Molinalogo

ICD-10	Description	CPT	HPCS Description
B97.29	Other coronavirus as the cause of diseases classified elsewhere	U0001	This code is used specifically for CDC testing laboratories
Z03.818	Encounter for observation for suspected exposure to other biological agents - ruled out	U0002	This code is used for non–CDC testing laboratories
Z20.828	Contact with and (suspected) exposure to other viral communicable diseases	87635	This code is used for non-CDC testing laboratories (effective 3/13/2020).  Provider can choose to use U0002 or 87635
U07.1	COVID-19 Confirmed Cases, virus identified. Assigned to a disease diagnosis of COVID-19 confirmed by laboratory testing.
U07.2	COVID-19 Suspected/Probable cases, virus not identified. Assigned to a clinical or epidemiological diagnosis of COVID-19 where laboratory confirmation is inconclusive or not available.

• Molina will waive co-pays and cost share for any COVID-19 related diagnostic laboratory testing, office visits, urgent care visits and ED visits Molina will cover the test kit for patients who meet CDC guidelines for testing, which can be done in any authorized location (excluding LabCorp or Quest sites). No prior authorization is needed for this testing.
• Visits for any other symptoms or diagnoses will continue to have co-pays and cost share. This includes other laboratory testing (besides COVID-19 testing), x-rays or add-on testing.

Resources

COVID-19 Molina Clinical Policy

WA DOH Healthcare Provider Resources & Recommendations

CMS Provider Partner Toolkit

CDC: ICD-10-CM Official Coding Guidelines

Specimen collection guidelines (by Quest Diagnostics)

Washington Chapter of American Academy of Pediatrics COVID Resources to support health care providers working with children, teens and families.

Washington State Partner Toolkit

4/9/2020 Bulletin

4/14/2020 Bulletin

4/28/2020 Bulletin

4/29/2020 Bulletin

4/30/2020 Bulletin

5/04/2020 Bulletin

5/18/2020 Bulletin

Molina will pay providers for a variety of modalities in lieu of in-person visits to support evaluation, assessment and treatment of members. These modalities include telemedicine for HIPAA compliant, interactive, real-time audio and video telecommunications, which are already covered, and other forms of telehealth such as online digital exchange through a patient portal, telephone call, FaceTime, Skype or email.

Telehealth for Physical Health Providers

Molina’s detailed COVID-19 Telehealth Billing Policy for Physical Health Providers

EPSDT Appointments via Telemedicine/Telehealth & In-Person Follow-up

For an EPSDT appointment via telemedicine/telehealth, bill per the below guidance:

• • Services provided via a telehealth modality choose the appropriate EPSDT visit code, with modifier CR and the POS indicator that best describes Services provided via a telehealth modality choose the appropriate EPSDT visit code, with modifier CR and the POS indicator that best describes where the client is.
• • Services provided via a telehealth modality choose the appropriate EPSDT visit code, with modifier CR and the POS indicator that best describes Services provided via telemedicine modality, choose the appropriate EPSDT visit code, with modifier CR, POS 02
• • Services provided via a telehealth modality choose the appropriate EPSDT visit code, with modifier CR and the POS indicator that best describes For the in-person follow-up appointment to complete EPSDT components, bill:
  • o 99429 with modifier CR (see COVID-19 fee schedule)

Note: remember to add any of the additional procedure codes that are applicable to other services/screenings provided (see HCA’s EPSDT billing guide and Physician-related/healthcare services billing guide)

Telehealth for Medicaid Physical, Occupational and Speech Therapy Providers

Molina follows the Apple Health telehealth requirements for physical, occupational and speech therapy guidance found on the HCA COVID-19 Resource Page.

