Notices of material changes/amendments to contract - May 2023

Notices of material changes/amendments to contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements. In this issue, please reference the following articles:

• Medical Policy and Clinical Guideline updates
• Reimbursement policy update: Multiple and Bilateral Surgery Processing – Professional
• Specialty pharmacy updates
• Reimbursement policy update: Technology Assisted Surgical Procedures – Professional and Facility
• Clinical Criteria updates for specialty pharmacy
• Transition to Carelon Medical Benefits Management, Inc. MRI Breast Clinical Appropriateness Guidelines