Date: October 14, 2021
To: Enrolled Physicians, Physician Assistants, Advance Practice Nurses, Local Health Departments, Federally Qualified Health Centers, Rural Health Centers, Encounter Rate Clinics, Hospitals, and Independent Laboratories
Re: HFS COVID Portal for the Uninsured Update: Requirements for Claim Submissions and RIN Requests
This notice provides updated information to that communicated in the July 17, 2020, September 25, 2020, and February 8, 2021 provider notices regarding the Department's deployment of the HFS COVID Portal, an online portal for reimbursement of COVID-19 testing services for uninsured individuals who have been tested for COVID-19, regardless of income, citizenship, or immigration status.
The Department urges providers to pursue payment of COVID testing services for uninsured individuals through the HFS COVID Portal. Before uploading patient information to the portal, providers should first check MEDI for active Medicaid coverage. Active Medicaid coverage includes a Recipient Identification Number (RIN) generated from a previous submission to the HFS COVID Portal. MEDI will display "COVID 19 TESTING COVERAGE" for the RINs created through the portal for the uninsured that have coverage limited to COVID testing and testing related services. The HFS COVID Portal also provides a downloadable return file that includes RINs assigned to the uninsured individuals uploaded through the portal. Please use the RIN already assigned to an individual for billing subsequent testing and testing related services.
COVID-19 tests for customers who already have a RIN for limited COVID-19 testing coverage may be billed through the provider's normal claims processing method. Testing and testing-related covered procedure codes are identified in the COVID-19 Fee Schedule.
Providers are encouraged to submit comprehensive data, including a Social Security Number (SSN), for all patients uploaded to the HFS COVID Portal. Please reference the detailed file requirements attached to the February 8, 2021 provider notice for additional information.
Providers can continue to use the federal Health Resources and Services Administration (HRSA) COVID-19 Uninsured Program to request reimbursement for the following services, regardless of income, citizenship, or immigration status:
- COVID-19 testing and testing-related services for dates of service between February 4 and March 17, 2020
- Treatment services for dates of service after March 17, 2020, as treatment is not covered under the HFS COVID-19 Testing Program
- COVID-19 vaccine administration, as this service is not covered under the HFS COVID-19 Testing Program
Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565.
Kelly Cunningham, Administrator
Division of Medical Programs