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| Item Number | Provider Manual Chapter | Date Posted | Comment Period Closed | Document Links |
|---|---|---|---|---|
| 2021-Professional Services-24 | Section 5.1 – Sinus Procedures | 12/15/21 | 1/29/22 | Section 5.1 – Sinus Procedures |
| 2021-PBMS-1 | Section 37.1 - Covered Services, Exclusions, and Limitations | 12/13/21 | 1/27/22 | Section 37.1 - Covered Services, Exclusions, and Limitations |
| 2021-BH-16 | Section 2.3 – Outpatient Services | 12/2/21 | 1/16/22 | Section 2.3 – Outpatient Services |
| 2021-ROW-10 | Section 38.8 – Record Keeping | 11/17/21 | 1/1/22 | Section 38.8 – Record Keeping |
| 2021-DME-6 | Section 18.2 – Specific Coverage Criteria | 11/16/21 | 12/31/21 | Section 18.2 – Specific Coverage Criteria |
| 2021-BH-15 | Section 2.4 – Addiction - OTP | 11/5/21 | 12/20/21 | Section 2.4 – Addiction - OTP |
| 2021-ROW-9 | Appendix B – Glossary | 11/3/21 | 12/18/21 | Appendix B – Glossary |
| 2021-ROW-8 | Section 38.11 – Incidents, Accidents and Complaints | 11/3/21 | 12/18/21 | Section 38.11 – Incidents, Accidents and Complaints |
| 2021-ROW-7 | Section 38.10 – Program Monitoring | 11/3/21 | 12/18/21 | Section 38.10 – Program Monitoring |
| 2021-ROW-6 | Section 38.9 – Reimbursement –Monitoring. | 11/3/21 | 12/18/21 | Section 38.9 – Reimbursement –Monitoring. |
| 2021-ROW-5 | Section 38.7 – Staffing Requirements | 11/3/21 | 12/18/21 | Section 38.7 – Staffing Requirements |
| 2021- ROW-4 | Section 38.5 – Service Access and Authorization | 11/3/21 | 12/18/21 | Section 38.5 – Service Access and Authorization |
| 2021-ROW-3 | Section 38.4 – Rights and Responsibilities | 11/3/21 | 12/18/21 | Section 38.4 – Rights and Responsibilities |
| 2021-Professional Services-23 | Section 5.1 - Covered Services – Cardiovascular | 10/29/21 | 12/13/21 | Section 5.1 - Covered Services – Cardiovascular |
| 2021-Medical Transportation-6 | Section 10.8 – Emergency Ambulance Transportation | 10/22/21 | 12/6/21 | Section 10.8 – Emergency Ambulance Transportation |
| 2021-Medical Transportation-7 | Section 10.13 – Ambulance – Claims and Encounters | 10/22/21 | 12/6/21 | Section 10.13 – Ambulance – Claims and Encounters |
| 2021-ROW-2 | Section 38.3 – Beneficiary Requirements | 10/20/21 | 12/4/21 | Section 38.3 – Beneficiary Requirements |
| 2021-BH-11 | Section 2.2 – Bed Based Services – Crisis Stabilization for Adults | 9/27/21 | 11/11/21 | Section 2.2 – Bed Based Services – Crisis Stabilization for Adults |
| 2021-BH-12 | Section 2.3 – Outpatient Services – Crisis Response Services for Adults | 9/27/21 | 11/11/21 | Section 2.3 – Outpatient Services – Crisis Response Services for Adults |
| 2021-BH-13 | Appendix B – Glossary/Acronyms | 9/27/21 | 11/11/21 | Appendix B – Glossary/Acronyms |
| 2021-BH-14 | Appendix D – Approved Curriculum Equivalency | 9/27/21 | 11/11/21 | Appendix D – Approved Curriculum Equivalency |
| 2021-Medical Transportation-1 | Section 10.1 – Covered Services | 9/24/21 | 11/8/21 | Section 10.1 – Covered Services |
| 2021-Medical Transportation-2 | Section 10.2 – Scheduling and Authorization | 9/24/21 | 11/8/21 | Section 10.2 – Scheduling and Authorization |
| 2021-Medical Transportation-3 | Section 10.3 – Provider Requirements | 9/24/21 | 11/8/21 | Section 10.3 – Provider Requirements |
| 2021-Medical Transportation-4 | Section 10.4 – Provider Responsibilities | 9/24/21 | 11/8/21 | Section 10.4 – Provider Responsibilities |
| 2021-Medical Transportation-5 | Section 10.6 – Claims and Encounters | 9/24/21 | 11/8/21 | Section 10.6 – Claims and Encounters |
| 2021 – Professional Services -22 | Section 5.1 – Covered Services - Cardiology | 9/14/21 | 10/29/21 | Section 5.1 – Covered Services - Cardiology |
