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COVID-19: News and Resources

COVID-19: ForwardHealth News and Resources

Contact Information

For specific questions about COVID-19 as it relates to ForwardHealth coverage and policy, contact Provider Services at 800-947-9627.

For specific questions about testing considerations or to discuss a case during business hours, call 608-267-9003 or email DHSDPHBCD@wi.gov.

Information about the COVID-19 virus is changing rapidly. ForwardHealth has established this page to keep providers informed about news, resources, and policy related to the virus so they can effectively care for ForwardHealth members. Providers are encouraged to check this page frequently to stay informed about this quickly evolving situation.

General resources for COVID-19 information:

Program-specific COVID-19 information:

Information About Wisconsin’s Medicaid Section 1135 Waiver

On April 16, 2020, Department of Health Services sent a letter to the federal Centers for Medicare & Medicaid Services (CMS) to request approval for flexibilities listed under Section 1135 of the Social Security Act (42 U.S.C. § 1320b-5) as related to the state’s response to the COVID-19 pandemic. Additional information on Wisconsin’s Medicaid Section 1135 waiver is forthcoming and will be posted here.

ForwardHealth Alerts for Providers

ForwardHealth Alerts are short, targeted publications designed to disseminate the latest COVID-19 information to providers quickly. They may contain news, policy, or resources deemed critical or helpful for providers. Providers will receive messaging letting them know when Alerts have been published that may impact them, and all Alerts relating to COVID-19 will be linked from this page.

The following ForwardHealth Alerts relating to COVID-19 have been published:

  • New! Alert 068: Bebtelovimab Monoclonal Antibody Therapy Transition to Commercial Distribution (9/23/22)
  • Alert 067: Coverage of Novavax COVID-19 Vaccine for Members Aged 12 Through 17 Years (8/31/22)
  • Alert 066: Coverage of Moderna COVID-19 Vaccine for Members Aged 6 Through 17 Years (8/22/22)
  • Alert 065: Coverage of Novavax COVID-19 Vaccine (7/28/22)
  • Alert 064: COVID-19 Vaccines Approved for Members Aged 6 Months to 5 Years (6/28/22)
  • Alert 063: Pfizer-BioNTech Booster Dose Approved for Members Aged 5 to 11 (5/24/22)
  • Alert 062: Coverage of Second COVID-19 Vaccine Booster Dose and Access to Therapeutics (4/28/22)
  • Alert 061: New COVID-19-Related Procedure Codes for Inpatient Hospital Claims (3/21/22)
  • Alert 060: New COVID-19 Diagnosis Codes (3/18/22)
  • Alert 059: New Procedure Codes for COVID-19 Vaccine and Vaccine Administration (3/16/22)
  • Alert 058: Coverage Reminder for At-Home, Rapid COVID-19 Tests and for COVID-19 Vaccines Administered by Pharmacies (3/1/22)
  • Alert 057: New Procedure Codes for Remdesivir COVID-19 Treatment and COVID-19 Monoclonal Antibodies (2/4/22)
  • Alert 056: Expanded Coverage for COVID-19 Vaccines (1/26/22)
  • Alert 055: ForwardHealth Will Reimburse Place of Service Code 17 on Claims for COVID-19 Vaccination (1/26/22)
  • Alert 054: Policy for Mailing Immunization Status (1/21/22)
  • Alert 053: Temporary Changes to Narcotic Treatment Services to Continue Through the Public Health Emergency (12/21/21)
  • Alert 052: Continuation of HIPAA Flexibilities Through the Public Health Emergency (12/21/21)
  • Alert 051: Temporary Policy Changes for Personal Care Providers to Continue Through the Public Health Emergency (12/21/21)
  • Alert 050: Procedure Codes for Vaccine Counseling and COVID-19 Vaccine Home Administration (12/15/21)
  • Alert 049: Emergency Rules for Vaccination of Health Care Staff (11/18/21)
  • Alert 048: Coverage for Ambulance Providers Administering COVID-19 Vaccines (11/4/21)
  • Alert 047: ForwardHealth Accepts Certain Procedure Codes From Eligible Providers Who Test Patients for COVID-19 (10/21/21)
  • Alert 046: New Procedure Codes for COVID-19 Monoclonal Antibody Infusion (9/24/21)
  • Alert 045: Administration of an Additional Dose of COVID-19 Vaccine (9/21/21)
  • Alert 044: COVID-19 and Influenza Laboratory Procedure Codes 87636, 87637, and 87428 Will Be Allowable (7/22/21)
  • Alert 043: COVID-19 Vaccination Data Submission to the Wisconsin Immunization Registry (6/4/21)
  • Alert 042: COVID-19 Monoclonal Antibody Infusions Rate Increase (6/3/21)
  • Alert 041: Pfizer Vaccine Approved for Members Aged 12 to 15 (5/17/21)
  • Alert 040: COVID-19 Vaccine and COVID-19 Vaccine Administration Coverage Under Tuberculosis-Related Medicaid and Family Planning Only Limited Benefit Plans (5/11/21)
  • Alert 039: Reimbursement Resumed for Administration of Johnson & Johnson COVID-19 Vaccine (5/4/21)
  • Alert 038: Revoked Emergency Use Authorization for Bamlanivimab When Administered Alone (4/28/21)
  • Alert 037: Reimbursement Paused for Administration of Johnson & Johnson COVID-19 Vaccine (4/16/21)
  • Alert 036: Reimbursement Rate Increase for COVID-19 Vaccine Administration (3/29/21)
  • Alert 035: New COVID-19-Related Inpatient Procedure Codes (3/19/21)
  • Alert 034: New Procedure Codes for Johnson & Johnson Single-Dose COVID-19 Vaccine Effective February 27, 2021 (3/9/21)
  • Alert 033: New COVID-19-Related Diagnosis Codes Available for Claims Submission Effective January 1, 2021 (2/23/21)
  • Alert 032: Same-Day Transportation to COVID-19 Vaccination Appointments Available for Eligible BadgerCare Plus and Wisconsin Medicaid Members (2/12/21)
  • Alert 031: SeniorCare Covers the COVID-19 Vaccine Effective December 11, 2020 (2/1/21)
  • Alert 030: COVID-19 Laboratory Procedure Codes 87426 and 87811 Allowable With Modifier QW (1/25/21)
  • Alert 029: New CPR and Respiratory Care Services Training Requirements During the COVID-19 Public Health Emergency (1/6/21)
  • Alert 028: New Procedure Codes in Response to COVID-19 (11/6/20)
  • Alert 027: Wisconsin COVID-19 Vaccine Program Enrollment Now Open (11/5/20)
  • Alert 026: ForwardHealth Increasing Coverage for Influenza Vaccination (10/28/20)
  • Alert 025: Public Health Emergency Extended Into January 2021 (10/15/20)
  • Alert 024: ForwardHealth Billing Reminders When Submitting Claims for Vaccinations (10/2/20)
  • Alert 023: ForwardHealth Will End Coverage for Some Non-Physician Phone Assessment Services (7/28/20)
  • Alert 022: Providers May Not Charge Members Additional Fees for COVID-19 Precautions (6/02/20)
  • Alert 021: Medicaid-Enrolled Provider Requirement Temporarily Waived for Prescribing, Referring, or Ordering Certain COVID-19-Related Laboratory Codes (5/27/20)
  • Alert 020: COVID-19 Laboratory Procedure Codes U0002 and 87635 Allowable With Modifier QW (5/15/20)
  • Alert 019: Opioid Treatment Programs Submitting Claims for Phone Calls Under the Five-Minute Threshold (5/15/20)
  • Alert 018: ForwardHealth Will End Expanded Presumptive Eligibility for Express Enrollment for Children (5/5/20)
  • Alert 017: Billing Clarifications for Dental Telehealth Services (Revised 5/11/20)
  • Alert 016: ForwardHealth-Accepted Procedure Codes from Eligible Providers Who Test Medicaid-Enrolled Members for COVID-19 (4/23/20)
  • Alert 015: Nurse Practitioners and Physician Assistants May Temporarily Order Home Health Services (Revised 5/11/20)
  • Revised! Alert 014: ForwardHealth Will Expand Presumptive Eligibility for Express Enrollment (Hospitals) (4/17/20) May 5, 2020: This Alert has been revised since its original publication. The information from Alert 012, which has been replaced by Alert 018, has been removed.
  • Alert 013: Enhanced Reimbursement for Therapy Provided as Part of the Birth to 3 Program Using Telehealth (Revised 5/11/20)
  • Alert 012: ForwardHealth Will Expand Presumptive Eligibility for Express Enrollment (4/10/20) May 5, 2020: This Alert has been replaced by Alert 018.
  • Alert 011: ForwardHealth Is Implementing Two New Diagnosis Codes Effective April 1, 2020 (4/6/20)
  • Alert 010: ForwardHealth Has Expanded the List of Drugs Available Through Expedited Emergency Supply (Revised 5/7/20)
  • Alert 009: Temporary Changes for Durable Medical Equipment and Disposable Medical Supplies Face-to-Face Requirements (Revised 5/11/20)
  • Alert 008: Temporary Change for Urgent Prior Authorization Requests (Revised 5/8/20)
  • Alert 007: Respiratory Care Services Training During the COVID-19 Public Health Emergency (Revised 5/8/20) January 21, 2021: This Alert has been replaced by Alert 029.
  • Alert 006: CPR Training During the COVID-19 Public Health Emergency (Revised 5/8/20) January 21, 2021: This Alert has been replaced by Alert 029.
  • Alert 005: Temporary Changes to Narcotic Treatment Services (Revised 5/7/20)
  • Alert 004: Tribal and Non-Tribal Federally Qualified Health Centers Billing Guidance for Telehealth Policy Changes in ForwardHealth Update 2020-09 (3/23/20)
  • Alert 003: Non-Emergency Medical Transportation (NEMT) Services (3/20/20)
  • Alert 002: Temporary Policy Changes for Personal Care Providers (Revised 5/11/20)
  • Alert 001: ForwardHealth Accepted Procedure Codes From Eligible Providers Who Test Patients for COVID-19 (3/18/20)

