New York
Provider Communications

September 2022 Newsletter

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Title Category

Continuing to explore the intersection of race and disability

Administrative

Monkeypox resources and recommendations for our care providers

Administrative

New patient evaluation and management services when reported for the same patient within the last three years

Administrative

Drug code billing reminder

Administrative

Important information about women’s preventive care visits

Administrative

CAA: Current provider directory information is key for members and providers to engage with you seamlessly

Administrative

Empire to accept Hospital in Home services

Administrative

Updates to the Claim Attachment workflow

Digital Tools

OBRA 93 claim filing for Federal Employee Program

Federal Employee Plan (FEP)

Reimbursement policy update: Modifiers 25 and 57: Evaluation and Management with Global Procedures (Policy G- 06003), (Informational only)

Medicaid

Clinical Criteria updates

Medicaid

New specialty pharmacy medical step therapy requirements

Medicaid

Enhancing claims attachment processes through digital applications

Medicaid

Alcohol use disorders linked to chronic diseases

Medicaid

Prior authorization requirement changes effective December 1, 2022

Medicare

Reimbursement policy update: Modifiers 25 and 57: Evaluation and Management with Global Procedures (Policy G- 06003)

Medicare

Empire BlueCross BlueShield expands specialty pharmacy precertification list – effective 11/1/2022

Medicare

Empire BlueCross BlueShield expands specialty pharmacy precertification list - effective 12/1/2022

Medicare

Reminder: AIM prior authorization phone number change for Medicare

Medicare

Keep up with Medicare news - September 2022

View this Medicare article:
  • Clinical Criteria Updates
  • Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQ
Medicare

Enhancing claims attachment processes through digital applications

Medicare

Specialty pharmacy updates - September 2022

Material Adverse Change (MAC)
Pharmacy

Clinical Criteria updates for specialty pharmacy

Material Adverse Change (MAC)
Pharmacy

Update to formulary lists for Commercial health plan pharmacy benefit

Pharmacy

New Back Pain Management Program

Products & Programs

Reimbursement policy update - Modifier Rules (Professional)

Material Adverse Change (MAC)
Reimbursement Policies

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

Reimbursement Policies

Reimbursement policy update - Modifier 66: Surgical Teams (Professional)

Reimbursement Policies
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