MassHealth has issued All Provider Bulletin 337, MassHealth Pharmacy Coverage of Over-the-Counter Diagnostic Antigen Tests for SARS-CoV-2 indicating that effective January 14, 2022, the following at-home antigen self-test kits have been added to the MassHealth Non-Drug Product List and will be covered through the MassHealth pharmacy benefit.
• BinaxNOW
• FlowFlex
• IHealth
• Inteliswab
• QuickVue At-home
This follows the Department of Public Health (DPH) issuance of a standing order authorizing licensed pharmacists to dispense OTC diagnostic SARS-CoV-2 antigen tests (“at-home antigen self-test kits”) to any individual. This standing order authorizes licensed pharmacists to treat the standing order as a prescription for any such test. Accordingly, MassHealth is issuing this bulletin to establish coverage for up to eight such at-home antigen self-test kits per member per month without prior authorization.
This MassHealth coverage bulletin applies to members enrolled in MassHealth fee-for-service, the Primary Care Clinician Plan and Primary Care Accountable Care Organizations, as well as Health Safety Net patients and Children’s Medical Security Plan members. Information about coverage through other MassHealth Managed Care Entities (MCEs) and the Program of All-inclusive Care for the Elderly is provided in MCE Bulletin 80.