Key Updates
CommercialMedicare AdvantageMedicaidJuly 1, 2025
Benefits of utilization management attestations: a guide for care providers
Recent Updates
CommercialMedicare AdvantageMedicaidJuly 18, 2025
New mandatory fields in roster templateCommercialJuly 14, 2025
Clinical UM Guidelines notificationMedicaidJuly 10, 2025
Quarterly pharmacy formulary change noticeCommercialMedicare AdvantageMedicaidJuly 1, 2025
Benefits of utilization management attestations: a guide for care providersCommercialJuly 1, 2025
Reimbursement policy update: Bundled Services and Supplies — ProfessionalMedicare AdvantageJuly 1, 2025
Implementation of chargemaster‑based claims edit for ER levelingCommercialJuly 1, 2025
A quick guide to understanding JW and JZ modifiersMedicare AdvantageJuly 1, 2025
A quick guide to understanding JW and JZ modifiersCommercialMedicare AdvantageMedicaidJuly 1, 2025
Seamless Provider Enrollment and Network Management through Availity Essentials optimizes the care provider experienceCommercialJuly 1, 2025
Enroll with Availity to verify your provider dataCommercialJuly 1, 2025
Update: essential ICD‑10‑CM compliance for outpatient facility claimsCommercialJuly 1, 2025
CMS drug fee schedule update effective August 1, 2025MedicaidJuly 1, 2025
Member Rights and Responsibilities section is online in the provider manualCommercialMedicare AdvantageMedicaidJuly 1, 2025
Streamlining behavioral health authorizations via Availity EssentialsMedicare AdvantageJuly 1, 2025
Combat diabetes: Close the statin therapy gap for better heart healthCommercialMedicare AdvantageMedicaidJuly 1, 2025
Join the 2025 Clinical Quality in Practice webinar seriesMedicaidJuly 1, 2025
Important information about utilization managementCommercialMedicare AdvantageMedicaidJuly 1, 2025
National Drug Codes (NDCs) are required for professional and outpatient claimsMedicare AdvantageJune 27, 2025
Precertification/prior authorization requirement changesEffective November 1, 2025
Medicare AdvantageJune 27, 2025
Specialty pharmacy precertification list expandedEffective November 1, 2025
Axtle, Bizengri, and Bynfezia pen
Medicare AdvantageJune 23, 2025
Essential information for providers: understanding Medicare Advantage group retiree plansCommercialJune 23, 2025
Precertification/Prior Authorization list change notification July 1, 2025Medicare AdvantageJune 17, 2025
Specialty pharmacy precertification list expansion — key updatesCommercialMedicare AdvantageMedicaidJune 4, 2025
National Drug Codes (NDC) are required for outpatient claimsMedicaidJune 3, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective July 9, 2025
CommercialJune 2, 2025
Specialty pharmacy updates: June 2025CommercialJune 1, 2025
Medical Policies and Clinical Utilization Management Guidelines are now availableCommercialMedicare AdvantageJune 1, 2025
LabCorp and Quest Diagnostics are in-network — reminderCommercialJune 1, 2025
Update to claims system for global surgical procedures for professional providersMedicare AdvantageJune 1, 2025
Bridging the gap: enhancing medication adherence for better health outcomesCommercialMedicare AdvantageMedicaidJune 1, 2025
Submitting BH authorizations in Availity EssentialsCommercialJune 1, 2025
Unlock updated pharmacy insights today — visit our provider websiteCommercialJune 1, 2025
Availity Essentials Provider Overpayments application launchMedicaidJune 1, 2025
Enhance patient care with our Complex Care Management programCommercialMedicare AdvantageMedicaidJune 1, 2025
Registration is now available for our upcoming CME webinar on Integrating Cancer CareMedicare AdvantageJune 1, 2025
Claims guidance: updating inpatient and outpatient bill typesMedicare AdvantageMay 27, 2025
Learn about annual Model of Care training for special needs plansCommercialMedicare AdvantageMedicaidMay 27, 2025
Boost your roster submission skills with Availity EssentialsMedicaidMay 26, 2025
2025 Clinical Practice GuidelinesMedicaidMay 22, 2025
Provider manual updates for Nevada MedicaidCommercialMay 22, 2025
Action required: annual patient safety attestationMedicare AdvantageMay 22, 2025
New specialty pharmacy medical step therapy requirementsEffective July 1, 2025
Pavblu, Ahzantive, Enzeevu, Opuviz, and Yesafili
MedicaidMay 20, 2025
Prior authorization updates for medications billed under the medical benefitEffective July 1, 2025
Ahzantive, Enzeevu, Opuviz, Pavblu, and Yesafili
MedicaidMay 15, 2025
Prior authorization updates for medications billed under the medical benefitEffective July 1, 2025
Jubbonti; Wyost, Nemluvio, Nypozi, Rytelo, Tecelra, and Yimmugo