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Medicare Member Liability for Telehealth and COVID-19 Treatment Services to be Reinstated Starting June 1, 2021

As we continue address the COVID-19 pandemic, we want to update you on important Medicare benefit information as it relates to currently expanded coverages. For dates of service June 1, 2021 onward, Medicare member liability (copayments, coinsurance and/or deductible cost sharing) will be reinstated as according to their benefits for the following services:

COVID-19 Treatment Services

  • COVID-19 treatment services (those billed with a confirmed ICD-10 diagnosis code) will continue to be eligible for coverage for the duration of the public health emergency (PHE).
  • Prior authorization requirements will also continue to be waived for COVID-19 treatment services during the PHE.
  • Providers should resume collecting Medicare member liability at the point of service on June 1, 2021 onward.

All Telehealth Services

  • Any Services that can be delivered virtually will continue to be eligible for telehealth coverage for the duration of the public health emergency (PHE).
  • Prior authorization requirements will also continue to be waived for all telehealth services during the PHE.
  • Providers should resume collecting Medicare member liability at the point of service on June 1, 2021 onward.
  • Providers should reflect telehealth care on their claim form by following standard telehealth billing protocols in their state.
  • For further coding guidance for telehealth services, we recommend following what is being published by:

In accordance with this reinstatement, WellCare has updated the Billing Guidance for COVID-19 Vaccines, Testing, Screening, and Treatment document posted on our website.

WellCare continues to work in close partnership with state, local and federal authorities to serve and protect our members and communities during the COVID-19 pandemic, including ensuring that our providers have relevant and up-to-date information. We value your partnership during these unprecedented times.

This guidance is in response to the current COVID-19 pandemic and may be retired at a future date.

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