CommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsMarch 1, 2025

March 2025 Provider Newsletter

Featured Articles

Digital SolutionsCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsMarch 1, 2025

Reminder: provider data attestation

Education & TrainingCommercialMarch 1, 2025

You are invited: Availity Essentials overview

Administrative

AdministrativeCommercialMarch 1, 2025

Certain modifiers for outpatient claims will receive prepayment coding review

AdministrativeCommercialMarch 1, 2025

Update: Drug claims edits to focus on FDA‑approved indications

AdministrativeCommercialMarch 1, 2025

New coding guidelines: include the anatomic modifier

Digital SolutionsCommercialNovember 1, 2024

Adopting digital member ID cards

Digital SolutionsCommercialFebruary 4, 2025

Expansion of Carelon Medical Benefits Management, Inc. programs

Education & Training

Education & TrainingCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJanuary 1, 2025

Enhance billing and coding accuracy with new Payment Integrity training

WebinarsCommercialFebruary 21, 2025

Start 2025 with an easy way to earn continuing education credits

Policy Updates

Policy UpdatesBadgerCare Plus and Medicaid SSI ProgramsJanuary 30, 2025

Clinical Criteria updates

Effective March 7, 2025

Policy UpdatesMedicare AdvantageFebruary 14, 2025

Clinical Criteria updates

Effective March 24, 2025

Medical Policy & Clinical GuidelinesBadgerCare Plus and Medicaid SSI ProgramsFebruary 17, 2025

MCG Care Guidelines 29th edition

Effective June 1, 2025

Medical Policy & Clinical GuidelinesCommercialFebruary 18, 2025

MCG Care Guidelines 29th edition

Effective June 1, 2025

Medical Policy & Clinical GuidelinesMedicare AdvantageFebruary 20, 2025

MCG Care Guidelines 29th edition

Effective June 1, 2025

Products & Programs

Federal Employee Program (FEP)CommercialMarch 1, 2025

Changes in Postal Service Health Benefits for 2025

PharmacyBadgerCare Plus and Medicaid SSI ProgramsFebruary 19, 2025

Prior authorization updates for medications billed under the medical benefit

Effective April 1, 2025
Anktiva, Hercessi, and Imdelltra

PharmacyBadgerCare Plus and Medicaid SSI ProgramsFebruary 24, 2025

Prior authorization updates for medications billed under the medical benefit

Effective April 1, 2025
Tevimbra and Tyenne

PharmacyBadgerCare Plus and Medicaid SSI ProgramsFebruary 25, 2025

Prior authorization updates for medications billed under the medical benefit

Effective April 1, 2025
Orencia and Avsola

WIBCBS-CDCRCM-078147-25 , CPN78072