New York
Provider Communications

August 2021 Newsletter

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Title Category

Inpatient Readmission (Facility)

Reimbursement Policies

Distinct Procedural Service, Modifiers 59 and XE, XP, XS, & XU

Material adverse change (MAC) notification
Reimbursement Policies

Virtual Visits - Professional and Facility

Material adverse change (MAC) notification

Reimbursement Policies

Specialty dose rounding program for certain oncology medications

Pharmacy

Specialty dose rounding program for certain non-oncology medications beginning August 1, 2021

Pharmacy

Immune globulin adjusted body weight dosing program beginning August 1, 2021

Pharmacy

Clinical criteria updates for specialty pharmacy

Material adverse change (MAC) notification

Pharmacy

Empire to update formulary lists for commercial health plan pharmacy benefit

Pharmacy

Updates for specialty pharmacy effective November 1, 2021

Pharmacy

Pharmacy information available on empireblue.com

Pharmacy

City of New York offers Medicare Advantage option in 2022

Medicare

Preventing claims denials: Shingles vaccine

Medicare

Policy reminder: Inpatient Readmissions

Medicare

Keep up with Medicare news

Medicare

Transition to AIM Specialty Health Imaging of the Heart clinical appropriateness guideline for Computed Tomography to detect coronary artery calcification

Medical Policy & Clinical Guidelines

Medical policy and clinical guideline updates

Material adverse change (MAC) notification
Medical Policy & Clinical Guidelines

Keep up with Medicaid news

Medicaid

Change in email submission of service requests for Federal Employee Program members

Material adverse change (MAC) notification
Federal Employee Plan (FEP)

Digital scheduling feature in the Availity Portal: the Appointment Scheduler application

Digital Tools

2021 Provider Manual now available

Administrative

Telehealth visits can impact after-hospitalization follow-up care for mental illness

Administrative

Clearing up coding confusion for retinal eye exams (DRE)

Administrative

Register now for our August CME webinars

Administrative
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