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Humana COVID-19 Updates

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03/17/2020

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 SheetSummary 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.