COVID-19 provider information

There are local and national lines available for physicians looking for emotional support during this time.

1. OPAL-C emotional support for providers: The Oregon Psychiatric Access Line (OPAL) is now opening OPAL-C (COVID-19), providing emotional support to prescribing providers in the state.
   • 503-346-1000, 9 a.m. to 5 p.m. Monday through Friday
2. Physician Support Line: Free, confidential, national support line run by volunteer psychiatrists.
   • 888-409-0141, 5 a.m. to 9 p.m. every day
   • physiciansupportline.com

 

For guidance on test ordering, specimen collection and processing please consult your contracted lab, hospital or the OHA for the state lab. Medicare and the AMA have released the following codes for use when testing of COVID-19:

COVID-19 diagnostic testing

• Medicare:
  • U0001: SARS-CoV-2 diagnostic tests performed specifically at CDC testing laboratories.
  • U0002: SARS-CoV-2/2019-nCoV diagnostic tests performed at non-CDC testing laboratories, otherwise known as the novel coronavirus or COVID-19.
  • U0003: Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique, making use of high throughput technologies.
  • U0004: 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC, making use of high throughput technologies.
• AMA:
  • 87635: Severe acute respiratory syndrome coronavirus 2 (SARS-2-CoV-2) (coronavirus disease [COVID-19]).

COVID-19 antibody testing

• 86328: Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single step method (e.g., reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]).
• 86769: Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]).
• 87426: Infectious agent antigen detection by immunoassay technique (e.g., enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (e.g., SARS-CoV, SARS-CoV-2 [COVID-19]).
• 0223U: Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qualitative RT-PCR, nasopharyngeal swab, each pathogen reported as detected or not detected.
• 0224U: Antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), includes titer(s), when performed.

During the COVID-19 emergency, CareOregon will follow Oregon Health Plan (OHP) coverage guidance for COVID-19 antibody testing. COVID-19 antibody testing (also known as serology testing) to diagnose SARS-CoV-2 coverage criteria:

• Uses tests that have FDA Emergency Use Authorization (EUA) or FDA approval and
• Is to evaluate a hospitalized person under age 21 for possible multisystem inflammatory syndrome in children (MIS-C).

 

Current codes and guidance for telephone and/or video appointments

• Telemedicine technical assistance guide
• Behavioral health technical assistance guide
• Telehealth FAQ for providers
• Primary care providers: Codes for telehealth and other communication-based services in response to COVID-19
• Behavioral health providers: Codes for services via telephone in response to COVID-19
• Dental providers (CareOregon dental providers and members ONLY): Teledentistry Codes for COVID-19
• Expanded teledentistry guidance, including preventive services

Additional telehealth reference material

• OHA COVID-19 for Oregon Health Plan partners (benefit information)
  • Provider Guide
  • April 17 webinar
  • April 17 webinar Q&A
  • Expansion of fee-for-service telemedicine coverage, including telephone services during an epidemic of an infectious disease
  • DCBS-OHA telehealth guidance
  • OHA expanded telehealth for behavioral health
• Medicare telemedicine health care provider fact sheet (3/17)
• HHS: Notification of enforcement discretion for telehealth remote communications during the COVID-19 nationwide public health emergency
• COVID-19 public health emergency response and 42 CFR part 2 guidance
• Payment parity implementation for two-way audio-video visits

• Behavioral health access report
• Mental health considerations for older adults and individuals receiving care in facility-based settings during the COVID-19 pandemic
• COVID-19 prioritization guidelines for behavioral health populations
• Substance Abuse and Mental Health Services (SAMHSA): Coronavirus resources
• SAMHSA: Medication-assisted treatment guidance
• Practitioners Clinical Support System: Telemedicine guidance on Buprenorphine
• American Society of Addiction Medicine: Alcohol withdrawal management
• HHS: Emergency situation preparedness, planning and response
• Oregon SUD Resources Collaborative
• Oregon Recovery Network: Recovery support resources
• American Academy of Family Physicians: Virtual visit algorithm
• U.S. Department of Justice Diversion Control Division: COVID-19 information
• Synergy: Pain Flares: A peer’s perspective
• Synergy: Flare-ups during COVID-19
• COVID-19 and chronic pain management
• Resource digest - June 19, 2020
• Resource digest - June 26, 2020
• Resource digest - July 10, 2020

