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Provider Communications

Articles Category: Policy Updates

Title Publication Category Date

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

Material Adverse Change (MAC)

July 2022 Newsletter Reimbursement Policies Jul 1, 2022

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

Material Adverse Change (MAC)

July 2022 Newsletter Reimbursement Policies Jul 1, 2022

New reimbursement policy: Transitional Care Management - professional

July 2022 Newsletter Reimbursement Policies Jul 1, 2022

Retraction for reimbursement policy — Sexually Transmitted Infections - professional

July 2022 Newsletter Reimbursement Policies Jul 1, 2022

New reimbursement policy: Place of Service - facility

Material Adverse Change (MAC)
July 2022 Newsletter Reimbursement Policies Jul 1, 2022

New reimbursement policy: Modifier FB – Professional and Facility

Material Adverse Change (MAC)
July 2022 Newsletter Reimbursement Policies Jul 1, 2022

Reimbursement policy update: Modifier Rules – Professional

Material Adverse Change (MAC)
July 2022 Newsletter Reimbursement Policies Jul 1, 2022

Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines

Material Adverse Change (MAC)

June 2022 Newsletter Medical Policy & Clinical Guidelines Jun 1, 2022

Updates to AIM Specialty Health musculoskeletal clinical appropriateness guidelines

Material Adverse Change (MAC)
June 2022 Newsletter Medical Policy & Clinical Guidelines Jun 1, 2022

Updates to AIM Specialty Health sleep disorder management clinical appropriateness

Material Adverse Change (MAC)

June 2022 Newsletter Medical Policy & Clinical Guidelines Jun 1, 2022

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services (Facility)

Material Adverse Change (MAC)

June 2022 Newsletter Reimbursement Policies Jun 1, 2022

Medical policy and clinical guideline updates

Material Adverse Change (MAC)

May 2022 Newsletter Medical Policy & Clinical Guidelines May 1, 2022

AIM Specialty Health Outpatient Rehabilitative and Habilitative Services clinical appropriateness guidelines updates

Material Adverse Change (MAC)
March 2022 Newsletter Medical Policy & Clinical Guidelines Mar 1, 2022

Clarification to reimbursement policy update: Virtual Visits - Professional and Facility

February 2022 Newsletter Reimbursement Policies Feb 1, 2022

Medical policy and clinical guideline updates

Material Adverse Change (MAC)

January 2022 Newsletter Medical Policy & Clinical Guidelines Jan 1, 2022

Updates to AIM Specialty Health Musculoskeletal Interventional Pain Management clinical appropriateness guideline

Material Adverse Change (MAC)
December 2021 Newsletter Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Cardiology clinical appropriateness guidelines

Material Adverse Change (MAC)
December 2021 Newsletter Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Radiation Oncology clinical appropriateness guideline

Material Adverse Change (MAC)
December 2021 Newsletter Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Advanced Imaging clinical appropriateness guideline

Material Adverse Change (MAC)
December 2021 Newsletter Medical Policy & Clinical Guidelines Dec 1, 2021

Reimbursement policy update: Assistant at Surgery (Modifiers 80, 81, 82, AS) - professional

Material Adverse Change (MAC)

December 2021 Newsletter Reimbursement Policies Dec 1, 2021

New reimbursement policy update: Modifier 62: Co-Surgeon Services and Modifier 66: Surgical Teams - professional

Material Adverse Change (MAC)

December 2021 Newsletter Reimbursement Policies Dec 1, 2021

Reimbursement policy update: Virtual Visits - professional and facility

December 2021 Newsletter Reimbursement Policies Dec 1, 2021

Clarification to reimbursement policy updates: Modifier Rules and Guidelines for Reporting Timed Units for Physical Medicine and Rehabilitation (Professional)

November 2021 Newsletter Reimbursement Policies Nov 1, 2021

Medical policy and clinical guideline updates

Material adverse change (MAC) notification

October 2021 Newsletter Medical Policy & Clinical Guidelines Oct 1, 2021

Reimbursement policy update: Sexually Transmitted Infections Testing (Professional)

Material adverse change (MAC) notification

September 2021 Newsletter Reimbursement Policies Sep 1, 2021

Reimbursement policy update: Drug Screen Testing (Professional)

Material adverse change (MAC) notification
September 2021 Newsletter Reimbursement Policies Sep 1, 2021

Reimbursement policy reminder Professional Anesthesia Services (Professional)

September 2021 Newsletter Reimbursement Policies Sep 1, 2021

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

August 2021 Newsletter Medical Policy & Clinical Guidelines Aug 1, 2021

Medical policy and clinical guideline updates

Material adverse change (MAC) notification
August 2021 Newsletter Medical Policy & Clinical Guidelines Aug 1, 2021

Inpatient Readmission (Facility)

August 2021 Newsletter Reimbursement Policies Aug 1, 2021

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

Material adverse change (MAC) notification
August 2021 Newsletter Reimbursement Policies Aug 1, 2021

