Coronavirus (COVID-19) Information for Providers

UCare Medicare Plans
The federal Medicare program no longer covers OTC COVID-19 tests. After May 11, 2023, UCare members can use their UCare Healthy Savings® cards to purchase OTC COVID-19 tests.

UCare Individual & Family Plans
Members can obtain up to eight Food and Drug Administration (FDA)-authorized OTC tests for COVID-19. These tests are available at no cost to UCare members every 30 days with a prescription.

MinnesotaCare, Minnesota Senior Care Plus, Prepaid Medical Assistance Program, UCare Connect, UCare Connect + Medicare and UCare’s Minnesota Senior Health Options
UCare will cover up to eight OTC COVID-19 tests per month at a pharmacy with a prescription.

All UCare Products
COVID-19 vaccines are covered with no cost share as a preventive service for all products.
Information about COVID-19 vaccines can be found on the CMS COVID-19 Vaccines and Monoclonal Antibodies page.

All UCare Products
Cost share applies to monoclonal antibody treatments that are approved for emergency use or authorized by the FDA. COVID-19 treatments continually change.

Reference the CMS COVID-19 Vaccines and Monoclonal Antibodies page for the most up-to-date list of other monoclonal antibodies which are approved for emergency use or authorized by the FDA. There you will also find the associated codes, effective dates and monoclonal antibodies that are no longer authorized.

Member COVID-19 Information

All UCare Products
Cost share will be applied for inpatient, observation, outpatient, office-based clinic and emergency department services.

UCare Medicare Plans and UCare Individual & Family Plans Products
The -CS modifier was used during the PHE to waive member cost-share for services related to testing and evaluation of COVID-19. The -CS modifier should not be used for claims with dates of service on or after May 12, 2023. View the list of CMS waivered services here.

UCare Medicare Plans
The DR and CR Modifiers were used during the PHE and should not be used for claims with dates of service on or after May 12, 2023. For more information, refer to the Medicare Claims Processing Manual, Chapter 38.

UCare Medicare Plans and UCare Individual & Family Plans Products
The weighting factor of the assigned Diagnostic-Related Group (DRG) to inpatient claims for individuals diagnosed with COVID-19 will no longer be increased by 20%.

All UCare Products
If an eligible provider furnishes telehealth-eligible services from home after usual office hours, the address submitted on the claim should be the same as the one the provider customarily uses when submitting claims to UCare. If the provider performs services from a home-based office that has been enrolled with UCare, then the home-based office address should be submitted on the claim.

UCare Medicare Plans and UCare Individual & Family Plans Products
UCare will follow the expansion of telehealth guidelines through Dec. 31, 2024 for Medicare products and UCare Individual and Family Plans. Refer to the Telehealth policy changes after the COVID-19 public health emergency page for a complete guide to telehealth services.

UCare Medicare Plans and UCare Individual & Family Plans Products
When an eligible outpatient provider, employed by the hospital, furnishes telehealth-eligible services (e.g., physical therapy, occupational therapy, speech language therapy), append the -95 modifier to the telehealth eligible service(s) provided.

UCare Medicare Plans and UCare Individual & Family Plans Products
The below limitations applied to telehealth services are applicable until Dec. 31, 2024:

• A subsequent inpatient visit (99231-99233) can be furnished via telehealth, without the limitation that the telehealth visit occurs only once every three days;
• A subsequent skilled nursing facility visit (99307-99310) can be furnished via telehealth, without the limitation that the telehealth visit is once every 30 days; and
• Critical care consult codes (G0508-G0509) may be furnished by telehealth beyond the once per day limitation.

State Public Programs
RHC claims for audio only telehealth services:

• Use CPT Code 99441, 99442 or 99443
• Use place of service 10
• Use Modifier 95

FQHC claims for telehealth services started July 1, 2020:

• Submit telehealth using revenue code 052X;
• HCPCS code G2025; and
• Append modifier –CG to the claim. Modifier -95 is optional.

The requirements for CAH Method II providers have not changed. When distant site services are billed CAH method II providers on an institutional claim, the -GT modifier should be appended to services performed via telehealth.

State Public Programs
UCare follows the Department of Human Services (DHS) telehealth guidelines related to eligible providers and services as outlined in the DHS Coronavirus (COVID-19) Information link.