduction and bone-anchored hearing aids [PDF].
BMC Healthnet, Well Sense Health Plan (Commercial, Medicaid, Dual-Eligible) [PDF]: An updated policy for implantable bone-anchored hearing aids.
Centene (Medicaid Plans: Absolute Total Care, Ambetter of Tennessee, Arizona Complete Health, Arkansas Health & Wellness, Arkansas Total Care, Buckeye Health Plan, California Health and Wellness, Centene Corporation, Coordinated Care Health Plan, HealthNet, Home State Health, Iowa Total Care, Louisiana Healthcare Connections, Magnolia Health, MHS Indiana, MHS Wisconsin, Nebraska Total Care, New Hampshire Healthy Families, Peach State Health Plan, Sunflower Health Plan, Superior Health Plan of Texas, Trillium Community Health Plan) [PDF]: An updated policy regarding cochlear implant replacement.
Excellus and Univerva Healthcare [PDF]: An updated policy for speech generating devices was published with new terminology and definitions for coverage.
HealthLink: An updated covered code list with additions and removals was published for the plans that fall under their purview.
Health New England [PDF]: An updated policy is availabe with standards of practice information and site of service information on Telehealth (Telemedicine) Services.
Independence Blue Cross: A new version of the policy for Bone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids (Medicare Advantage) was published with changes to CPT coding requirements and coverage.
Lifewise and Premera Health Plans [PDF]: An updated policy for bone anchored hearing aids and implantable bone conduction was published, which contains additions to the CPT code list.
Lifewise and Premera Health Plans [PDF]: An updated speech therapy policy was published, which adds specific medical necessity language for gender transformation services.
North Dakota Medicaid Manual [PDF]: Updated provider manual with new considerations for telehealth place of service.
Oxford Health Plans [PDF]: A policy update was published, which adds language to alert members that a 3-month rental may be required prior to coverage of a purchase on certain plans.
Providence Health Plans [PDF]: Updated guidance was published with new dates related to the global pandemic. Until further notice, location codes 10, 11, 12, and 99 are allowed for virtual E/M services.
South Dakota Medicaid [PDF]: An updated policy is available with changes to distant site billing for telehealth.
UHC Community Plan (Nebraska Medicaid) [PDF]: An updated cochlear implant policy is available with criteria changes.
UHC Community Plan (Tennessee Medicaid) [PDF]: An updated cochlear implant policy with changes to criteria and supporting information.
UHC Community Plans (Louisiana Medicaid [PDF], Mississippi Medicaid [PDF], Kentucky Medicaid, Indiana Medicaid [PDF], New Jersey Medicaid [PDF], Tennessee Medicaid [PDF]): An updated policy on hearing aids and devices including wearable, bone-anchored and semi-implantable.
UPMC Health Plan [PDF]: A policy was published updating place of service, coding, and coverage criteria information.