Virtual Visits - Professional and Facility

Material adverse change (MAC) notification

August 2021 Newsletter Reimbursement Policies Aug 1, 2021

Medical policy updates and clinical guideline updates

Material adverse change (MAC) notification
July 2021 Newsletter Medical Policy & Clinical Guidelines Jul 1, 2021

New reimbursement policy: Non-patient Laboratory Services (Facility)

Material adverse change (MAC) notification
July 2021 Newsletter Reimbursement Policies Jul 1, 2021

Reimbursement policy update: Consultations (Professional)

Material adverse change (MAC) notification
July 2021 Newsletter Reimbursement Policies Jul 1, 2021

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines

Material adverse change (MAC) notification
June 2021 Newsletter Medical Policy & Clinical Guidelines Jun 1, 2021

Updates to AIM Musculoskeletal Program Clinical Appropriateness Guidelines

Material adverse change (MAC) notification
June 2021 Newsletter Medical Policy & Clinical Guidelines Jun 1, 2021

Clinical Criteria updates for specialty pharmacy

Material adverse change (MAC) notification
June 2021 Newsletter Medical Policy & Clinical Guidelines Jun 1, 2021

Empire to enhance claim edits for Outpatient Facility Claims

June 2021 Newsletter Reimbursement Policies Jun 1, 2021

Clinical guideline updates

Material adverse change (MAC) notification

May 2021 Newsletter Medical Policy & Clinical Guidelines May 1, 2021

Update to AIM Specialty Health oncologic imaging clinical appropriateness guidelines

May 2021 Newsletter Medical Policy & Clinical Guidelines May 1, 2021

Reimbursement policy update: Frequency editing (Professional)

May 2021 Newsletter Reimbursement Policies May 1, 2021

Update for commercial providers regarding the AIM Sleep Program CPT Code E1399, NOC: Durable medical equipment, miscellaneous

April 2021 Newsletter Medical Policy & Clinical Guidelines Apr 1, 2021

MCG Care Guidelines 25th Edition

April 2021 Newsletter Medical Policy & Clinical Guidelines Apr 1, 2021

Medical policy updates

Material adverse change (MAC) notification
April 2021 Newsletter Medical Policy & Clinical Guidelines Apr 1, 2021

Claims editing update for ICD-10-CM Excludes 1 notes

April 2021 Newsletter Reimbursement Policies Apr 1, 2021

Update: Notice of changes to the AIM Small Joint Surgery Guideline

March 2021 Empire Provider News Medical Policy & Clinical Guidelines Mar 1, 2021

Emergency Room Transfers (Facility)

Material Adverse Change (MAC) Notification
February 2021 Empire Provider News Reimbursement Policies Feb 1, 2021

Treatment Rooms with Office Evaluation and Management Services (Facility)

Material Adverse Change (MAC) Notification
February 2021 Empire Provider News Reimbursement Policies Feb 1, 2021

MCG Care Guidelines 24th edition customization

Material Adverse Change (MAC) Notification
January 2021 Empire Provider News Medical Policy & Clinical Guidelines Jan 1, 2021

Medical Policy updates

Material Adverse Change (MAC) Notification
January 2021 Empire Provider News Medical Policy & Clinical Guidelines Jan 1, 2021

Multiple Diagnostic Imaging procedures (Professional)

Material Adverse Change (MAC) Notification
January 2021 Empire Provider News Reimbursement Policies Jan 1, 2021

Frequency Editing (Professional)

Material Adverse Change (MAC) Notification
January 2021 Empire Provider News Reimbursement Policies Jan 1, 2021

Guidelines for reporting timed units for Physical Medicine and Rehabilitation (Professional)

Material Adverse Change (MAC) Notification
January 2021 Empire Provider News Reimbursement Policies Jan 1, 2021

Modifier Rules (Professional)

Material Adverse Change (MAC) Notification
January 2021 Empire Provider News Reimbursement Policies Jan 1, 2021

Unit Frequency Maximum for Drugs and Biologicals (Professional)

Material Adverse Change (MAC) Notification
January 2021 Empire Provider News Reimbursement Policies Jan 1, 2021

Evaluation and Management changes 2021

January 2021 Empire Provider News Reimbursement Policies Jan 1, 2021

Updates to AIM Cardiology Clinical Appropriateness Guidelines

Material Adverse Change (MAC) Notification
December 2020 Empire Provider News Medical Policy & Clinical Guidelines Dec 1, 2020

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline

Material Adverse Change (MAC) Notification
December 2020 Empire Provider News Medical Policy & Clinical Guidelines Dec 1, 2020

Updates to AIM Radiation Oncology Clinical Appropriateness Guideline

Material Adverse Change (MAC) Notification
December 2020 Empire Provider News Medical Policy & Clinical Guidelines Dec 1, 2020

Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines

December 2020 Empire Provider News Medical Policy & Clinical Guidelines Dec 1, 2020

Bundled Services and Supplies (Professional)

December 2020 Empire Provider News Reimbursement Policies Dec 1, 2020

Empire expands hospice policy

December 2020 Empire Provider News Reimbursement Policies Dec 1, 2020

Clinical Guideline Updates

Material Adverse Change (MAC) notification
November 2020 Empire Provider News Medical Policy & Clinical Guidelines Nov 1, 2020