| 2021-Professional Services-21 | Section 5.1 - Covered Services - Cochlear Implants | 9/9/21 | 10/24/21 | Section 5.1 - Covered Services - Cochlear Implants |
| 2021-Hospitals-1 | Section 25.6 - Prior Authorization | 9/9/21 | 10/24/21 | Section 25.6 - Prior Authorization |
| 2021-Professional Services-20 | Section 5.1 – Covered Services – Anesthesia | 9/7/21 | 10/22/21 | Section 5.1 – Covered Services – Anesthesia |
| 2021-DME-5 | Section 18.2 – Specific Coverage Criteria | 9/7/21 | 10/22/21 | Section 18.2 – Specific Coverage Criteria |
| 2021-RHC-2 | Section 40.1 – Covered Services | 8/13/21 | 9/26/21 | Section 40.1 – Covered Services |
| 2021-FQHC-2 | Section 22.1 – Covered Services | 8/13/21 | 9/26/21 | Section 22.1 – Covered Services |
| 2021-RHC-1 | Section 40.4 - Reimbursement | 8/10/21 | 9/23/21 | Section 40.4 - Reimbursement |
| 2021-FQHC-1 | Section 22.4 - Reimbursement | 8/10/21 | 9/23/21 | Section 22.4 - Reimbursement |
| 2021-Professional Services-19 | Section 5.1 – Covered Services - EPSDT | 8/10/21 | 9/23/21 | Section 5.1 – Covered Services - EPSDT |
| 2021-Professional Services-18 | Section 5.1 – Covered Services – Skin Substitutes | 8/3/21 | 9/16/21 | Section 5.1 – Covered Services – Skin Substitutes |
| 2021-NOW-4 | Section 32.8 - Record Keeping | 7/27/21 | 9/10/21 | Section 32.8 - Record Keeping |
| 2021-Professional Services-17 | Section 5.1 – Genetic Testing | 7/26/21 | 9/9/21 | Section 5.1 – Genetic Testing |
| 2021-NOW-1 | Section 32.1 – Covered Services | 7/15/21 | 8/29/21 | Section 32.1 – Covered Services |
| 2021-NOW-2 | Section 32.5 – Service Access and Authorization | 7/15/21 | 8/29/21 | Section 32.5 – Service Access and Authorization |
| 2021-NOW-3 | Section 32.6 – Provider Requirements | 7/15/21 | 8/29/21 | Section 32.6 – Provider Requirements |
| 2021-BHS-1 | Section 2.3 – Outpatient Services – Outpatient Therapy by Licensed Practitioners | 7/7/21 | 8/21/21 | Section 2.3 – Outpatient Services – Outpatient Therapy by Licensed Practitioners |
| 2021-ROW Services-1 | Section 38.0 – Overview | 6/23/21 | 8/6/21 | Section 38.0 – Overview |
| 2021-Pharmacy Benefits Management Services - 1 | Section 37.1 – Covered Services | 6/22/21 | 8/5/21 | Section 37.1 – Covered Services |
| 2021-PACE-5 | Section 35.1 – Services | 6/14/21 | 7/29/21 | Section 35.1 – Services |
| 2021-PACE-6 | Section 35.2 – Beneficiary Requirements | 6/14/21 | 7/29/21 | Section 35.2 – Beneficiary Requirements |
| 2021-PACE-7 | Section 35.3 – Service Access and Authorization | 6/14/21 | 7/29/21 | Section 35.3 – Service Access and Authorization |
| 2021-PACE-8 | Section 35.4 – Provider Requirements | 6/14/21 | 7/29/21 | Section 35.4 – Provider Requirements |
| 2021-PACE-9 | Section 35.7 – Reimbursement | 6/14/21 | 7/29/21 | Section 35.7 – Reimbursement |
| 2021-PACE-10 | Section 35.X – Beneficiary Rights and Responsibilities | 6/14/21 | 7/29/21 | Section 35.X – Beneficiary Rights and Responsibilities |
| 2021-PACE-11 | Appendix A - Glossary | 6/14/21 | 7/29/21 | Appendix A - Glossary |
| 2021-Professional Services-7 | Section 5.0 – Overview | 5/20/21 | 7/3/21 | Section 5.0 – Overview |
| 2021-Professional Services-8 | Section 5.1 – Critical Care Services | 5/20/21 | 7/3/21 | Section 5.1 – Critical Care Services |
| 2021-Professional Services-9 | Section 5.1 – Global Surgery Period | 5/20/21 | 7/3/21 | Section 5.1 – Global Surgery Period |
| 2021-Professional Services-10 | Section 5.1 – Gynecology | 5/20/21 | 7/3/21 | Section 5.1 – Gynecology |
| 2021-Professional Services-11 | Section 5.1 – Medical Review | 5/20/21 | 7/3/21 | Section 5.1 – Medical Review |
| 2021-Professional Services-12 | Section 5.1 – Modifiers | 5/20/21 | 7/3/21 | Section 5.1 – Modifiers |
| 2021-Professional Services-13 | Section 5.1 - Obstetrics | 5/20/21 | 7/3/21 | Section 5.1 - Obstetrics |
