COVID-19 (Coronavirus): Coverage for respiratory equipment and related supplies

May 14, 2020

This article was revised on May 14, 2020, to update the effective timeline.

AmeriHealth is committed to providing our members with access to the care they need. As COVID-19 has escalated into a pandemic, we are working to make sure that our members can receive appropriate testing and treatment for the virus causing COVID-19 if needed.

We encourage all AmeriHealth members to visit our dedicated AmeriHealth New Jersey and AmeriHealth Pennsylvania COVID-19 webpages regularly for the latest news and updates. We will continue to evaluate member needs as the situation changes.

Respiratory equipment and related supplies

From March 6, 2020, through June 30, 2020, AmeriHealth will provide coverage for respiratory equipment (e.g., ventilator, respiratory assist device) and supplies to support ongoing acute care respiratory services in the home setting. Quantity limits for medically necessary respiratory supplies will be waived during the COVID-19 public health emergency.

In addition, AmeriHealth is temporarily suspending prior authorization requirements for continuous positive airway pressure (CPAP) devices, bi-level (Bi-PAP) devices, and all supplies.

Medical policies

Three policies address respiratory equipment and related supplies:

  • #05.00.30m: Noninvasive Respiratory Assist Devices (RADs): Continuous Positive Airway Pressure (CPAP) Devices
    and Bi-Level Devices (AmeriHealth Administrators)
  • #05.00.58I: Home Oxygen Therapy
  • #07.03.05w: Sleep Disorder Testing and Positive Airway Pressure Therapy Services and Supplies (AmeriHealth)

Coding

A complete list of codes for ventilator, respiratory assist device/CPAP device, home oxygen, and supplies can be found in the policies or in the announcement, Waiver of Certain Requirements During COVID-19 Outbreak Related to Respiratory Equipment and Related Supplies for AmeriHealth Members, in the News & Announcements section of our Medical Policy Portal.

Learn more

For more information about the AmeriHealth position on COVID-19, please review the following resources: