Effective May 18, 2020, AmeriHealth will no longer reimburse dermatology providers for performing certain pathology procedures in the office setting. This applies to providers in our service area (i.e., participating counties in New Jersey, Pennsylvania, Delaware, and Maryland).

Policy update

CPT^®​ procedure codes have been updated to reflect the changes in the PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services policy.

The affected CPT procedure codes are:

A Notification was posted to the AmeriHealth Medical Policy Portal on February 14, 2020, to address the changes in policy #00.01.25aw: PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services.

Learn more

To view the Notification for this policy, visit our Medical Policy Portal. If you have questions about the program or how to access the reports, please email us at pnsproviderrequests@amerihealth.com.

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