| 2021-Professional Services-14 | Section 5.1 – Physician Administered Drugs | 5/20/21 | 7/3/21 | Section 5.1 – Physician Administered Drugs |
| 2021-Professional Services-15 | Section 5.1 – Sterilizations | 5/20/21 | 7/3/21 | Section 5.1 – Sterilizations |
| 2021-PBMS-1 | Section 35.5.11- Medication Administration | 4/29/21 | 6/12/21 | Section 35.5.11- Medication Administration |
| 2021-Hospice-2 | Section 24.3 – Covered Service | 4/26/21 | 6/9/21 | Section 24.3 – Covered Service |
| 2021-Hospice–1 | Section 24.2 – Election of Hospice | 4/26/21 | 6/9/21 | Section 24.2 – Election of Hospice |
| 2021-PACE-4 | Section 35.10 – Grievances/Complaints | 4/21/21 | 6/4/21 | Section 35.10 – Grievances/Complaints |
| 2021-PACE-3 | Section 35.9 – Program Quality and Oversight | 4/21/21 | 6/4/21 | Section 35.9 – Program Quality and Oversight |
| 2021-PACE-2 | Section 35.6 – Record Keeping | 4/21/21 | 6/4/21 | Section 35.6 – Record Keeping |
| 2021-PACE-1 | Section 35.0 – Overview | 4/21/21 | 6/4/21 | Section 35.0 – Overview |
| 2021-Behavioral Health Services–2 | Section 2.5 - CSoC | 4/7/21 | 5/23/21 | Section 2.5 - CSoC |
| 2021-Behavioral Health Services–1 | Appendix D – Approved Curriculum Equiv. | 4/7/21 | 5/23/21 | Appendix D – Approved Curriculum Equiv. |
| 2021-Dental Services–16 | Appendix J – Contact Referral Information | 3/31/21 | 5/15/21 | Appendix J – Contact Referral Information |
| 2021-Dental Services–15 | Appendix F – Claim Denial Simplification Process | 3/31/21 | 5/15/21 | Appendix F – Claim Denial Simplification Process |
| 2021-Dental Services–14 | Appendix D – Adjustment-Void Forms and Instructions | 3/31/21 | 5/15/21 | Appendix D – Adjustment-Void Forms and Instructions |
| 2021-Dental Services–13 | Appendix C – Dental Claim Form Instructions | 3/31/21 | 5/15/21 | Appendix C – Dental Claim Form Instructions |
| 2021-Dental Services–12 | Appendix B – Adult Denture Fee Schedule | 3/31/21 | 5/15/21 | Appendix B – Adult Denture Fee Schedule |
| 2021-Dental Services–11 | Appendix A – EPSDT Fee Schedule | 3/31/21 | 5/15/21 | Appendix A – EPSDT Fee Schedule |
| 2021-Dental Services–10 | Section 16.11 – Adult Denture – Prior Authorization | 3/31/21 | 5/15/21 | Section 16.11 – Adult Denture – Prior Authorization |
| 2021-Dental Services–9 | Section 16.9 – Adult Denture – Covered Services | 3/31/21 | 5/15/21 | Section 16.9 – Adult Denture – Covered Services |
| 2021-Dental Services–8 | Section 16.8 – Adult Denture – Beneficiary Eligibility | 3/31/21 | 5/15/21 | Section 16.8 – Adult Denture – Beneficiary Eligibility |
| 2021-Dental Services–7 | Section 16.7 – EPSDT - Prior Authorization | 3/31/21 | 5/15/21 | Section 16.7 – EPSDT - Prior Authorization |
| 2021-Dental Services–6 | Section 16.5 – EPSDT - Covered Services | 3/31/21 | 5/15/21 | Section 16.5 – EPSDT - Covered Services |
| 2021-Dental Services–5 | Section 16.4 – EPSDT - Securing Services | 3/31/21 | 5/15/21 | Section 16.4 – EPSDT - Securing Services |
| 2021-Dental Services–4 | Section 16.3 – EPSDT - Beneficiary Eligibility | 3/31/21 | 5/15/21 | Section 16.3 – EPSDT - Beneficiary Eligibility |
| 2021-Dental Services–3 | Section 16.2 – Claims Related Information | 3/31/21 | 5/15/21 | Section 16.2 – Claims Related Information |
| 2021-Dental Services–2 | Section 16.1 – Provider Requirements | 3/31/21 | 5/15/21 | Section 16.1 – Provider Requirements |
| 2021-Dental Services–1 | Section 16.0 – Overview | 3/31/21 | 5/15/21 | Section 16.0 – Overview |
| 2021-Professional Services–7 | Section 5.1 – Covered Services - Obstetrics | 3/16/21 | 4/29/21 | Section 5.1 – Covered Services - Obstetrics |
| 2021-Pharmacy–1 | Section 37.1 – Covered Services | 3/10/21 | 4/23/21 | Section 37.1 – Covered Services |
| 2021-Professional Services–1 | Section 5.1 – Covered Services – ‘Incident To’ Services | 2/22/21 | 4/7/21 | Section 5.1 – Covered Services – ‘Incident To’ Services |