Reminder: Post-service reviews using AIM

November 2020 Empire Provider News Medical Policy & Clinical Guidelines Nov 1, 2020

Documentation Standards for Episodes of Care (Professional)

Material Adverse Change (MAC) notification
November 2020 Empire Provider News Reimbursement Policies Nov 1, 2020

Modifier Rules (Professional)

Material Adverse Change (MAC) notification
November 2020 Empire Provider News Reimbursement Policies Nov 1, 2020

Bundled Services and Supplies (Professional)

Material Adverse Change (MAC) notification
November 2020 Empire Provider News Reimbursement Policies Nov 1, 2020

Medical Policy & Clinical Guideline updates

Material Adverse Changes
October 2020 Empire Provider News Medical Policy & Clinical Guidelines Oct 1, 2020

Clinical Criteria updates for specialty pharmacy are available

Material Adverse Change
October 2020 Empire Provider News Medical Policy & Clinical Guidelines Oct 1, 2020

Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines

October 2020 Empire Provider News Medical Policy & Clinical Guidelines Oct 1, 2020

Reimbursement Policy Update: Emergency Department: Leveling of Evaluation and Management Services (Facility)

Material Adverse Change
October 2020 Empire Provider News Reimbursement Policies Oct 1, 2020

Reimbursement Policy Update: Laboratory and Venipuncture (Professional)

Material Adverse Change
October 2020 Empire Provider News Reimbursement Policies Oct 1, 2020

Distinct Procedural Services- Modifiers 59, XE, XP, XS, XU (Professional)

September 2020 Empire Provider News Reimbursement Policies Sep 1, 2020

Frequency Editing (Professional)

September 2020 Empire Provider News Reimbursement Policies Sep 1, 2020

Medical Policy and Clinical Guideline updates

July 2020 Empire Provider News Medical Policy & Clinical Guidelines Jul 1, 2020

Clinical Criteria updates for specialty pharmacy are available

July 2020 Empire Provider News Medical Policy & Clinical Guidelines Jul 1, 2020

Medical Policy Updates

June 2020 Empire Provider News Medical Policy & Clinical Guidelines Jun 1, 2020

Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines

June 2020 Empire Provider News Medical Policy & Clinical Guidelines Jun 1, 2020

New Reimbursement Policy: Nurse Practitioner and Physician Assistant Services - Professional

June 2020 Empire Provider News Reimbursement Policies Jun 1, 2020

Medical Policy and Clinical Guideline updates

May 2020 Empire Provider News Medical Policy & Clinical Guidelines May 1, 2020

Clinical Criteria updates for specialty pharmacy are available

May 2020 Empire Provider News Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline

May 2020 Empire Provider News Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

May 2020 Empire Provider News Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM MSK Interventional Pain Management Clinical Appropriateness Guideline

May 2020 Empire Provider News Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Musculoskeletal Program Joint Surgery Clinical Appropriateness Guidelines

May 2020 Empire Provider News Medical Policy & Clinical Guidelines May 1, 2020

Reminder about System Updates

May 2020 Empire Provider News Reimbursement Policies May 1, 2020

Outpatient Surgical Grouper

May 2020 Empire Provider News Reimbursement Policies May 1, 2020

Policy Updates

April 2020 Empire Provider News Medical Policy & Clinical Guidelines Apr 1, 2020

Clinical Guideline Update - June 2020

March 2020 Empire Provider News Medical Policy & Clinical Guidelines Mar 1, 2020

Medical Policy and Clinical Guideline updates

February 2020 Empire Provider News Medical Policy & Clinical Guidelines Feb 1, 2020

Updates to AIM Musculoskeletal Program Clinical Appropriateness Guidelines

February 2020 Empire Provider News Medical Policy & Clinical Guidelines Feb 1, 2020

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines

February 2020 Empire Provider News Medical Policy & Clinical Guidelines Feb 1, 2020

Clinical Laboratory Improvements Amendments for Empire

February 2020 Empire Provider News Reimbursement Policies Feb 1, 2020

Important Update: Milliman Care Guideline (MCG), 23rd Edition, ORG: W0163 Pelvic Organ Prolapse Repair

January 2020 Empire Provider News Policy Updates Jan 1, 2020

Reimbursement Policy update - Outpatient Facility Edit Implementation

January 2020 Empire Provider News Reimbursement Policies Jan 1, 2020

New Reimbursement Policy Durable Medical Equipment - Rent to Purchase and Durable Medical Equipment - Modifiers (Professional)

December 2019 Empire Provider News Reimbursement Policies Dec 1, 2019

System updates for 2020 - Professional

December 2019 Empire Provider News Reimbursement Policies Dec 1, 2019

Medical Policy & Clinical Guideline updates

November 2019 Empire Provider News Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Advanced Imaging of the Abdomen and Pelvis Clinical Appropriateness Guideline

November 2019 Empire Provider News Medical Policy & Clinical Guidelines Nov 1, 2019
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