Provider Resources: COVID-19

Information about the Coronavirus disease 2019 (COVID-19) is constantly changing. Driscoll Health Plan is here to assist our providers with up to date tools and information so they may continue to provide our members with quality care.

Please review all available provider guidance, actions and resources listed below.



For questions, contact DHP Provider Services: 

Hidalgo Service Area: 1-855-425-3247

Nueces Service Area: 1-877-324-3627

Preauthorization and Referrals (CHIP/STAR/STAR Kids)
Utilization Management Department
Ph: 1-877-455-1053
Fax: 1-866-741-5650

Prior authorization for PDN, PCS, and LTSS services
Ph: 1-844-376-5437
Fax: 1-844-381-5437

Providers should check the DSHS website and social media accounts for the most current information, as information is subject to change.

How to enroll to be a COVID-19 vaccinator:

  • Any facility, organization, or healthcare provider licensed to process or administer vaccines or provide vaccination services is eligible to enroll.
  • Providers must register through this website to administer and receive COVID-19 vaccines in Texas: The following steps must also be finalized:
  1. Complete Module 10 of the CDC’s “You Call the Shots” Training. (Highly recommended.)
  2. Evaluate patient population. Identify critical population groups of people that are served by your practice.
  3. Complete the COVID-19 Provider Agreement form.
  4. Agree to maintain vaccine safety and inventory.
  5. Agree to report COVID-19 doses administered in the required time frame.
  • For questions about registration call the DSHS COVID-19 Vaccine Provider hotline at (877) 835-7750, Monday-Friday, 8am – 5pm or email

COVID-19 vaccines are being distributed as they become available.

  • The Texas Commissioner of Health appointed an Expert Vaccine Allocation Panel to make recommendations on vaccine allocation decisions.
  • This panel uses best available scientific evidence and epidemiology at the time, while allowing for flexibility due to local conditions, to identify and prioritize groups with the goal of providing protection to vulnerable populations and critical state resources.
  • Other groups will receive vaccines in coming months as more vaccines are made available.

DSHS currently directs all vaccines received by COVID-19 vaccine providers to be immediately administered to phase 1A and 1B individuals. This includes:

  • Healthcare staff.
  • Texans 65 years of age and older.
  • People 16 years of age and older with at least one chronic medical condition that puts them at increased risk for severe illness from the virus that causes COVID-19, such as but not limited to:
    • Cancer
    • Chronic kidney disease
    • COPD (chronic obstructive pulmonary disease)
    • Heart conditions, such as heart failure, coronary artery disease or cardiomyopathies
    • Solid organ transplantation
    • Obesity and severe obesity (body mass index of 30 kg/m2 or higher)
    • Pregnancy
    • Sickle cell disease
    • Type 2 diabetes mellitus

Safety remains a top priority.

  • COVID-19 vaccines have been evaluated in tens of thousands of volunteers during clinical trials and are only authorized for use if they are found to be safe.
  • Even though no safety issues were found, the CDC and other federal partners will continue to monitor the COVID-19 vaccines.
  • Providers can play an important role in helping the CDC and federal partners monitor the safety of COVID-19 vaccines.
  • The US vaccine safety system is already strong and robust and includes required reporting to the Vaccine Adverse Event Reporting System (VAERS).
  • New safety systems have been added for COVID-19 vaccines, including the following new CDC initiatives:

Providers should continue to remind patients that getting “back to normal” will take all our tools.

  • Get vaccinated when you become eligible.
  • Wear a mask.
  • Stay 6 feet away from others and avoid crowds.
  • Wash your hands often.
  • Be alert for patients who meet the criteria for persons under investigation and know how to coordinate laboratory testing.
  • Review your infection prevention and control policies and CDC’s recommendations for health-care facilities for COVID-19.
  • Know how to report a potential COVID-19 case or exposure to facility infection control leads and public health officials. Contact your local and/or state health department to notify necessary health officials in the event of a person under investigation for COVID-19.
  • Refer to the Centers for Disease Control and Prevention (CDC) and the World Health Organization for the most up-to-date recommendations about COVID-19, including signs and symptoms, diagnostic testing, and treatment information.
  • Provider Communications Newsletter: COVID-19 Testing
  • Ask patients complaining of fever and lower respiratory illness about recent travel to China or other infected areas.
  • Instruct symptomatic patients with travel history to China or other infected areas to wear a surgical or isolation mask and promptly place the patient in a private room with the door closed.
  • Health-care personnel encountering symptomatic patients with travel history to China or other infected areas should follow contact precautions, airborne with N95 precautions, and wear eye protection and other personal protective equipment.
  • Refer to the CDC’s criteria for a patient under investigation for COVID-19. Notify local and/or state health departments in the event of a patient under investigation for COVID-19. Maintain a log of all health-care personnel who provide care to a patient under investigation.
  • Monitor and manage ill and exposed health-care personnel.
  • Safely triage and manage patients with respiratory illness, including COVID-19. Explore alternatives to face-to-face triage and visits as possible, and manage mildly ill COVID-19 cases at home, if possible.

New Telehealth Policies Expand Coverage for Healthcare Services

For more information, please refer to the guidelines below.

HCPCS and CPT Codes for COVID-19 Testing Services

  • Starting April 1st, 2020, providers performing the COVID-19 test can begin billing us for services that occurred after February 4, 2020, using the following newly created HCPCS codes:
    • HCPCS U0001 – For CDC developed tests only – 2019-nCoV Real-Time RT-PCR Diagnostic Panel.
    • HCPCS U0002 – For all other commercially available tests – 2019-nCoV Real-Time RT-PCR Diagnostic Panel.
    • CPT 87635 – Effective March 13, 2020 and issued as “the industry standard for reporting of novel coronavirus tests across the nation’s health care system.”
      Please note:  It is not yet clear if CMS will rescind the more general HCPCS Code U0002 for non-CDC laboratory tests that the Medicare claims processing system is scheduled to begin accepting starting April 1, 2020.
  • All member cost share (copayment, coinsurance and/or deductible amounts) will be waived across all products for any claim billed with the new COVID-19 testing codes.
  • We have configured our systems to apply $0 member cost share liability for those claims submitted utilizing these new COVID-19 testing codes.
  • In addition to cost share, authorization requirements will be waived for any claim that is received with these specified codes.
  • Providers billing with these codes will not be limited by provider type and can be both participating and non-participating.
  • We will temporarily waive requirements that out-of-state Medicare and Medicaid providers be licensed in the state where they are providing services when they are licensed in another state.
  • Adjudication of claims is currently planned for the first week of April 2020.

Medicare Reimbursement Rates for COVID-19 Testing Services for All Provider Types

  • We are complying with the rates published on 3/12/20 by CMS:
    • U0001 = $35.91
    • U0002 = $51.31
    • Please note: Commercial products will reimburse COVID-19 testing services in accordance with our negotiated commercial contract rates.
  • Any additional rates will be determined by further CMS and/or state-specific guidance and communicated when available.