| 2021-Professional Services–2 | Section 5.1 – Covered Services – Physician’s Assistant | 2/22/21 | 4/7/21 | Section 5.1 – Covered Services – Physician’s Assistant |
| 2021-Professional Services–3 | Section 5.1 – Covered Services – Preventative Medicine Evaluation | 2/22/21 | 4/7/21 | Section 5.1 – Covered Services – Preventative Medicine Evaluation |
| 2021-Professional Services–4 | Section 5.1 – Covered Services – Prior Authorization | 2/22/21 | 4/7/21 | Section 5.1 – Covered Services – Prior Authorization |
| 2021-Professional Services–5 | Section 5.1 – Covered Services – Professional Fee Schedule | 2/22/21 | 4/7/21 | Section 5.1 – Covered Services – Professional Fee Schedule |
| 2021-Professional Services–6 | Section 5.1 – Covered Services – Prohibited and Non-Covered Services | 2/22/21 | 4/7/21 | Section 5.1 – Covered Services – Prohibited and Non-Covered Services |
| 2021-GIA-1 | General Information and Administration - Section 1.4 – General Claims Filing | 2/9/21 | 3/25/21 | General Information and Administration - Section 1.4 – General Claims Filing |
| 2020-EPSDT Health-1 | EPSDT Health + Idea - Section 20.0 – Overview | 12/28/20 | 2/11/21 | EPSDT Health + Idea - Section 20.0 – Overview |
| 2020-EPSDT Health-2 | EPSDT Health + Idea - Section 20.1 – Covered Services | 12/28/20 | 2/11/21 | EPSDT Health + Idea - Section 20.1 – Covered Services |
| 2020-EPSDT Health-3 | EPSDT Health + Idea - Section 20.2 – Eligibility Criteria | 12/28/20 | 2/11/21 | EPSDT Health + Idea - Section 20.2 – Eligibility Criteria |
| 2020-EPSDT Health-4 | EPSDT Health + Idea - Section 20.3 – Provider Requirements | 12/28/20 | 2/11/21 | EPSDT Health + Idea - Section 20.3 – Provider Requirements |
| 2020-EPSDT Health-5 | EPSDT Health + Idea - Section 20.4 – Program Requirements | 12/28/20 | 2/11/21 | EPSDT Health + Idea - Section 20.4 – Program Requirements |
| 2020-EPSDT Health-6 | EPSDT Health + Idea - Section 20.5 – Record Keeping | 12/28/20 | 2/11/21 | EPSDT Health + Idea - Section 20.5 – Record Keeping |
| 2020-EPSDT Health-7 | EPSDT Health + Idea - Section 20.6 – Reimbursement | 12/28/20 | 2/11/21 | EPSDT Health + Idea - Section 20.6 – Reimbursement |
| 2020-Behavioral Health-10 | Behavioral Health Services - Section 2.3 – Outpatient Services – Peer Support Services | 12/22/20 | 2/5/21 | Behavioral Health Services - Section 2.3 – Outpatient Services – Peer Support Services |
| 2020-Behavioral Health-9 | Behavioral Health Services - Appendix D - Approved Curriculum/Equivalency | 12/22/20 | 2/5/21 | Behavioral Health Services - Appendix D - Approved Curriculum/Equivalency |
| 2020-Behavioral Health-8 | Behavioral Health Services - Appendix E-4 – Evidenced Based Practices – (EBPs) Policy – Multi-Systemic Therapy (MST) | 12/21/20 | 2/4/21 | Behavioral Health Services - Appendix E-4 – Evidenced Based Practices – (EBPs) Policy – Multi-Systemic Therapy (MST) |
| 2020-Independent Labs-1 | Independent Laboratories - Section 27.0 - Overview | 12/9/20 | 1/23/21 | Independent Laboratories - Section 27.0 - Overview |
| 2020-Independent Labs-2 | Independent Laboratories - Section 27.1 – Covered Services | 12/9/20 | 1/23/21 | Independent Laboratories - Section 27.1 – Covered Services |
| 2020-Independent Labs-3 | Independent Laboratories - Section 27.2 – Provider Requirements | 12/9/20 | 1/23/21 | Independent Laboratories - Section 27.2 – Provider Requirements |
| 2020-Independent Labs-4 | Independent Laboratories - Section 27.3 - Reimbursement | 12/9/20 | 1/23/21 | Independent Laboratories - Section 27.3 - Reimbursement |
| 2020-Independent Labs-5 | Independent Laboratories - Appendix A – Fee Schedule | 12/9/20 | 1/23/21 | Independent Laboratories - Appendix A – Fee Schedule |
| 2020-ESRD-1 | End Stage Renal Disease – Covered Services Section 17.1 | 12/8/20 | 1/22/21 | End Stage Renal Disease – Covered Services Section 17.1 |
| 2020-Professional Services-10 | Professional Services - 5.1 – Covered Services – Laboratory and Radiology | 12/8/20 | 1/22/21 | Professional Services - 5.1 – Covered Services – Laboratory and Radiology |
| 2020-Hospital-1 | Hospital - 25.2 – Inpatient Services | 11/18/20 | 1/2/21 | Hospital - 25.2 - Inpatient Services |
| 2020-Behavioral Health Services-7 | Behavioral Health - Appendix F – Covered Services – CSoC Wraparound Model | 11/18/20 | 1/2/21 | Behavioral Health - Appendix F – Covered Services - CSoC Wraparound Model |
| 2020-Behavioral Health Services–6 | Behavioral Health Services - 2.4 – OTP – Addiction | 11/18/20 | 1/2/21 | Behavioral Health Services - 2.4 – OTP - Addiction |
| 2020 Behavioral Health Services–5 | Behavioral Health Services - 2.3 – Outpatient Therapy by Licensed Practitioners | 11/18/20 | 1/2/21 | Behavioral Health Services - 2.3 - Outpatient Therapy by Licensed Practitioners |
| 2020-Behavioral Health Services-4 | Behavioral Health - 2.2 – Bed Based Services (TGH) | 11/18/20 | 1/2/21 | Behavioral Health - 2.2 – Bed Based Services (TGH) |
| 2020-Behavioral Health Services–3 | Behavioral Health Services - 2.2 – Bed Based Services (PRTF) | 11/18/20 | 1/2/21 | Behavioral Health Services - 2.2 - Bed Based Services (PRTF) |
| 2020-Behavioral Health Services-2 | Behavioral Health Services - 2.0 – Overview | 11/18/20 | 1/2/21 | Behavioral Health Services - 2.0 - Overview |
| 2020-Pharmacy-2 | Pharmacy - 37.1– Covered Services | 11/18/20 | 1/2/21 | Pharmacy - 37.1– Covered Services |
| 2020-Professional Services-7 | Professional Services -5.1 – Covered Services – Obstetrics | 11/17/20 | 1/1/21 | Professional Services -5.1 – Covered Services – Obstetrics |
| 2020-Professional Services-8 | Professional Services -5.1 – Covered Services – Breast Surgery | 11/17/20 | 1/1/21 | Professional Services -5.1 – Covered Services – Breast Surgery |
| 2020-Professional Services-9 | Professional Services -5.1 – Covered Services – Bariatric Surgery | 11/17/20 | 1/1/21 | Professional Services -5.1 Covered Services Bariatric Surgery |
| 2020-Professional Services-6 | Professional Services -5.1 – Covered Services – Concurrent Care | 11/13/20 | 12/28/20 | Professional Services -5.1 - Professional Services -Covered Services – Concurrent Care |
| 2020-TRANS-1 | Transportation -10.0 – Overview | 10/29/20 | 12/13/20 | Transportation -10.0 – Overview |
| 2020-TRANS-2 | Transportation -10.1 – Covered Services | 10/29/20 | 12/13/20 | Transportation -10.1 – Covered Services |
| 2020-TRANS-3 | Transportation -10.2 – Scheduling and Authorization | 10/29/20 | 12/13/20 | Transportation -10.2 – Scheduling and Authorization |
| 2020-TRANS-4 | Transportation -10.3 – Provider Requirements | 10/29/20 | 12/13/20 | Transportation -10.3 – Provider Requirements |
| 2020-TRANS-5 | Transportation -10. 4 – Provider Responsibilities | 10/29/20 | 12/13/20 | Transportation -10. 4 – Provider Responsibilities |
| 2020-TRANS-6 | Transportation -10.5 – Record Keeping | 10/29/20 | 12/13/20 | Transportation -10.5 – Record Keeping |
| 2020-TRANS-7 | Transportation -10.6 – Ambulance Overview | 10/29/20 | 12/13/20 | Transportation -10.6 – Ambulance Overview |
| 2020-TRANS-8 | Transportation -10.7 – Emergency Ambulance | 10/29/20 | 12/13/20 | Transportation -10.7 – Emergency Ambulance |
| 2020-TRANS-9 | Transportation -10.8 – Non Emergency Ambulance | 10/29/20 | 12/13/20 | Transportation -10.8 – Non Emergency Ambulance |
| 2020-TRANS-10 | Transportation -10.9 – Air Ambulance | 10/29/20 | 12/13/20 | Transportation -10.9 – Air Ambulance |
| 2020-TRANS-11 | Transportation -10.10 – Ambulance Memberships | 10/29/20 | 12/13/20 | Transportation -10.10 – Ambulance Memberships |
