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Humana COVID-19 Updates

Humana has a provider-facing website on COVID-19 that can be used as a resource. The link is https://www.humana.com/provider/coronavirus.

This is also available within Humana’s Payer Spaces on Availity under the news and announcement tab. There is a specific area on the site specific to member services: Coronavirus: Protecting members and reducing the spread of COVID-19.

Updated Documentation:

Telehealth Updated FAQs - Five new FAQs pertaining to services coverable using video, hospital modifier details for billing, virtual visit time calculation, telephone E/M CPT code details, and RHCs and FQHCs furnishing and billing for telehealth.  Please note: Some of the existing answers have been updated as well.

  • Can the Practitioner Assessment Form (PAF) (CPT code 96160) be done via telehealth and can it be done using real-time interactive audio only? 
  • Can the Member Summary with clinical inference be done via telehealth and can it be done using real- time interactive audio only? 
  • Is a physical therapist considered an eligible provider to deliver services via telehealth? 
  • When is the effective date of Humana’s modified telehealth policy? Will it be applied retroactively to claims already submitted? 

Stars COVID Impact Fact Sheet – Summary of changes to quality improvement and data collection activities for measurement years 2019 and 2020 that impact Star Ratings for plan years 2021 and 2022. 

Additional Updates:

Effective May 22, 2020
Update – Humana lifts suspension of authorizations and referrals for all diagnoses except COVID-related diagnoses
Exceptions apply. Click here for more details.

Effective May 15, 2020
Update – Humana will resume medical record requests for claims reviews as states ease restrictions on elective procedures. Click here for more information.

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