ModifiedNew Hampshire Department of Health and Human ServicesPolicy N/A

Coverage of COVID-19 At-Home Antigen Tests

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This provider bulletin governs New Hampshire Medicaid coverage of over-the-counter COVID-19 at-home antigen tests obtained through Medicaid-enrolled pharmacies. It applies to Fee-for-Service beneficiaries, managed care members, beneficiaries also covered by Medicare, and members of the limited Medicaid COVID-19 Group.

Policy Summary

PayerNew Hampshire Department of Health and Human Services

PolicyCoverage of COVID-19 At-Home Antigen Tests

Policy CodePolicy N/A

Change TypeAdded pharmacy benefit

Effective Date01/21/2022

Next Review DateN/A

Key ActionMedicaid-enrolled pharmacies should bill COVID-19 at-home antigen testing supplies to Medicaid beginning January 21, 2022.

SourceLink

POLICY UPDATE CHANGES

New Hampshire Medicaid added a pharmacy benefit covering over-the-counter COVID-19 at-home antigen tests for eligible beneficiaries.

8Maximum tests per beneficiary per month

$0Beneficiary out-of-pocket cost

01/21/2022Pharmacy billing start date

All beneficiaries

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ModifiedNew Hampshire Department of Health and Human ServicesPolicy N/A

Coverage of COVID-19 At-Home Antigen Tests

Customize your policy alerts

Sign up for all New Hampshire Department of Health and Human Services policy alerts

Know when New Hampshire Department of Health and Human Services releases new policies or updates existing guidance.

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Policy Summary

PayerNew Hampshire Department of Health and Human Services

PolicyCoverage of COVID-19 At-Home Antigen Tests

Policy CodePolicy N/A

Change TypeAdded pharmacy benefit

Effective Date01/21/2022

Next Review DateN/A

Key ActionMedicaid-enrolled pharmacies should bill COVID-19 at-home antigen testing supplies to Medicaid beginning January 21, 2022.

SourceLink

POLICY UPDATE CHANGES

New Hampshire Medicaid added a pharmacy benefit covering over-the-counter COVID-19 at-home antigen tests for eligible beneficiaries.

8Maximum tests per beneficiary per month

$0Beneficiary out-of-pocket cost

01/21/2022Pharmacy billing start date

All beneficiaries

At-Home Antigen Test Coverage

At-Home Antigen Test Coverage Criteria

Covered at-home antigen tests must meet all of the following criteria:

ALL of the following

The item is an over-the-counter COVID-19 at-home antigen test.
The test is obtained through a Medicaid-enrolled pharmacy.
The beneficiary obtains the test at the pharmacy counter.
The beneficiary does not exceed eight individual COVID-19 tests per month.

Quantity Limit

Monthly Quantity Limit

Monthly limitUp to eight individual COVID-19 tests per beneficiary per month

Beneficiary costNo out-of-pocket cost for covered at-home antigen tests

Covered itemOver-the-counter at-home antigen tests

Pharmacy Dispensing and Billing

Note

Dispensing Location Requirement

The patient must visit the pharmacy counter to obtain coverage for at-home antigen test kits. There is no out-of-pocket cost when eligible beneficiaries pick up the tests.

Billing Rule

Pharmacy Billing

Pharmacies should bill COVID-19 at-home antigen testing supplies to New Hampshire Medicaid for eligible beneficiaries.

Billing begins: January 21, 2022
Coverage applies when tests are obtained through a Medicaid-enrolled pharmacy.

Policy Summary

PayerNew Hampshire Department of Health and Human Services

PolicyCoverage of COVID-19 At-Home Antigen Tests

Policy CodePolicy N/A

Change TypeAdded pharmacy benefit

Effective Date01/21/2022

Next Review DateN/A

Key ActionMedicaid-enrolled pharmacies should bill COVID-19 at-home antigen testing supplies to Medicaid beginning January 21, 2022.

SourceLink

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