You are using an outdated browser. Please upgrade your browser to improve your experience.

You are using an outdated browser.

To ensure optimal security, this website will soon be unavailable on this browser. Please upgrade your browser to allow continued use of ACP websites.

You are here

COVID-19 State and Private Payer Policies

Last updated 5/22/2020

Many payers, both public and private, have adjusted many rules related to payment, prior authorization, cost sharing, and enrollment. This CMS Summary provides information about all the flexibilities during the COVID-19 public health emergency.  

CDC is encouraging communities, including 1st responders, healthcare “providers,” and health systems to offer telehealth. The federal government is requesting private payers to cover telehealth for COVID-19 as a way to minimize the spread of the virus in the community and clinical settings.  Please note that changes in payer policies are changing from day to day, so be sure and check the policies of your practice’s most common payers.

Revised! Provide input to help inform ACP's advocacy and practice management support during COVID-19. Even if you have taken the survey before, feel free to respond again so we can see if there are trends!

Take the survey

State-by-state Policy Changes Due to COVID-19 Public Health Emergency

Many states have issued their own public health emergencies, resulting in changes to Medicaid, private payer, and licensure for telehealth.  

  • This COVID-19 resource from the Center for Connected Health Policy (CCHP) provides an up to date summary of telehealth rules, including state licensure and private payer policies regarding telehealth coverage.
  • The Alliance for Connected Care also has created an easy to read chart showing state changes to licensure, coverage, and other changes.

In addition to those payers listed in the above CCHP resource, we provide links to supplemental information as we become aware of them:

  • Summary of Medicare and Medicaid Policy Announcements Related to COVID-19: This document summarizes the various flexibilities, telehealth, waivers, and other changes resulting from the COVID-19 public health emergency. Dated 4/10/2020.
    • CMS has issued revised guidance regarding additional flexibilities specific to FQHCs and RHCs (revised April 30).
    • Physician assistants, nurse practitioners, and clinical nurse specialists can now certify the need for home health services and order services. These changes are permanent, and retroactive to March 1, 2020.
  • Private Payers: See this chart summarizing recent policy announcements by some of the major insurance companies regarding testing, cost sharing, prescriptions, and provider enrollment. (Revised 5/22/2020.)
    • America’s Health Insurance Plans (AHIP) has put together a list of COVID-19 related announcements from individual health plans.  
  • California – The state of California has directed all health plans to reimburse providers at the same rate, whether a service is provided in-person or through telehealth, including video and telephone, and with the same level of cost-sharing as if provided in-person. They have also created a special enrollment period for Californians who wish to enroll in the California Health Benefits Exchange, Covered California.