Notice of Material Changes/Amendments to Contract and Prior Authorization Changes - November 2020

Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements starred (*) below.

 

• Prior authorization updates for specialty pharmacy are available*
• Medical policy and clinical guideline updates*
• Correction to Prior Authorization Update for Commercial business*
• New reimbursement policy: Documentation Standards for Episodes of Care (Professional)*
• Reimbursement policy update: Modifier rules (Professional)*
• Reimbursement policy update: Bundled Services and Supplies (Professional)*