• Early refills and up to a 90-day supply of medications is allowed
• Prior authorization for new requests is turned back on
• For more details: CareOregon pharmacy benefits (Medicaid)
• For more details: CareOregon pharmacy benefits (Medicare)
• CareOregon Clozapine Advisory
• CareOregon Long-Acting Medication Advisory
• Pharmacy Resource List

• OHA COVID 19 updates
• CDC COVID 19 guidance
• AAFP: Prepare for corona (COVID-19)
• OHA Strategies to limit spread and increase capacity
• OHA guidance for health systems regarding COVID-19 testing
• OHA infection control guidance for in-person interpreters and providers
• Oregon Medical Board topic of interest COVID-19
• COVID-19 guidance: Non-emergent medical transportation (NEMT)
• CareOregon Dental COVID-19 guidelines for providers
• UCSF School of Medicine: Contraception during COVID-19: Best practices and resources
• Better Care Playbook: Addressing complex care needs amid COVID-19
• Federal Communications Commission: COVID-19 telehealth program
• Drive-thru primary care: Tips and considerations
• COVID-19 communication for members who are deaf or hard of hearing
• COVID-19 communication for members who cannot speak
• Visual communication tools for members with disabilities
• Note: Providers serving Medicaid members may not charge members for personal protective equipment (PPE) used during their visits. Medicaid regulations require that providers accept Medicaid payment as payment in full, meaning providers are not allowed to bill Medicaid members for any extra PPE that may be required to perform medical or dental services. Clinics are responsible for providing PPE for all members of the care team, including interpreters.

• If a member has symptoms of COVID-19, CareOregon is recommending they call their primary care provider. You can best advise members on the next steps, including how to get tested.
  
  
• We are encouraging members to stay at home and practice social distancing whenever possible. We are reinforcing that this is the most effective way to help prevent the spread of COVID-19.
  
  
• You should notify members about canceling or postponing any non-urgent appointments to protect your staff. We are reminding members that the Oregon Health Authority and the Governor’s office are asking people to avoid going to providers’ offices, urgent care facilities or hospital emergency rooms, in order to keep the staff members at those facilities safe.
  
  

• We are urging clients receiving mental health and substance use treatment services to contact their providers directly to learn how to access services. Many providers are shifting to offering services by phone, though some in-person visits are still available. Please see the telehealth and phone-based services guidelines for behavioral health included above.
  
  
• Most, if not all, elective procedures are being postponed until COVID-19 precautions are over. To reduce the administrative burden on providers and reassure members, authorizations for elective procedures are being extended until January 1, 2021.
  
  
• Members still have access to CareOregon’s provider network. None of their benefits have changed, and CareOregon is still committed to helping members meet their physical, dental, mental health and addiction-related care needs.
  
  
• You may be able to set up a telephone or online video call with your patients. We know our provider network is working to use these methods when appropriate and possible. We’ve encouraged members to call their provider to ask if these options are available. See above for an update on telehealth codes.
  
  
• If members need medication, they can still get it. If members get their prescription refilled, we will extend their prescription to 90 days’ worth of medication. They can refill their prescriptions early. They also have the option to receive prescriptions from a mail-order pharmacy. If a member has an approved pre-authorization that expires before the end of the year, we are automatically extending the expiration date by six months.
  
  
• Members and providers still have access to interpretation services. CareOregon’s approved interpretation vendors are Passport to Languages and Linguava. To arrange for an interpreter to be present during an appointment — whether by phone or in-person — complete the CareOregon Interpreter request form found on our Provider Policies and Forms webpage. You can also access our vendors’ online systems to request and confirm an interpreter:
  • Passport to Languages:passporttolanguages.com
  • Linguava:portal.linguava.com/Account/Login
    
• Some rides to appointments are still available for members. Due to COVID-19, ride availability may be limited. Members should call Ride to Care at 855-321-4899 to ask about service availability.

We’ve provided answers to other common questions below. This page will continue to be updated with more information as it becomes available. 

A: The coronavirus, also known as COVID-19, is a respiratory illness that began spreading in people in December 2019. For more information, visit the Oregon Health Authority website.

A: Symptoms of the coronavirus include fever, cough and shortness of breath. Symptoms can appear in as few as two or as many as 14 days after a person is exposed to the virus.

