Individuals enrolled in Apple Health (Medicaid), Public Employees Benefits Board, and School Employees Benefits Board coverage - and those accessing behavioral health services - will not experience a disruption in care due to the federal government shutdown. In addition, health care providers will continue to be paid for the services they provide. We will continue to monitor the situation closely and share updates if anything changes.
Emails relevant to rules, Medicaid provider guides, and policies.
| Date | Provider Alert |
|---|---|
| 1/10/2024 | Home health provider must implement electronic visit verification (EVV) and begin submitting claims with EVV data elements |
| 1/16/2024 | Dental – Reminder of increased frequency of periodontal maintenance procedures effective January 1, 2024 |
| 1/24/2024 | Dental – Revised frequency schedule for limited visual oral assessments |
| 1/31/2024 | Inpatient Hospital – Administrative days |
| 1/31/2024 | Dental – Correction on revised frequency schedule for limited visual oral assessments |
| 2/2/2024 | Updates to Prescription Drug Program and COVID-19 Testing Policy Billing Guides Effective February 1, 2024 |
| 2/15/2024 | Place of service (POS) updates in the Physicians billing guide |
| 2/29/2024 | Eliminating requirement for prior authorization on CDT® codes D7280 and D7283; effective March 1, 2024 |
| 3/7/2024 | Home health care services – Electronic visit verification (EVV) system requirements |
| 4/4/2024 | Policy Update on Hyaluronic Acid/Platelet-Rich Plasma, Eff. July 1, 2024 |
| 4/9/2024 | ABA providers – effective 7/1/2024 – provider enrollment requirements |
| 5/3/2024 | Home Health - Use of procedure codes and revenue codes for in home setting – Effective Immediately |
| 5/5/2024 | Home health – Electronic visit verification (EVV) technical assistance |
| 5/16/2024 | Behavioral health audio-only procedure code list updates |
| 5/30/2024 | Apple Health Fee for Service (FFS) Documentation Requirements for Prior Authorization Requests for Medical Equipment, Supplies, Complex Rehabilitation Technology (CRT) and Prosthetics & Orthotics (P&O) |
| 5/31/2024 | Vaccines For Children (VFC) – VFC Administration billing update, effective July 1, 2024 |
| 6/04/2024 | Physicians billing guide restructure/reformat |
| 6/17/2024 |
Apple Health (Medicaid) forms related to Medical Equipment and Supplies and Outpatient Rehabilitation |
| 6/18/2024 |
Correction – Prior Authorization and Proof of Delivery requirements for medical equipment and Complex Rehab Technology |
| 6/20/2024 | Quarterly Billing Guide Updates, Effective July 1, 2024 |
| 6/28/2024 | Update – ABA providers – enrollment requirements |
| 8/30/2024 | Sunsetting COVID-19 Vaccine Clinical Policy Billing Guide, Eff. 10/1/2024 |
| 9/19/2024 | ABA providers – Important enrollment requirements |
| 9/25/2024 | Quarterly Billing Guide update effective 10/01/2024 |
| 9/27/2024 |
Vaccines for children (VFC) - further billing clarification |
| 9/27/2024 |
Electronic Visit Verification (EVV) for Home Health Services – Claim denial and NPI number |
| 9/30/2024 |
Apple Health fee-for-service coverage for social determinants of health risk screening (HCPCS G0136) |
| 9/30/2024 |
New Pregnancy-Related Services Billing Guide |
| 10/01/2024 |
Acupuncture Services and Chiropractic for Adult Services – Effective January 1, 2025 |
| 10/04/2024 | HCA Rulemaking Notice for WSR 24-20 |
| 11/01/2024 | New e-consults policy to take effect January 1, 2025 |
| 11/01/2024 | Retroactive to July 1, 2024 – Prior authorization requests and photographic evidence |
| 11/07/2024 | Ambulance transportation – Eff November 1, 2024 – EPA no longer required for alternative destination ground ambulance |
| 11/22/2024 | Medical equipment providers - Apple Health Fee for Service (FFS) Documentation Requirements for Prior Authorization Requests for Medical Equipment, Supplies, Complex Rehabilitation Technology (CRT) and Prosthetics & Orthotics (P&O) |
| 11/22/2024 | Applied Behavioral Analysis (ABA) – Provider Enrollment by June 30, 2025 |
| 11/26/2024 | Bathroom equipment – Apple Health fee-for-service (FFS) prior authorization requests |
| 12/13/2024 | January Quarterly Billing Guide update |
| 12/16/2024 | Outpatient Hospital Services Billing Guide – Effective 1/1/2025 |
| 12/17/2024 | Correction - Outpatient Rehabilitation Billing Guide – Effective 1/1/2025 |
| 12/19/2024 |
Compression garments – Eff. January 1, 2025, MES Compression Garments form (HCA 13-871) is no longer required |
| 12/20/2024 | Updates to the EPSDT Well-Child Program Billing Guide effective January 1, 2025 |
| 12/20/2024 | Hearing Services Billing Guide – Effective January 1, 2025 |
| 12/20/2024 | Home Infusion Therapy and Parenteral Nutrition Program Billing Guide, Effective 01/01/2025 |
| 12/20/2024 | COVID-19 Molecular and Antigen Testing Changes to Take Effect April 1, 2025 |
| 12/20/2024 | Updates to Telemedicine Policy Billing Guide and Apple Health (Medicaid) Physical Health Audio-Only Procedure Code List effective 1/1/ 2025 |
| 12/20/2024 | Behavioral Health- Telemedicine FAQ – Effective January 1, 2025 |
| 12/30/2024 | Respiratory care, new form requirement for prior authorization requests for high frequency chest wall oscillation air-pulse generator systems |