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Notification of Reimbursement Policy Revisions Effective January 1, 2024 (Posted November 1, 2023)
| Reimbursement Policy | Revision |
|---|---|
| Add-On Codes MA Notification (PDF) | Labor epidural language added. Medical Director approved. Notification on 11/1/2023 for effective date 1/1/2024. |
| Drug and Biologicals MA Notification (PDF) | Added coding guidance to Reimbursement Guidelines for reimbursement of administration fees. Medical Director approved. Notification on 11/1/2023 for effective date 1/1/2024. |
| Evaluation and Management MA Notification (PDF) | Removed language regarding codes 99381 – 99397. Medical Director approved. Notification on 11/1/2023 for effective date 1/1/2024. |
Nonpayment for Serious Adverse Events MA Notification (PDF)
| New policy developed. Medical Director approved. Notification on 11/1/2023 for effective date 1/1/2024. |
| Opioid Treatment Program Reimbursement MA Notification (PDF) | New policy developed. Medical Director approved. Notification on 11/1/2023 for effective date 1/1/2024. |
| Pricing and Adjudication Principles MA Notification (PDF) | Bullets added for CMS rationale for reimbursement and reimbursement for denied or non-covered codes. Medical Director Approved. Notification on 11/1/2023 for effective date 1/1/2024. |
| Reduced and Discontinued Services MA Notification (PDF) | New policy developed. Medical Director approved. Notification on 11/1/2023 for effective date 1/1/2024. |
| Telehealth MA Notification (PDF) | Removed language regarding codes 99381-99397. Medical Director approved. Notification on 11/1/2023 for effective date 1/1/2024. |
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