2022 Fast Facts

December 29, 2022
Winter issue of Connections now online (PDF)
December 20, 2022
Benefit limit exception (BLE) process reminder (PDF)
December 8, 2022
Changes to the 2023 Statewide Preferred Drug List (PDL) (PDF)
December 7, 2022
Inpatient (IP) claims and Medicare Part B billing recommendations (PDF)
November 17, 2022
Correction: new solution for online prior authorizations launch dates (PDF)
November 17, 2022
Third-party liability and coordination of benefits reminder (PDF)
October 27, 2022
2022 – 2023 flu vaccination (PDF)
October 12, 2022
Update: Naloxone take-home distribution by federally qualified health centers (FQHCs) and rural health clinics (RHCs) (PDF)
October 6, 2022
Adult vaccine procedure code updates and additions (PDF)
September 29, 2022
Reinstatement of prior authorization requirements for shift care services for members under 21 years of age (PDF)
September 20, 2022
Implicit bias training (PDF)
September 15, 2022
Surgical procedure anatomical modifier requirement (PDF)
September 14, 2022
Additions to the Medical Assistance fee schedule for monkeypox laboratory testing and vaccines (PDF)
September 12, 2022
Reminder: requirement to utilize in-network laboratory service providers (PDF)
September 8, 2022
2022 Keystone First Dental Provider Supplement now available online (PDF)
September 7, 2022
Billing for repairs to home accessibility durable medical equipment (DME) (PDF)
August 31, 2022
Check member eligibility due to changes in HealthChoices membership starting September 1, 2022 (PDF)
August 25, 2022
Changes to membership in HealthChoices starting September 1, 2022 (PDF)
August 16, 2022
Update: prior authorization for septoplasty, submucous resection (PDF)
August 9, 2022
Updated and enhanced remark codes on Explanation of Benefits (EOBs) (PDF)
July 27, 2022
Ordering and dispensing blood pressure monitors (PDF)
July 26, 2022
Summer issue of Connections now online (PDF)
July 6, 2022
Important change to blood lead reference value (PDF)
June 28, 2022
Updated 2022 Provider Manual now available online (PDF)
June 23, 2022
2022 recommended childhood and adolescent immunization schedule now online (PDF)
June 15, 2022
Clarification: continued stay coverage, review, and billing reminders (PDF)
June 9, 2022
Changes to Pennsylvania’s HealthChoices physical health plans (PDF)
May 18, 2022
Take the annual mandatory fraud, waste, and abuse training (PDF)
May 11, 2022
Continued stay coverage, review, and billing reminders (PDF)
May 11, 2022
June 2022 formulary changes (PDF)
May 11, 2022
2022 medical provider claims filing instructions now available (PDF)
April 5, 2022
Prior authorization submission tip sheet (PDF)
March 30, 2022
Update to home accessibility durable medical equipment (DME) coverage and billing (PDF)
March 25, 2022
March issue of our provider newsletter, Connections, now online (PDF)
March 23, 2022
Update to Modifier 25 policy (PDF)
March 21, 2022
Our 2022 Quality Enhancement Program manual is now available (PDF)
March 9, 2022
Introduction of a new procedure code (T1019) for Electronic Visit verification (EVV) reporting for Personal Care Services (PCS) (PDF)
March 1, 2022
NaviNet upgrades for Condition Optimization Program (formerly Intensive Case Management Program) (PDF)
February 23, 2022
New COMPASS℠ program (specialty providers) (PDF)
February 23, 2022
New COMPASS℠ program (primary care providers) (PDF)
January 10, 2022
CPT codes for pediatric Pfizer, Inc. SARS-CoV-2 vaccine (PDF)
January 3, 2022
Update: formulary changes (PDF)

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Providers