| 2020-TRANS-12 | Transportation -10.11 – Return Trips and Transfers | 10/29/20 | 12/13/20 | Transportation -10.11 – Return Trips and Transfers |
| 2020-TRANS-13 | Transportation -10.12 – Claims and Encounters | 10/29/20 | 12/13/20 | Transportation -10.12 – Claims and Encounters |
| 2020-TRANS-14 | Transportation -10.13 – Record Retention | 10/29/20 | 12/13/20 | Transportation -10.13 – Record Retention |
| 2020-TRANS-15 | Certification of Ambulance Transportation | 10/29/20 | 12/13/20 | Certification of Ambulance Transportation |
| 2020-EarlySteps-1 | Overview | 10/8/20 | 11/22/20 | Overview |
| 2020-EarlySteps-2 | Covered Services | 10/8/20 | 11/22/20 | Covered Services |
| 2020-EarlySteps-3 | Eligibility Criteria | 10/8/20 | 11/22/20 | Eligiblity Criteria |
| 2020-EarlySteps-4 | Provider Requirements | 10/8/20 | 11/22/20 | Provider Requirements |
| 2020-EarlySteps-5 | Program Requirements | 10/8/20 | 11/22/20 | Program Requirements |
| 2020-EarlySteps-6 | Procedure Codes | 10/8/20 | 11/22/20 | Procedure Codes |
| 2020-EarlySteps-7 | Definitions/Acronyms | 10/8/20 | 11/22/20 | Definitions/Acronyms |
| 2020-Professional Services-1 | Professional Services - 5.1 – Diabetes Education | 9/21/20 | 11/5/20 | Professional Services - 5.1 – Diabetes Education |
| 2020-Professional Services-2 | Professional Services - 5.1 – Newborn Care and Discharge | 9/21/20 | 11/5/20 | Professional Services - 5.1 – Newborn Care and Discharge |
| 2020-Professional Services-3 | Professional Services - 5.1 – Oral and Maxillofacial Surgery | 9/21/20 | 11/5/20 | Professional Services - 5.1 – Oral and Maxillofacial Surgery |
| 2020-Professional Services-4 | Professional Services - 5.1 – Outpatient Chemotherapy | 9/21/20 | 11/5/20 | Professional Services - 5.1 – Outpatient Chemotherapy |
| 2020-Professional Services-5 | Professional Services - 5.1 – Psychiatric Services | 9/21/20 | 11/5/20 | Professional Services - 5.1 – Psychiatric Services |
| 2020-Pharmacy-1 | Pharmacy - 31.1 - Covered Services | 9/21/20 | 11/5/20 | Pharmacy - 31.1 - Covered Services |
| 2020-Behavioral Health Services-1 | Behavioral Health Services - 2.4 – Addiction Services | 8/21/20 | 10/5/20 | Behavioral Health Services - 2.4 – Addiction Services |
| 2020-Professional Services-1 | Professional Services - 5.1 – Covered Services – Routine Care Provided to Beneficiaries Enrolled in Clinical Trials | 8/7/20 | 9/21/20 | Section 5.1- Covered Services-Routine Care Provided- Clinical Trials |
| 2020-BH-2 | Behavioral Health Services - Appendix E-1 – Evidence Based Practices (EBPs) | 7/29/20 | 9/12/20 | Appendix E-1 – Evidence Based Practices (EBP) |
| 2020-Professional Services-4 | Professional Services - Section 5.1 – Covered Services - Advance Practice Registered Nurses | 7/21/20 | 9/4/20 | Section 5.1 - Covered Services - Advance Practice Registered Nurses |
| 2020-Professional Services-5 | Professional Services - Section 5.1 – Covered Services - Chiropractic | 7/21/20 | 9/4/20 | Section 5.1 – Covered Services - Chiropractic |
| 2020-Professional Services-6 | Professional Services - Section 5.1 – Covered Services - Consultations | 7/21/20 | 9/4/20 | Section 5.1 – Covered Services - Consultations |
| 2020-Professional Services-7 | Professional Services - Section 5.1 – Covered Services - Hyperbaric Oxygen Therapy | 7/21/20 | 9/4/20 | Section 5.1 – Covered Services - Hyperbaric Oxygen Therapy |
| 2020-Professional Services-8 | Professional Services - Section 5.1 – Covered Services - "Incident To" Services | 7/21/20 | 9/4/20 | Section 5.1 – Covered Services - "Incident To" Services |
| 2020-Professional Services-9 | Professional Services - Section 5.1 – Covered Services - Podiatry | 7/21/20 | 9/4/20 | Section 5.1 – Covered Services - Podiatry |
