CommercialMedicare AdvantageMedicaidAugust 1, 2024
August 2024 Provider Newsletter
Featured Articles
CommercialAugust 1, 2024
MCG Care Guidelines 28th edition
Medicare AdvantageMedicaidAugust 1, 2024
Admission, discharge, and transfer information is now available for Medicare Advantage and Medicaid members
Administrative
Medicare AdvantageAugust 1, 2024
ICD-10-CM Excludes1 notesCommercialAugust 1, 2024
Device-dependent procedures — facility editing updateCommercialAugust 1, 2024
Incidental services — facility editing updateCommercialAugust 1, 2024
CAA: Providers required to verify their online provider directory informationMedicaidAugust 1, 2024
Keeping your provider directory information current: inactive providersMedicaidAugust 1, 2024
Mutually exclusive places of serviceCommercialAugust 1, 2024
Material adverse change
Evaluation and management services correct coding (professional)CommercialJuly 24, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsCommercialMedicare AdvantageMedicaidAugust 1, 2024
Save time and get better results with optimized CPT code search in Availity EssentialsBehavioral Health
MedicaidAugust 1, 2024
Learn to Live: A Digital Mental Health Benefit for Anthem members!Education & Training
CommercialMedicare AdvantageAugust 1, 2024
August is National Breastfeeding MonthPolicy Updates
MedicaidJuly 25, 2024
Update: Use 59 Modifier for increased multiple birth reimbursementsMedicaidJune 26, 2024
Clinical Criteria updates — November 2023MedicaidJuly 10, 2024
Carelon Medical Benefits Management, Inc. updates effective October 20, 2024CommercialJune 25, 2024
Material adverse change
Updates to Carelon Medical Benefits Management Clinical Appropriateness GuidelinesMedicare AdvantageJuly 5, 2024
Medical Policies and Clinical Utilization Management Guidelines updateEffective August 8, 2024
CommercialAugust 1, 2024
Notification of authorization fax number changesCommercialAugust 1, 2024
Material adverse change
New reimbursement policy: Intraoperative Neuromonitoring — ProfessionalCommercialAugust 1, 2024
Reimbursement policy update: Modifiers 26 and TC — ProfessionalMedicare AdvantageAugust 1, 2024
Reimbursement policy update: Modifier 78CommercialAugust 1, 2024
Material adverse change
Reimbursement policy update: Professional Anesthesia ServiceCommercialAugust 1, 2024
Material adverse change
Reimbursement policy update: Bundled Services and Supplies — FacilityCommercialAugust 1, 2024
Material adverse change
Reimbursement policy update: Outpatient Facility Revenue Code Billing Requirements — FacilityMedicare AdvantageAugust 1, 2024
Reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesMedicaidAugust 1, 2024
Reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesProducts & Programs
CommercialJuly 25, 2024
Material adverse change
Specialty pharmacy updates — February 2024Note: This article corrects the Clinical Criteria for Spravato (esketamine), which was incorrectly listed in a February 2024 article.
CommercialAugust 1, 2024
Material adverse change
Specialty pharmacy updates — August 2024Tevimbra, Tyenne, and Wezlana
NVBCBS-CDCRCM-063100-24
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