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Provider Alerts 2020

Emails relevant to rules, Medicaid provider guides, and policies


Provider Alert


Orthodontic Services CDT Codes 1/1/2020


MSS and ICM Billing Guide update eff. 1/1/2020
1/21/20 Ambulatory Surgery Centers Billing changes for dental services provided to MCO clients, eff. 1/1/2020
1/31/20 Outpatient Hospital Billing Guide updates eff. 2/1/2020
1/31/20 Physician-Related Services/Health Care-Related Services Billing Guide updates eff. 2/1/2020
1/31/20 Ambulatory Surgery Center and Inpatient Hospital Billing Guide updates eff. 2/1/2020
2/10/20 Orthodontic Services Billing Guide update, eff. 2/8/2020

Dental prior authorization documentation submission


Ambulance transports - new requirements for PCS form

3/18/20 Dental emergencies - prior authorization requirement for general anesthesia or intravenous sedation suspended temporarily
3/18/20 Dental Providers COVID 19 DOH Health Alert
3/19/20 Changes to Orthodontic Services Payment Methodology

Dental/orthodontic payment methodology changes - DELAYED

3/25/20 Dental and orthodontic authorizations – effective immediately
3/25/20 Apple Health Billing Guide Updates, Effective 4/1/2020
3/26/20 Emergency coverage - dental phone triage
3/26/20 Withdrawal of Notices of Proposed Rule Making (CR-102) and Cancellation of April 7, 2020 Public Hearing

Ambulance transports related to COVID-19


HCA rulemaking webpages upgraded

4/17/20 Ambulance providers – enhanced rates for COVID-19 related transports
4/22/20 Ambulance transports – enhanced rates for ground and air ambulance
4/23/20 Ambulance transports COVID-19 effective date for modifier
5/15/20 Reimbursement dental personal protective equipment
6/22/20 Apple Health Billing Guide Updates, Effective 7/1/20
6/30/20 Updated Expedited Authorization List
6/30/20 Dental/orthodontic payment methodology changes – DELAYED UNTIL FURTHER NOTICE
7/07/20 Hospitals – Correction to facility fees for certain procedure code
7/17/20 New Benefit – Bed Encasements
7/17/20 Temporary add-on rate COVID-19
7/23/20 Disproportionate Share Hospital Program - August 1 Application Due Date

School-Based Health Care Services - Billing Guide Updates

7/31/20 Substance Use Disorder Billing Guide Updates
8/7/20 Prescription Drug Program - New phone number for the PRC referral line
8/10/20 Inpatient Hospital - Temporary enhanced rate increase for COVID-19-related DRG claims
9/04/20 Orthodontic payment methodology
9/15/20 Orthodontic payment methodology - efffective October 1, 2020

Dental - Billing requirements for CDT code D1999

9/18/20 Apple Health Billing Guide Updates, Effective 10/1/2020
9/29/20 Orthodontic payment methodology effective October 1, 2020

Dental billing requirements for CDT code D1999, personal protective equipment (PPE)


New filings page to be discontinued