COVID-19 vaccine administration and certain monoclonal antibody treatments: cost-sharing, coding, and billing
April 5, 2021- Download our latest update that includes information on the Janssen COVID-19 vaccine, as well as coding and billing for monoclonal antibody treatments.
Extension of copayment, coinsurance, and deductible waivers for COVID-19 treatment through February 28, 2021
February 2, 2021 - Blue Shield of California will continue waiving copayments, coinsurance, and deductible requirements for COVID-19 treatment for members who are covered under fully insured commercial HMO and PPO plans, Medicare Advantage and Medicare Supplement plans through February 28, 2021. These cost-sharing waivers also apply to members enrolled in self-funded or flex-funded plans administered by Blue Shield if the plan sponsor has elected to participate in the waiver. Cost-sharing for medical services is not applicable to Medi-Cal and Cal MediConnect plans.
Blue Shield of California assuming financial responsibility for COVID-19 vaccine administration cost for HMO commercial plan members
February 2, 2021 – In order to support the efforts of our network HMO IPA/medical groups and reduce administrative burden, Blue Shield has made a business decision to assume financial responsibility for COVID-19 vaccine administration cost, effective for dates of service on and after December 11, 2020. This business decision applies to members with commercial HMO plan coverage and separates this cost from administration of other types of vaccines. HMO IPA/medical groups will continue to be financially responsible for administration and drug costs for other vaccines in accordance with their provider agreement with Blue Shield.
Review information (PDF, 51 KB)
Los Angeles County providers and facilities: Sign up to get on list for receiving next phases of COVID-19 vaccine
January 6, 2021 - Providers and facilities in Los Angeles County are encouraged to visit the Los Angeles County’s Public Health website to get information on the next phases of the COVID-19 vaccine, make vaccination appointments for staff, sign up to get the vaccine for patients and add their names to a list to receive distribution updates.
Visit the LA County Public Health website.
Relaxation of prior authorizations, transfer requirements and DME coordination for hospitals
January 4, 2021 - Blue Shield of California and Blue Shield of California Promise Health Plan are committed to reducing administrative burden for hospitals and other facilities during the COVID-19 pandemic. The updated requirements include changes implemented on December 17, 2020 that will continue through March 31, 2021.
Review updated requirements (PDF, 50 KB)
Latest cost-sharing, coding, and billing guidelines for COVID-19 specimen collection and testing: HMO and PPO commercial plan members
October 13, 2020 – Blue Shield of California wants to give you the information you need for submitting COVID-19 testing claims that will help us process them accurately and efficiently.
See the latest recommendations concerning specimen collection and various types of testing for fully insured commercial HMO and PPO plan members and self-funded plan members. Get helpful details about claims for testing essential workers as they are defined by the Department of Managed Health Care (DMHC), in our Cost-sharing, coding, and billing section of this website.
Review coding and billing recommendations (PDF, 123KB)