A: CareOregon recommends that members call their primary care provider and ask them the safest way to receive care. The CDC recommends staying home and avoiding close contact with other people until they’ve had no symptoms for 24 hours. Experts think people are most contagious when symptoms are worse.

CareOregon also recommends that members tell their provider if they have traveled to an affected area within the last 14 days (CDC COVID-19 page with map of affected areas).

A: The current risk for most people is low. While there are some cases in the U.S., health officials are working to identify and evaluate suspected cases. The CDC says, “At this time most people in the United States have little immediate risk of exposure to the virus that causes COVID-19.”

A: According to the CDC, steps one would normally take to prevent the flu and the common cold can also help prevent the spread of the coronavirus:

• If someone is sick, avoid contact with them. The coronavirus can spread between people about six feet from each other.
• Cover coughs and sneezes with a tissue. Throw used tissues in the trash.
• Clean items in the home that are touched often. Use wipes or sprays to disinfect.
• Wash hands with soap and water often, for at least 20 seconds. Wash:
  • After going to the bathroom.
  • After coughing or sneezing.
  • Before eating.
  • Before touching the eyes, nose or mouth.
• Use hand sanitizer with at least 60% alcohol if soap isn’t available.

A: The CDC now recommends that people wear face coverings in settings where social distancing is difficult to maintain, like in grocery stores or pharmacies. Anyone who shows symptoms of coronavirus or is in close contact with people who have symptoms should wear a facemask. The CDC has guidelines for homemade coverings. CareOregon recommends that if a member needs a professional-grade mask because they’re sick, or are caring for someone who is sick, they should talk to their primary care provider. CareOregon only provides masks to staff who fit criteria for having a clinical need for respiratory protection, and who have completed medical screening and fit testing. 

A: If members want to refill their prescriptions, their prescriptions will be extended to 90 days’ worth of medication. Members can also refill their prescription early. If a member has other questions or concerns about the medications they take, we recommend they contact their prescribing provider or their pharmacist. Providers and pharmacists can help guide members on best next steps.

CareOregon is in close contact with the Oregon Health Authority and is following CDC guidelines. Members can visit the CareOregon website at careoregon.org/covid-19 for the latest information.

A: According to the CDC, there is no specific treatment for the coronavirus. We recommend members contact their primary care provider if they have symptoms and believe they need care. We are reinforcing that their primary care provider is the first person they should call.

A: The Center for Disease Control and Prevention (CDC) is monitoring the situation closely. Members can learn more at cdc.gov/coronavirus/2019-ncov. They can also call 211 or visit the 211 website at 211info.org/corona-virus for more general information.

OHA has posted some helpful fact sheets that can be found here:

• COVID-19 fact sheet
• Prevention fact sheet

A: Sourcing these items is difficult for everyone, including CareOregon. We do not stock supplies or maintain a surplus. While we understand the need we do not have the resources to assist with additional supply needs. See OHA’s March 9 statement for more information.

A: If there is a CareOregon staff member embedded in a clinic, we are telling them to follow their respective clinic’s guidance regarding COVID-19. If they have any additional concerns, we’ve asked them to reach out to their CareOregon supervisor.

If you have a question specifically about CareOregon staff in your clinic, please ask for their supervisors contact information.

A: This is an evolving situation that we are monitoring closely. CareOregon is aligning with current CDC, OHA and Multnomah County guidance and we are continuing to monitor and share information.

A: CareOregon supports and encourages in person interpretation, and we want to make sure that interpretation needs continue being met. Clinics can schedule a telephonic interpreter through Linguava, Passport to Languages or by calling CareOregon Provider Customer Service.

What should clinic staff do if they suspect someone in their care has the coronavirus? 

Please reach out to the CDC, OHA or Multnomah County. They can help you with any suspected cases and suggest the appropriate next steps. 

Resources for health care staff: 

• CDC: cdc.gov/coronavirus/2019-ncov/hcp/caring-for-patients.html
• OHA: oregon.gov/oha/PH/DISEASESCONDITIONS/DISEASESAZ/Pages/emerging-respiratory-infections.aspx
• Multnomah County: multco.us/novel-coronavirus-covid-19

Who should we call if we have questions? 

If providers or clinic staff have other questions about COVID-19, they should reach out to OHA directly.