New York
Provider Communications

July 2022 Newsletter

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Title Category

Physician Office Lab Listing - updates effective August 1, 2022

Administrative

Provider manual updated effective October 1, 2022

Administrative

Introducing Elevance Health - Focusing on whole health and its most powerful drivers

Administrative

Help patients heal from the comfort of home with Hospital in Home care

Administrative

Updates to edits associated with implants

Administrative

Enhanced reimbursement for voluntary Cancer Care Quality program to be discontinued effective December 31, 2022

Administrative

Update to facility editing: HCPCS code G0463

Administrative

CAA: Keep your provider directory information current

Administrative

More potato chips, sugary drinks, and less physical activity are key contributors to childhood obesity

Administrative

Clearing up coding confusion for diabetic retinal screenings

Administrative

MCG to InterQual Behavioral Health Transition

Behavioral Health

Coming soon: The Empire BlueCross BlueShield Provider Learning Hub makes Availity learning easier

Digital Tools

Enhancing claims attachment processes through digital applications

Digital Tools

Radiology prior authorization review transitioning to AIM

Federal Employee Plan (FEP)

Prior authorization requirement changes effective August 1, 2022

Medicaid

MCG care guidelines 26th edition

Medicaid

Update to electronic verification visit key points

Medicaid

Provider reimbursement for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Counseling program

Medicaid

Keep up with Medicaid news- July 2022

View these Medicaid articles:

  • Three-point match verification for professional claims payment
  • Prior authorization updates for medications billed under the medical benefit
  • Updates for medication codes billed under the medical benefit
Medicaid

MCG care guidelines 26th edition

Medicare

Bedford Central School District, New York moves to the Empire BlueCross BlueShield Retiree Solutions Medicare Advantage Plan

Medicare

Update use of Modifier 25 for billing for visits that include preventive services and problem-oriented evaluation and management services

Medicare

Cancer Care Navigator

Medicare

Keep up with Medicare news - July 2022

View this Medicare article:

  • New specialty pharmacy medical step therapy requirements
Medicare

Clinical Criteria updates for specialty pharmacy

Material Adverse Change (MAC)

Pharmacy

Pharmacy information available online

Pharmacy

New reimbursement policy: Modifier FB – Professional and Facility

Material Adverse Change (MAC)
Reimbursement Policies

Reimbursement policy update: Modifier Rules – Professional

Material Adverse Change (MAC)
Reimbursement Policies

Reimbursement policy update: Laboratory and Venipuncture Services - Professional & Facility

Material Adverse Change (MAC)

Reimbursement Policies

Reimbursement policy update: Distinct Procedural Service, Modifiers 59 and XE, XP, XS, and XU - professional

Material Adverse Change (MAC)

Reimbursement Policies

New reimbursement policy: Transitional Care Management - professional

Reimbursement Policies

Retraction for reimbursement policy — Sexually Transmitted Infections - professional

Reimbursement Policies

New reimbursement policy: Place of Service - facility

Material Adverse Change (MAC)
Reimbursement Policies
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