17 de diciembre de 2020
The Specialty Medication Administration Site of Care Policy, effective March 15, 2020, will be updated to add these HCPCS codes: J0791, Q5121, J0584, J3060, J0223, J0638, J3245, J3397, J0222, J3241, J1746, J1303, J3032 and J1558.
An updated RX501.096 Medical Policy will be posted prior to Jan. 1, 2021 to assist providers in determining when to apply benefit preauthorization requirements for these codes. The Specialty Pharmacy Infusion Site of Care Benefit Preauthorization Drug List can be found on the Prior Authorization page of the sitio web para prestadores de servicios médicos de BCBSNM.
As always, it is critical to check eligibility and benefits first, prior to rendering care and services, to confirm coverage, network status and other important details.
Please note that verification of eligibility and benefits, and/or the fact that a service or treatment has been preauthorized/pre-notified for benefits is not a guarantee of payment. Los beneficios se determinarán una vez que se reciba el reclamo y se basarán, entre otras cosas, en la elegibilidad del asegurado y los términos del certificado de asegurado de la cobertura aplicable en la fecha en la que se prestaron los servicios. Regardless of benefits, the final decision about any medication is between the member and their health care provider. Si tiene preguntas, comuníquese con el número que figura en la tarjeta de asegurado.