​COVID-19 (Coronavirus): Urgent Care providers cost-share waiver

December 28, 2021

​AmeriHealth will cover member cost-share for members who receive COVID-19 tests through urgent care providers.

Urgent care providers who have a Clinical Laboratory Improvement Amendments (CLIA) Certificate​ of Waiver and processed the COVID-19 lab test code onsite should bill with their contracted urgent care code (S9083) and the lab test code on the claim. Only the urgent care code will be reimbursed according to the terms of your contract. The COVID-19 lab test code on the claim is needed for member cost-share to be adjusted. 

AmeriHealth will recognize the following lab test codes:

  • ​​​U0002
  • 0241U
  • 86413
  • 87635
  • 0224U
  • 86328
  • 86769
  • 87636
  • 0226U
  • 86408
  • 87426
  • 87637
  • 0240U
  • 86409
  • 87428

Urgent care providers who do not have a CLIA Certificate of Waiver or have sent the COVID swab to another lab for processing, should bill with their contracted urgent care code (S9083) and a COVID-19 swab code on the claim. Only the urgent care code will be reimbursed according to the terms of your contract. The COVID-19 swab code on the claim is needed for member cost-share to be adjusted. Swab codes G2023 and G2024 are recognized by AmeriHealth.

If needed, please submit a corrected claim with the urgent care visit code and the lab test code or swab code for us to adjust cost-share on the urgent care visit.  

AmeriHealth Administrators

Urgent care providers should bill with their contracted urgent care code (S9083) and a CS Modifier. The urgent care code will be reimbursed according to the terms of your contract. The CS Modifier is needed for member cost-share to be adjusted. If needed, please submit a correct claim with the urgent care code and a CS Modifier.

Learn more

Read more about coverage of services related to COVID-19 in the News Articles posted 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.​​