| 2020-BH-1 | Behavioral Health - Section 2.3 – Outpatient Services - OLP | 6/15/20 | 7/30/20 | Section 2.3 – Outpatient Services - OLP |
| 2020-Professional Services-1 | Professional Services - Section 5.1 – Covered Services - Genetic Testing | 6/12/20 | 7/27/20 | Section 5.1 – Covered Services - Genetic Testing |
| 2020-FQHC-1 | FQHC - Section 22.0 – Overview | 5/29/20 | 7/13/20 | 22.0 Overview |
| 2020-FQHC-2 | FQHC - Section 22.1 – Covered Services | 5/29/20 | 7/13/20 | 22.1 Covered Services |
| 2020-FQHC-3 | FQHC - Section 22.2 – Provider Requirements | 5/29/20 | 7/13/20 | 22.2 Provider Requirements |
| 2020-FQHC-4 | FQHC - Section 22.4 – Reimbursement | 5/29/20 | 7/13/20 | 22.4 Reimbursement |
| 2020-FQHC-5 | FQHC - Appendix F – Behavioral Health Services Examples | 5/29/20 | 7/13/20 | Appendix F Behavioral Health Services |
| 2020-Professional Services-1 | Professional Services - Section 5.1 – Modifiers | 5/19/20 | 7/3/20 | Section 5.1 – Modifiers |
| 2020-Professional Services-2 | Professional Services - Section 5.1 – Telemedicine | 5/19/20 | 7/3/20 | Section 5.1 – Telemedicine |
| 2020-BH Services-1 | Behavioral Health Services - Appendix E-10 – EBP Policy – EMDR Therapy | 5/15/20 | 6/29/20 | Appendix E-10 – EBP Policy – EMDR Therapy |
| 2020-Dental Service-1 | Dental Services -16.5 - EPSDT Covered Services | 5/15/20 | 6/29/20 | 16.5 - EPSDT Covered Services |
| 2020-Dental Services-2 | Dental Services – Appendix B – Adult Denture Fee Schedule | 5/15/20 | 6/29/20 | Appendix B – Adult Denture Fee Schedule |
| 2020-Dental Service-3 | Dental Services – Appendix C – Dental Claim Form Instructions | 5/15/20 | 6/29/20 | Appendix C – Dental Claim Form Instructions |
| 2020-Dental Services-4 | Dental Services – Appendix F – Claim Denial Simplification | 5/15/20 | 6/29/20 | Appendix F – Claim Denial Simplification |
| 2020-ROW-1 | Residential Options Waiver - Appendix E - Billing Codes | 3/25/20 | 5/9/20 | Residential Options Waiver - Appendix E - Billing Codes |
| 2020-PHARM-1 | Pharmacy - 37.1 - Covered Services | 3/19/20 | 5/3/20 | Pharmacy - 37.1 - Covered Services |
| 2020-BH-3 | Behavioral Health Services - 2.6 - Record Keeping | 3/19/20 | 5/3/20 | Behavioral Health Services - 2.6 - Record Keeping |
| 2020-RHC-1 | Rural Health Clinics - Appendix E | 3/4/20 | 4/18/20 | Rural Health Clinics - Appendix E |
| 2020-RHC-2 | Rural Health Clinics - Appendix F | 3/4/20 | 4/18/20 | Rural Health Clinics - Appendix F |
| 2020-BH-1 | Behavioral Health Services - Section 2.0 - Overview | 2/13/20 | 3/29/20 | Behavioral Health Services - Section 2.0 - Overview |
| 2020-BH-2 | Behavioral Health Services - Section 2.3 - Outpatient Services - Rehabilitation Services for Children, Adolescents and Adults | 2/13/20 | 3/29/20 | Behavioral Health Services - Section 2.3 - Outpatient Services - Rehabilitation Services for Children, Adolescents and Adults |
| 2020-Supports Waiver-6 | Supports Waiver - 43.5 – Program Monitoring | 2/10/20 | 3/26/20 | Supports Waiver - 43.5 – Program Monitoring |
| 2020-Supports Waiver-1 | Supports Waiver - 43.0 – Overview | 2/6/20 | 3/22/20 | Supports Waiver - 43.0 – Overview |
| 2020-Supports Waiver-2 | Supports Waiver - 43.1 – Beneficiary Requirements | 2/6/20 | 3/22/20 | Supports Waiver - 43.1 – Beneficiary Requirements |
| 2020-Supports Waiver-3 | Supports Waiver - 43.2 – Rights and Responsibilities | 2/6/20 | 3/22/20 | Supports Waiver - 43.2 – Rights and Responsibilities |
| 2020-Supports Waiver-4 | Supports Waiver - 43.3 – Service Access Authorization | 2/6/20 | 3/22/20 | Supports Waiver - 43.3 – Service Access Authorization |
| 2020-Supports Waiver-5 | Supports Waiver – 43.4 – Covered Services | 2/6/20 | 3/22/20 | Supports Waiver – 43.4 – Covered Services |
| 2020-DME-1 | Durable Medical Equipment - 18.2 – Specific Coverage Criteria | 1/28/20 | 3/13/20 | Durable Medical Equipment - 18.2 – Specific Coverage Criteria |
