Provider Alerts 2021

Emails relevant to rules, Medicaid provider guides, and policies

Date Provider Alert
01/05/21 Dental - Removing prior authorization requirements for certain CDT® codes for children.
02/09/21 Orthodontic services – prior authorization requests for CDT® code D8670
02/15/21 Updates to COVID-19 vaccine clinical policy - 2/15/2021
03/04/21 Prescription drug signature requirements
03/04/21 Physician-Related Services/Health Care Professional Services Billing Guide updates
04/13/21 Updates to the COVID-19 vaccine clinical policy
04/21/21 Dental - change in how to check for available units for CDT codes
04/23/21 Revised policy for monoclonal antibodies
04/23/21 Updates to the COVID-19 vaccine clinical policy
04/29/21 Clarification to COVID-19 vaccine clinical policy updates
05/04/21 Revised policies related to telemedicine effective 7/1/2021
05/06/21 Physician-Related Services/Health Care Professional Services billing guide update
05/11/21 Corrected notice: Physician-Related Services/Health Care Professional Services billing guide update
05/13/21 Template billing for COVID-19 mass vaccinations now allowed
05/13/21 Dental surgeries – payment of inpatient hospital facility fees requiring prior authorization
07/16/21 Fluoride treatments provided by medical providers – new billing requirement effective 7/1/2021
07/27/21 Prior authorization requirement for replacement dentures
07/30/21 30-day grace period on requiring prior authorization for replacement dentures
08/31/21 Mental Health Services Billing Guide updates, effective 9/1/2021
09/28/21 COVID-19 testing clinical policy update, effective 10/1/2021
10/01/21 Sexual and Reproductive Health Program (SRHP) enhanced rate, effective October 1, 2021
10/07/21 COVID-19 vaccine clinical policy update, effective 9/22/2021
10/18/21 Tribal Health Billing Guide updates
10/28/21 Outpatient Hospital Services Billing Guide updates
10/29/21 Edit code 11120 posting on claims in error
11/01/21 COVID-19 vaccine clinical policy updates
11/04/21 Updates to the COVID-19 vaccine clinical policy, effective 10/29/2021
11/04/21 Noncovered codes for outpatient hospital and ambulatory surgery settings - orthognathic surgery
11/18/21 Orthodontic services - authorization requirement changing for CDT(R) codes D8680 and D8695, effective 1/1/2022
12/06/21 Dental program changes, effective 1/1/2022
12/15/21 Pharmacy - Updated expedited authorization (EA) list, effective 12/1/2021
12/17/21 Telehealth/telemedicine - new modifier FQ, effective 1/1/2022 and billing for POS 10
12/22/21 Apple Health (Medicaid) Billing Guide Updates, effective 1/1/2022