Resources

CMS Provider Telehealth and Telemedicine Toolkit

HHS Office of Civil Rights (OCR) Notice on Telehealth Remote Communications for COVID-19

Telepsychiatry in Era of COVID (free webinar from American Psychiatric Association and SAMHSA)

DEA COVID-19 and prescribing via telemedicine guidelines

FCC announces new plan dedicating additional funds to support telehealth programs

COVID-19 Remote Consultations Quick Guide

How to transition to virtual care

Molina Guidance for Audio Only Visits

Telehealth for Medicaid Behavioral Health Providers

Molina will follow the HCA Behavioral Health Policy and Billing for COVID-19 FAQs. found on the HCA COVID-19 Resource Page with limited exceptions.

Molina’s detailed COVID-19 Telehealth Billing Policy for Medicaid Behavioral Health Providers

Resources

Molina COVID BH Screener for Primary Care

Molina Psychological Impact of COVID-19

AACAP (American Academy of Child & Adolescent Psychiatry)-Telepsychiatry Toolkit and other information

AACAP- List of Telepsychiatry Websites

APA (American Psychiatric Association) Telepsychiatry in Era of COVID

APA video series on Telepsychiatry

HCA COVID-19 Involuntary Treatment Act- Guidance for ITA video evaluations

National Consortium of Telehealth Resource Centers-Webinar on Telehealth

SAMHSA (Substance Abuse Mental Health Services Administration)

SAMHSA Telebehavioral Health Training & Technical Assistance

UW-AIMS Center (Advancing Integrated Mental Health Solutions)

UW-BHI (Behavioral Health Institute) Behavioral Health Training, Workforce and Policy Innovation Center includes Tele-behavioral health information, trainings, and links to state resources

 

WA State ACH (Accountable Communities of Health) Trainings

• CPAA/UW-AIMS Center- Telehealth Tips & Tricks for Behavioral Health Teams training recording/slides
• Spokane Region/UW-AIMS Center- How to structure a 30-minute tele-visit webinar

Molina will extend authorizations for all elective surgeries, procedures, physical therapy, speech therapy, DME and occupational therapy that are scheduled to expire prior to Sept. 1st to be honored up to September 1, 2020. This does not include extending or adding services not included in the primary request. Authorization for new procedures not previously approved and new therapy requests must go through the normal approval process but should not expire before May 31, 2020 or after the usual 90- day approval whichever is longer.

Molina will relax refill timing on all* prescriptions until July 31, 2020. (If the outbreak continues please monitor our provider notifications for potential extension of this policy). Members can receive an early refill for 30 days, plus two additional refills, up to a 90-day supply. Additionally, Molina will allow 90-day prescription volumes on many routine medications currently or can approve a 90-day supply via an exception request. This includes new prescriptions and refills. Please allow 90-day supply of maintenance medications through both mail order and retail pharmacies, especially for members discharging from an inpatient facility given the current availability of follow-up appointments. CVS offers free prescription delivery through their mail order pharmacy at www.caremark.com

*Certain controlled medications require prior authorization prior to refill.

Molina has options in place for temporary and expedited credentialing. Providers can email their request for provisional credentialing to: MHWProviderContracting@molinahealthcare.com.

• Temporary providers will not require credentialing and include:
  • Covering practitioners (e.g., locum tenens)
  • Providers who are not part of the network and are providing care to our members as part of a federal, state or local government emergency response team.
  • Rental network practitioners who provide out-of-area care only, and members are not required or given an incentive to seek care from them.
  • Practitioners who practice exclusively in free-standing facilities and provide care for organization members only because members are directed to the facility
  • Practitioners who practice exclusively in an inpatient or group practice setting and provide care for members only because members are directed to the hospital or another inpatient setting or group practice
• Provisional Credentialing will be expedited and completed within 5 business days. Full credentialing will be required to be completed within 180-days of the provisional approval date.
• Recredentialing - Providers who are due to be recredentialed that have closed their office or are not able to respond to recredentialing requests will be placed on a temporary hold status.
• Site Reviews - Molina will not be conducting provider site reviews in any Molina state where Site Reviews are required as part of initial and/or recredentialing.

