Of course, the COVID-19 vaccine is THE topic of the moment. And as the state’s largest health insurer, we take very seriously our role as a health partner to our members, our providers, as well as to all Rhode Islanders. As such, we recently began a multi-faceted communications campaign to help spread the word about the state’s new vaccination appointment website, which launched on February 22.

Using a targeted approach, we’ve begun communicating with members age 65+ to remind them they are now eligible for the COVID-19 vaccine, which they can schedule on the new website (these appointments are for vaccines administered at state-run sites, not at CVS and Walmart)*. We are proactively sending communications to 64,000 members age 65+ who have opted in to our email or mobile messaging and are not covered under an ASC account (e.g, Lifespan, CNE, and State of Rhode Island members were not included).

We also wanted to provide updates on our COVID-19 vaccination payment policy*, which were also shared during our most recent Provider Relations provider conference call on February 23.

Medicare Advantage Plans and commercial plans:

• FDA approved vaccines for COVID-19 are covered when recommended by the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP), and when FDA guidelines are met.

Medicare Advantage plans:

• In accordance with Center for Medicare and Medicaid Services (CMS) billing guidelines, codes for the vaccine and the administration of COVID-19 vaccines must be submitted to Original Medicare for all patients enrolled in Medicare Advantage in 2020 and 2021.

Additional updates:

• Evaluation & Management (E/M) services should not be filed for the administration of the COVID-19 vaccination unless the E/M represents a separately identifiable service and modifier 25 is appended to the E/M code.
• If you bill for the vaccine itself, the claim will be processed through our claims system, and you will not be reimbursed and will not be able to bill the member.

See our full COVID-19 Vaccinations payment policy here.

Thank you for all you are doing to keep our senior members and all Rhode Islanders safe and healthy right now.

*Information is accurate as of publication date