This article was revised on October 29, 2021, to update the effective date range and simplify the format. To learn about treatment for COVID-19, please read this article. To learn about billing and coding for COVID-19 testing, please read this article.

Member coverage for COVID-19 testing

AmeriHealth New Jersey will cover COVID-19 testing as follows:

• Diagnostic tests: Covered without member cost-sharing* (i.e., copayment, deductible, and coinsurance) when performed at any site, including a physician's office, urgent care center, hospital or hospital emergency room, pharmacy, or during a home health visit or drive-through testing center visit.
• Antibody tests: Covered without member cost-sharing* when performed at a physician's office, urgent care center, hospital or hospital emergency room, pharmacy, or during a home health visit or drive-through testing center visit, when ordered or authorized by a licensed or qualified health care professional.
  

Coverage for AmeriHealth New Jersey members for both in and out-of-network testing and diagnosis of COVID-19 is effective March 6, 2020, through a period of 90 days following the end of the state of emergency.

AmeriHealth Pennsylvania will cover COVID-19 diagnostic tests and antibody tests with no member cost-sharing when directed by the member's health care provider. Testing coverage for AmeriHealth Pennsylvania members is effective March 6, 2020, through the duration of the public health emergency.

*The waiver of cost-sharing for both in and out-of-network testing and diagnosis of COVID-19 will continue until 90 days after the end of the state of emergency.

Fees related to furnishing or administration of COVID-19 testing

There is no cost sharing whether in network or out of network for fees related to the administration of the test for COVID-19.

Facility fees must be covered without cost sharing whether in network or out of network to the extent the fees relate to the furnishing or administration of the test or evaluating for the need for the test.

Coverage criteria and requirements

Read the policy News Article, Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for AmeriHealth New Jersey Members or Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) For AmeriHealth Pennsylvania Members, for more detailed information on coverage criteria and other requirements.

• Specimen collection administered by health care professionals and processed at an approved lab
• Diagnostic RT-PCR and antigen tests and antibody tests
• Differential diagnosis
• Specimen collection by an authorized worker from a home health agency
• Specimen collection by members
• Home test kits
• At-home self-sample collection
• Routine testing
• In advance of procedures
• Testing of nursing home residents and patients
• Public health surveillance and screening

Working with LabCorp

Laboratory Corporation of America^® Holdings (LabCorp), the national outpatient laboratory provider for AmeriHealth, is equipped to perform diagnostic and antibody testing for COVID-19 for all AmeriHealth members, even those who are not capitated to LabCorp.

AmeriHealth New Jersey members can visit any testing site for COVID-19 diagnostic testing and the specimen can be processed at any qualified lab. 

Testing

• The LabCorp diagnostic RT-PCR and antibody (IgG) tests are available to all offices – hospitals, urgent care centers, and physician offices. Please follow the Centers for Disease Control and Prevention guidelines for ordering the test. When ordering tests through LabCorp, use code 139900 for diagnostic tests and code 164055 for antibody tests.
• LabCorp will not obtain COVID-19 specimens at their patient service centers (PSC). Any person trying to get a COVID-19 test at a LabCorp PSC will be referred to their physician.
• LabCorp will collect antibody blood tests at their PSCs. Any person trying to get an antibody test must first place an order through a physician.
  

Note: The antibody test is only available for persons ages 18 or older.
​
For more information on sending test specimens and/or receiving testing supplies visit LabCorp's website

Resources

• LabCorp's website
  
• Diagnostic testing guide
• Antibody testing guide
• Collection grid
• Supply Order form
  
• Guidance for providers seeking to obtain UVT and media swabs

Note: The Supply Order form can be faxed or emailed. Both swabs and Universal Transport Media (UTM) can be ordered using this form. The UTM is on the form and the swab can be written in as the Nasopharyngeal or Oropharyngeal Swab.

A LabCorp account is needed to order tests. If you need to set up an account with LabCorp, visit NENewaccounts@labcorp.com or call 1-888-295-5915.​

Learn more

Please review the AmeriHealth New Jersey or AmeriHealth Pennsylvania policy News Article, Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)), for more detailed information.