HCA COVID-19 Information Website – includes a wealth of information including
Highlights include :

• BH provider office closures
• Clinical policy
• COVID-19 billing and coding
• No-cost telehealth for providers
• Opioid Treatment program
• Changes to eligibility and enrollment for Apple Health (Medicaid) clients

CMS COVID-19 Information

COVID-19 internet and phone plan resources

Safelink No-cost Cell Phone Program Overview

CARES Act emergency relief funding

CMS’ Accelerated Advance Payments program: offers providers three months of payments during COVID emergency.

US Department of Health and Human Services (HHS) Medicaid/CHIP Provider Relief Fund Webcasts- Register today!

Tuesday June 23 2-3 p.m. ET

Thursday June 25 2-3 p.m. ET

Molina Member COVID-19 Resource Website

Molina Coronavirus Chatbot: Members can click on the robot icon at the upper right-hand corner of our website for help with specific Coronavirus questions

Molina Nurse Advise Line will continue to be available 24 hours a day, 7 days a week: (888) 275-8750 (English/Other languages) or (866) 648-3537 (Spanish)

Emergency COVID-19 Meals

Molina is providing a temporary meal resource for Medicaid and Medicare members who have been diagnosed or live with someone with COVID-19 and who has limited food resources. If you would like to refer a Molina member to this program, please send a secure email to MHW_COVID_Meal@MolinaHealthcare.com or call our Member Services department at (800) 869-7165. Our Case Management team will reach out to the member in 1-2 business days from the date of the referral.

Mail order Prescription Service instructions: English | Spanish

Safelink/Tracfone Flyer(English/Spanish) Note: please ensure Molina members call the 800 number on the flyer for best customer service.

Dental Resources

DentistLink, provided by Arcora Foundation, offers a free service that can assist anyone with referrals to available dentists. Individuals can go to DentistLink.org or call/text (844) 888-5465 to get connected to the dental care they need to stay healthy.

Support for Well Child Care/Immunizations during COVID-19

Molina knows it’s important for children to get their checkups and stay up-to-date with their immunizations, especially during the COVID-19 pandemic. We are partnering with organizations such as Washington Chapter of American Academy of Pediatrics (WCAAP) to get the word out to your Molina patients. Click here for more resources.

Washington Joint Information Center Resources

Virtual Urgent Care

All Molina members have access to immediate care, advice, diagnosis, or assistance from a doctor or nurse practitioner 24/7 through Molina’s Virtual Urgent Care service. Members can talk to a provider from their phone, tablet or computer. Registration is required before meeting with a virtual care provider.

Molina is offering zero co-pay and cost share for virtual urgent care visits - for any diagnosis until May 1, 2020. (If the outbreak continues please monitor our provider notifications for potential extension of this policy). Molina members should use telemedicine as their first line of defense in order to limit potential exposure in physician offices.

All Molina members are strongly encouraged to use our 365/24/7 virtual urgent care services from their phone or computer before visiting a provider, urgent care or ER setting to reduce unnecessary exposure.

Overview:

• Members’ needs regarding low acuity issues can be addressed rapidly when access to their PCP may be limited, or after hours. Triage and home care guidance for members experiencing flu like symptoms reduces the potential spread of, or exposure to illness in PCP offices and ER facilities.
• Visit summaries are sent to primary care providers to preserve continuity of care
• No appointment is needed
• Whether the member is calling with flu-related symptoms or not, Molina Virtual Urgent Care provides members with updates related to COVID-19 and reinforces CDC-guided recommendations

For Medicaid Members

• Call (844) 870-6821, TTY 711 or visit wavirtualcare.molinahealthcare.com

• Fee: no cost to members
• For help registering, call (844) 870-6821

For Marketplace Members

• Call 800 TELADOC (800-835-2362), visit Teladoc.com/MolinaMarketplace, or download our Teladoc.com/mobile app

• Fee: no cost to members
• For help registering, call (800) 835-2362

NEW! For Medicare Members

• Call 800 TELADOC (800-835-2362), visit Teladoc.com/Molina, or download our Teladoc.com/mobile app

• Fee: no cost to members
• For help registering, call (800) 835-2362