COVID-19 (Coronavirus): Temporary claims processing code J3490 added to allow payment for primary care telemedicine visits

October 5, 2020

AmeriHealth is committed to providing our members with access to the care they need during the COVID-19 pandemic. We encourage all AmeriHealth members and providers 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.

Coverage of member cost-share

In order to reimburse providers in a timely manner for the waived HMO/POS/EPO member copayment for a primary care physician (PCP) telemedicine visit during COVID-19, we added code J3490 on the claim to pay the provider for the waived member copayment for telemedicine services. Reimbursement of member cost-sharing for telemedicine claims other than for HMO/POS/EPO primary care services do not require code J3490 to be added to the claim for processing.

Please be advised that your patients, our members, will see code J3490 on their explanation of benefits (EOB) as an additional claim line. The use of this code is temporary until a new code can be configured to process PCP telemedicine claim adjustments for reimbursement of HMO/POS/EPO member copayments to PCPs. We will inform you of any other updates related to coding for the cost-share waiver.

As a reminder, AmeriHealth New Jersey is waiving member cost-sharing for any covered telemedicine service.

Learn more

For detailed information related to our coverage of services during the COVID-19 public health emergency, please review our news articles on our Medical Policy Portal.

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