Forms & publications

Notice: If you are looking for Apple Health (Medicaid) client forms and publications, please visit our Free or low-cost forms library.

Substance Use Disorder Billing Guide (FFS benefits provided outside of the BHO process) (2016-10-01)

Provider billing guide

Substance Use Disorder Billing Guide (FFS benefits provided outside of the BHO process) (2017-01-01)

Provider billing guide

Substance Use Disorder Billing Guide (FFS benefits provided outside of the BHO process) (2017-07-01)

Provider billing guide

Substance Use Disorder Billing Guide (FFS benefits provided outside of the BHO process) (2017-10-01)

Provider billing guide

Substance Use Disorder Billing Guide (FFS benefits provided outside of the BHO process) (2018-01-01)

Provider billing guide

Substance Use Disorder Billing Guide (FFS benefits provided outside of the BHO process) (2018-04-01)

Provider billing guide

.DAT file formatting requirements

File formatting requirements for electronic visit verification data elements.

Publication

13-0051-drug-price-transparency-submitter-registration.pdf

13-0051

registration form used by manufacturers, PBMs, PSAOs, and carriers to register as a prescription drug price submitter

Form

18-0009-trading-partner-agreement.docx

18-0009

This Agreement sets forth the terms and conditions which govern all Electronic Data Interchange (EDI) communications between the parties by electronic transactions in agreed-upon formats as a means of accomplishing their business objectives for the mutual benefit of the Parties and compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Form

2013 CPT code changes: additional information

Instructions

Pages