As we continue to evaluate the information around the coronavirus pandemic, we want to make sure you have pertinent information available that impacts you and our members. Please don't hesitate to reach out with questions or issues.

COVID-19 Updates to Support our Providers 

COVID-19 extensions are being extended through December 31, 2022.  Please be advised of the following: 

  1. Temporarily suspending the requirement for a NE license if they are in good standing and free from disciplinary action in the state(s) where they are licensed. This includes those who are properly and lawfully licensed to perform:
    1. Advanced practice nursing
    2. Emergency medical services
    3. Medicine and surgery
    4. Mental health practice
    5. Nursing
    6. Osteopathy
    7. Perfusion
    8. Pharmacy
    9. Psychology
    10. Respiratory care
    11. Surgical assisting 
    12. Alcohol and drug counseling
    13. Audiology
    14. Speech-language pathology
    15. Medical nutrition therapy
    16. Medical radiography
    17. Nursing home administration
    18. Occupational therapy
    19. Physical therapy 
  2. Providers with inactive or expired licenses formerly licensed in the state of NE who want to renew a credential after its expiration date or go from an inactive to active status will not be subject to continuing competency requirements. 
  3. Temporarily suspend requirements for issuing licenses for physicians, nurses, and pharmacy related professions to be processed electronically prior to receipt of license fee, pending test scores, pending national criminal history (pending provider licenses)

For additional information please visit Administrative Updates. 

BCBSNE has made an enhancement to our system which will allow DX Z23 to be in any position along with the COVID-19 vaccine charge on institutional claims effective with DOS 9/15/22 and forward
BCBSNE will no longer require the COVID-19 vaccines to be billed on a separate claim when Z23 is the primary diagnosis. 

As we continue to support our healthcare providers throughout the state, BCBSNE has made the decision to allow Remdesivir in the OP setting without a prior authorization, effective December 23, 2021.

Effective immediately, BCBSNE will require preauthorization and will review its use with guidance from the medical policy. Due to lack of evidence and support from multiple national health associations, ivermectin’s use for COVID-19 treatment and prevention outside of a clinical trial is considered investigational. This applies to all commercial BCBSNE fully insured, self-funded, and individual plan members.

2 Easy Options

We have provided 2 easy options for our providers to request use of ivermectin.

  1. Use our online Medical Policy Tool available online at: Medical Policy Tool. We have enabled functionality for auto-determinations for some cases when this tool is used. Using other online programs and tools that are not operated by BCBSNE we are not able to adjust those programs for this use.
  2. Use the General Medication Preauthorization Physician Fax Form and fax to the number provided at the bottom of the form.

BCBS Federal Employee Program (FEP) understands there are times when it is necessary and appropriate for our non-teladoc network providers to also treat patients remotely. With this in mind, we will allow for appropriate covered services (i.e., office visits with primary care, specialty and mental health providers, ABA, speech and other therapies) when billed with the correct place of service (02) and modifier (95 GT and GQ).

In these cases, non-telehealth benefits will apply, meaning regular office visit copays will be charged to the member for the remote virtual visit depending on which option they are enrolled in, whether the provider is a PCP and SCP and what the provider’s contracted status is.  

However, if the claim is related to testing or treatment for COVID-19, member cost-share is waived regardless of the provider’s contracted status. 

Note: Cost-share is waived regardless of whether the COVID-19 test comes back positive or negative. 

For services provided under the telehealth benefit by a teladoc provider, member cost-share is being waived. For services from non-teladoc providers, member cost-share is only being waived if those services are for testing or treatment of COVID-19. Telehealth charges are accepted from any credentialed provider with no video component required during this pandemic urgency period.

A provider may bill using E&M codes, therapy codes or telehealth codes and must use the modifier 95, GT and GQ and POS 02 for reimbursement. Normal cost-shares will apply; however, if the claim is related to testing or treatment for COVID-19, member cost-share is waived regardless of the provider's contracted status.

Notice of termination for this policy will be given in writing at least 60 days prior to termination.  However, we will review and consider an extension for this policy as needed.    

Telehealth Codes

Please use in place of service 02 and modifier 95, GT and GQ with the appropriate CPT codes. We have updated the fee schedule to reflect these changes. To download the fee schedule,  log in to NaviNet.

Our members may seek telehealth services through their current provider, or they can receive services through teledoc. This information has been communicated separately to our members.

Thank you for the care you provide our members, especially in times of crisis.