ForwardHealth Updates for Providers

ForwardHealth Updates announce changes in policy and coverage, prior authorization requirements, and claim submission requirements. Links to all published Updates relating to COVID-19 will be available on this page, as well as being listed on the ForwardHealth Updates page of the ForwardHealth Portal. Several Updates related to COVID-19 are currently in work.

The following Updates relating to COVID-19 policy have been published:

  • New! 2022-06: ForwardHealth Coverage of At-Home, Rapid COVID-19 Test Kits (02/01/22)
  • 2021-21: Transition From Temporary to Permanent Synchronous Telehealth Coverage Policy and Billing Guidelines (7/1/21)
  • 2021-18: Hospital Billing for COVID-19 Vaccine Administration (6/24/21)
  • 2021-09: COVID-19 Vaccine Policy and Coverage Clarifications (3/4/21)
  • 2021-01: COVID-19 Vaccine Billing and Reimbursement (1/7/21)
  • 2020-36: Temporary Policy for Interprofessional Consultations and Remote Physiologic Monitoring (8/28/20)
  • 2020-34: Ensuring Appropriate COVID-19 Testing (8/7/20)
  • 2020-26: Member Copay Exemption for COVID-19 Laboratory Testing, Laboratory Testing-Related Services, and All COVID-19-Related Treatment Services (6/26/20)
  • 2020-19: Temporary Expansion of Provider Enrollment for Medicaid-Only Providers (5/8/20)
  • 2020-16: Approval of Nursing Home Levels of Care During COVID-19 (Revised 5/7/20)
  • 2020-15: Additional Services to Be Provided Via Telehealth (Revised 5/8/20)
  • 2020-14: Temporary Changes to the Provider Enrollment Process (Revised 5/7/20)
  • 2020-13: Temporary Changes to Clinical Policy and Prior Authorization (Revised 5/11/20)
  • 2020-12: Temporary Changes to Telehealth Policy and Clarifications for Behavioral Health and Targeted Case Management Providers (Revised 5/8/20)
  • 2020-11: COVID-19 Information for Pharmacies (Revised 5/8/20)
  • 2020-09: Changes to ForwardHealth Telehealth Policies for Covered Services, Originating Sites, and Federally Qualified Health Centers (3/18/20)

Telehealth Resources for Providers

The Telehealth Resources for Providers page includes summaries and explanations of the recently published materials, FAQs, and resources, all pertaining to telehealth.

Additional Messages for Providers

Resources and Links for Providers

Connecting Essential Workforce Families to Child Care

The Department of Children and Families (DCF) has launched two new tools to help connect essential workforce families to local, safe child care. Healthcare workers and essential employees are now able to submit a request for care through DCF’s updated Child Care Finder or proactively view up-to-date availability across the state using DCF’s new child care map. For any questions regarding this effort, contact dcfmbcovid19@wisconsin.gov.

HMO News

The following communications for BadgerCare Plus and Medicaid SSI HMO and Special Managed Care Programs (Care4Kids, Children Come First, and Wraparound Milwaukee) have been distributed:

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