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Important information for AmeriHealth Pennsylvania professional providers

May 2, 2017

Effective for dates of service on or after August 1, 2017, AmeriHealth HMO, Inc. and its affiliates (AmeriHealth) will be making the following changes:

  • updating the standard medical and drug fee schedules for AmeriHealth Pennsylvania professional providers;
  • amending the AmeriHealth Pennsylvania Professional Provider Agreement to conform with contract language changes to our standard form Professional Provider Agreement.

To the extent that you are affected by these changes, AmeriHealth mailed a postcard on May 1, 2017.

Resources

We have published resources related to the changes listed above on the NaviNet® web portal, including:

  • a sampling of rates from the standard medical fee schedule based on the CPT® codes most frequently billed by specialty;
  • drug fee schedule (note that the drug fee schedule will be updated again in July to reflect the most current drug pricing);
  • amendment to your AmeriHealth Pennsylvania Professional Provider Agreement, as applicable.

To access these documents, go to AmeriHealth NaviNet Plan Central and select Fee Schedules on the right-hand side under Provider Tools.

If you have any questions after reviewing the above documents, please email us. Be sure to include your name, contact number, and provider ID number.

Note:This information does not apply to providers contracted with Magellan Healthcare, Inc.


NaviNet is a registered trademark of NaviNet, Inc.

CPT copyright 2016 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

Magellan Healthcare, Inc. manages mental health and substance abuse benefits for most AmeriHealth members.


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