CommercialMedicare AdvantageMedicaidFebruary 1, 2025

February 2025 Provider Newsletter

Administrative

AdministrativeCommercialJanuary 16, 2025

Submitting authorization for NICU services facilitates accurate and timely claims processing

AdministrativeCommercialFebruary 1, 2025

Medical records needed for accurate payment of certain facility inpatient claims

AdministrativeCommercialJanuary 30, 2025

PT and OT fee increase for Commercial products

AdministrativeCommercialMedicare AdvantageMedicaidFebruary 1, 2025

New Communication Center added to Availity Essentials

Education & Training

Education & TrainingCommercialMedicare AdvantageMedicaidJanuary 1, 2025

Enhance billing and coding accuracy with new Payment Integrity training

Policy Updates

Medical Policy & Clinical GuidelinesCommercialFebruary 1, 2025

Medical Policy and Clinical Guideline updates

Medical Policy & Clinical GuidelinesCommercialFebruary 1, 2025

Clinical Criteria updates for specialty pharmacy

Reimbursement PoliciesCommercialFebruary 1, 2025

Reimbursement policy update: Diagnostic Radiopharmaceuticals and Contrast Materials — Professional and Facility

Reimbursement PoliciesCommercialFebruary 1, 2025

New reimbursement policy: Place of Service — Professional

Products & Programs

Federal Employee Program (FEP)CommercialFebruary 1, 2025

Corrected claim guidance for the Federal Employee Program®

Federal Employee Program (FEP)CommercialJanuary 14, 2025

Authorization for post‑acute care services for FEP members

PharmacyCommercialFebruary 1, 2025

Pharmacy information available on our provider website

PharmacyCommercialJanuary 27, 2025

Key formulary updates: effective January 1, 2025

PharmacyMedicaidJanuary 6, 2025

Prior authorization updates for medications billed under the medical benefit

Effective March 1, 2025
Kisunla and Piasky

Quality Management

Quality ManagementCommercialFebruary 1, 2025

Avoidance of Antibiotics Treatment for Acute Bronchitis/Bronchiolitis (AAB)

Optimizing HEDIS & STARSCommercialMedicare AdvantageFebruary 1, 2025

2025 Clinical Quality in Practice webinar series

NYBCBS-CDCRCM-076704-25