Posted in MVP (NY/VT) Insurance Payer, Training, Updates

MVP (NY) COVID-19 Vaccine Proper Billing and Coding guidance

The following medical billing and coding Guidance, for COVID-19 vaccines, ONLY applies to New York Providers.

As per MVP: ALL COVID-19 vaccines are covered for all PLANS without a member cost-share.

In order to get reimbursement, providers need to follow the proper COVID-19 vaccine billing and coding guidance.


For MVP Medicare Patients:

Providers please bill Medicare Fee-for-Service (FFS) directly for the vaccine and administration of the
vaccine to MVP Members enrolled in Medicare Advantage in 2020 and 2021. If Providers will bill the COVID-19 claims to MVP, they will be denied.

For MVP Commercial and Managed Medicaid Patients:

Since COVID-19 vaccines are provided by the government at no charge, Providers should not bill the Vaccine codes (please see below Picture 2). Instead providers should only bill the administration codes (see below Picture 1).


(Picture 1)
(Picture 2)

MVP will reimburse both In Network and Out of Network providers.


Posted in Insurance, Training, Updates

MVP Plans (NY) High Tech Radiology Policy Changes -2021

As of January 1, 2021 the following MVP Plans will no longer require prior authorization for High Tech Radiology Services:

MVP Medicare Advantage Plans

MVP Medicaid Managed Care

MVP Harmonious Health Plan (HARP)

MVP Child Health Plus (CHP)

These services include: MRI/MRA, PET Scan, Nuclear Cardiology, CT/CTA, and 3D Rendering Imaging Services

This applies only to the services rendered by IN Network Providers. For any of the above mentioned plans that do have Out of Network benefits and would like to go to an out of network provider: the Prior Authorization is Required!

To request an authorization: please complete a Prior Approval Request Form (PARF) and fax it to MVP at 1-800-280- 7346.

ALL other MVP plans still require a prior authorization for HIGH Radiology Services. To request an Auth please contact eviCore Healthcare by submitting requests at evicore.com or by calling 1-800-568-0458.

#MRI, #MRA, #PET, #MVPCHP, #MVPHARP