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Medicare AdvantageMay 1, 2023
Keep up with Medicare newsMedicare AdvantageMay 1, 2023
Genetic testingMedicare AdvantageMay 1, 2023
Did your patient have a recent fracture?Medicare AdvantageMarch 31, 2023
Keep up with Medicare newsPlease continue to check Important Medicare Advantage Updates at anthem.com/medicareprovider for the latest Medicare Advantage information, including:
MedicaidMarch 31, 2023
Correct coding for hospital outpatient clinic visits for MedicaidMedicaidMarch 31, 2023
Policy Update: Modifiers 25 and 57MedicaidMarch 31, 2023
Look what’s new in Provider PathwaysMedicaidMarch 31, 2023
Keep up with Medicaid newsPlease continue to check Medicaid Provider Communications & updates at anthem.com/nvmedicaiddoc for the latest Medicaid information, including:
Medicare AdvantageMarch 31, 2023
E-visitsMedicare AdvantageMarch 1, 2023
Keep up with Medicare newsPlease continue to check Important Medicare Advantage Updates at anthem.com/medicareprovider for the latest Medicare Advantage information, including:
MedicaidMarch 1, 2023
Keep up with Medicaid newsPlease continue to check Medicaid Provider Communications & updates at anthem.com/nvmedicaiddoc for the latest Medicaid information, including:
Medicare AdvantageMarch 1, 2023
Shared savings and transition care management after inpatient dischargesMedicare AdvantageMarch 1, 2023
Informational Update Modifier UsageMedicare AdvantageMarch 1, 2023
Annual planned visitsMedicare AdvantageJanuary 31, 2023
Name change announcement: myNEXUS will transition to Carelon Post Acute Solutions on March 1, 2023MedicaidJanuary 31, 2023
Keep up with Medicaid newsPlease continue to check Medicaid Provider Communications & updates at anthem.com/nvmedicaiddoc for the latest Medicaid information, including:
- Introducing the Provider Learning Hub
- Behavioral health therapy session limitations
- COVID-19 vaccine counseling
- Prior authorization updates for medications billed under the medical benefit (Enjaymo, Kimmtrak, Tezspire, Voxzogo)
- Medical Policies and Clinical Utilization Management Guidelines update
- Prior authorization updates for medications billed under the medical benefit
Medicare AdvantageJanuary 31, 2023
Keep up with Medicare newsPlease continue to check Important Medicare Advantage Updates at anthem.com/medicareprovider for the latest Medicare Advantage information, including:
- Introducing the Provider Learning Hub
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Fylnetra)
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Spevigo, Xenpozyme)
- Specialty pharmacy precertification list expansion (Rolvedon, Stimufend)
- New specialty pharmacy medical step therapy requirements
- Prior authorization requirement changes effective April 1, 2023
- Medical Policies and Clinical Utilization Management Guidelines update in Nevada
MedicaidDecember 30, 2022
Attention physicians and lab providers: COVID-19 update regarding reimbursementMedicaidDecember 30, 2022
Update to the Pregnancy Notification FormMedicare AdvantageDecember 30, 2022
Keep up with Medicare newsPlease continue to check Important Medicare Advantage Updates at anthem.com/medicareprovider for the latest Medicare Advantage information, including:
MedicaidDecember 30, 2022
Keep up with Medicaid newsPlease continue to check Medicaid Provider Communications & updates at anthem.com/nvmedicaiddoc for the latest Medicaid information, including:
MedicaidDecember 1, 2022
Keep up with Medicaid newsPlease continue to check Medicaid Provider Communications & updates at anthem.com/nvmedicaiddoc for the latest Medicaid information, including:
- Prior authorization requirement changes effective January 1, 2023
- Clinical Criteria updates
- Medical Policies and Clinical Utilization Management Guidelines update
- Prior authorization and notification requirements
- The Mental Health Practitioner Hub
- Prior authorization updates for medications billed under the medical benefit
Medicare AdvantageDecember 1, 2022
Keep up with Medicare newsPlease continue to check Important Medicare Advantage Updates at anthem.com/medicareprovider for the latest Medicare Advantage information, including:
Medicare AdvantageDecember 1, 2022
2023 Medicare Advantage service area and benefit updatesMedicare AdvantageDecember 1, 2022
Personal home helper benefit endingMedicaidNovember 1, 2022
Keep up with Medicaid news- Medical drug benefit Clinical Criteria updates
- Prior authorization requirement changes effective November 1, 2022
Medicare AdvantageNovember 1, 2022
Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (MAC)Material adverse change (MAC)
MedicaidNovember 1, 2022
Guidance for coding evaluation and management services for new and established patientsMedicare AdvantageNovember 1, 2022
Courtesy notification of specialty pharmacy medical step therapy updatesCommercialOctober 11, 2022
MCG Care Guidelines 26th editionEffective September 23, 2022, we will upgrade to the 26th edition of MCG care guidelines for the following modules: Inpatient/surgical care (ISC). The below tables highlight new guidelines and changes.
MedicaidOctober 1, 2022
Prior authorization updates for medications billed under the medical benefitMedicaidOctober 1, 2022
Prior authorization updates for medications billed under the medical benefitMedicaidOctober 1, 2022
Attention Provider Type 12 (Hospital, Outpatient): Cognitive Assessment and Care Planning Procedure Code 99483 May Be BilledMedicaid
A message from Nevada Department of Health and Human Services, Division of Health Care Financing and Policy
MedicaidOctober 1, 2022
New specialty pharmacy medical step therapy requirements (MAC)Medicaid
Material adverse change (MAC)
MedicaidOctober 1, 2022
Policy Update: Modifiers 25 and 57: Evaluation and Management with Global ProceduresMedicaidOctober 1, 2022
Reimbursement Policy Retraction: Sexually Transmitted Infections Testing (Professional)Medicare AdvantageOctober 1, 2022
Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (MAC)Medicare Advantage
Material adverse change (MAC)