This article was revised on September 15, 2021, to update the links to revised medical policies which added medical codes related to prophylactic use of Casirivimab/Imdevimab.
AmeriHealth will cover the use of several infusion drugs (and drug combinations) to treat members who have been diagnosed with COVID-19.
These drugs (and drug combinations) must be administered under supervision of a clinical professional. The following treatment regimens have received FDA's approval or Emergency Use Authorization to be administered in the following settings to allow the clinician to monitor and treat infusion reactions like anaphylaxis.
- Bamlanivimab® (LY-CoV555) in combination with Etesevimab® (LY-CoV016)
- Sotrovimab® (VIR-7831/GSK4182136)
- Tocilizumab (Actemra®)
- Veklury® (remdesivir) (including in combination with Olumiant® [baricitinib])
The coverage is effective:
- AmeriHealth Pennsylvania: October 22, 2020, through October 31, 2021.
- AmeriHealth New Jersey: October 22, 2020, through the later of either October 31, 2021, or for a period of 90 days following the end of the state of emergency and public health emergency.
Read more about the indications for use, coverage, dosage and administration recommendations, coding, and reimbursement on our Medical and Claim Payment Policy Portal:
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.