| 2020-DME-2 | Durable Medical Equipment - 18.5 – Prior Authorization | 1/28/20 | 3/13/20 | Durable Medical Equipment - 18.5 – Prior Authorization |
| 2020-DME-3 | Durable Medical Equipment - Appendix E – Contact Referral Information | 1/28/20 | 3/13/20 | Durable Medical Equipment - Appendix E – Contact Referral Information |
| 2020-DME-4 | Durable Medical Equipment - Appendix I – Breast Pump Form | 1/28/20 | 3/13/20 | Durable Medical Equipment - Appendix I – Breast Pump Form |
| 2020-Hospice-1 | Hospice – 24.2 – Election of Hospice Care | 1/23/20 | 3/8/20 | Hospice – 24.2 – Election of Hospice Care |
| 2020-Hospice-2 | Hospice – Appendix C – Hospice Diagnosis Codes | 1/23/20 | 3/8/20 | Hospice – Appendix C – Hospice Diagnosis Codes |
| 2019-ABA-1 | Section 4.3– Service Authorization Process | 12/27/19 | 2/10/20 | Section 4.3– Service Authorization Process |
| 2019-Pharmacy Benefits Management Services-1 | Section 37.0 – Overview | 12/12/19 | 1/26/20 | Section 37.0 – Overview |
| 2019-Pharmacy Benefits Management Services-2 | Section 37.1 - Covered Services, Limitations, and Exclusions | 12/12/19 | 1/26/20 | Section 37.1 - Covered Services, Limitations, and Exclusions |
| 2019-Pharmacy Benefits Management Services-3 | Section 37.2 – Provider Requirements and Participation Guidelines | 12/12/19 | 1/26/20 | Section 37.2 – Provider Requirements and Participation Guidelines |
| 2019-Pharmacy Benefits Management Services-4 | Section 37.3 – Reimbursement for Pharmacy Services | 12/12/19 | 1/26/20 | Section 37.3 – Reimbursement for Pharmacy Services |
| 2019-Pharmacy Benefits Management Services-5 | Section 37.4 – Managed Care Applicability (NEW) | 12/12/19 | 1/26/20 | Section 37.4 – Managed Care Applicability (NEW) |
| 2019-Pharmacy Benefits Management Services-6 | Section 37.7 – Reserved | 12/12/19 | 1/26/20 | Section 37.7 – Reserved |
| 2019-Pharmacy Benefits Management Services-7 | Section 37.8 – Reserved | 12/12/19 | 1/26/20 | Section 37.8 – Reserved |
| 2019-Pharmacy Benefits Management Services-8 | Section 37.9 – Reserved | 12/12/19 | 1/26/20 | Section 37.9 – Reserved |
| 2019-Pharmacy Benefits Management Services-9 | Section 37.10 – Reserved | 12/12/19 | 1/26/20 | Section 37.10 – Reserved |
| 2019-Pharmacy Benefits Management Services-10 | Section 37.11 – Reserved | 12/12/19 | 1/26/20 | Section 37.11 – Reserved |
| 2019-Pharmacy Benefits Management Services-11 | Section 37.12 – Reserved | 12/12/19 | 1/26/20 | Section 37.12 – Reserved |
| 2019-Pharmacy Benefits Management Services-12 | Section 37.14 – Reserved | 12/12/19 | 1/26/20 | Section 37.14 – Reserved |
| 2019-Pharmacy Benefits Management Services-13 | Section 37.16 – Reserved | 12/12/19 | 1/26/20 | Section 37.16 – Reserved |
| 2019-Pharmacy Benefits Management Services-14 | Section 37.17 – Reserved | 12/12/19 | 1/26/20 | Section 37.17 – Reserved |
| 2019-Pharmacy Benefits Management Services-15 | Section 37.19 – Reserved | 12/12/19 | 1/26/20 | Section 37.19 – Reserved |
| 2019-Pharmacy Benefits Management Services-16 | Section 37.20 – Reserved | 12/12/19 | 1/26/20 | Section 37.20 – Reserved |
| 2019-Pharmacy Benefits Management Services-17 | Section 37.21 – Reserved | 12/12/19 | 1/26/20 | Section 37.21 – Reserved |
| 2019-Pharmacy Benefits Management Services-18 | Section 37.22 – Reserve | 12/12/19 | 1/26/20 | Section 37.22 – Reserved |
| 2019-Pharmacy Benefits Management Services-19 | Appendix A – Forms and Links | 12/12/19 | 1/26/20 | Appendix A – Forms and Links |
| 2019-Pharmacy Benefits Management Services-20 | Appendix B – Claims Related Information | 12/12/19 | 1/26/20 | Appendix B – Claims Related Information |
| 2019-Pharmacy Benefits Management Services-21 | Appendix C – Glossary | 12/12/19 | 1/26/20 | Appendix C – Glossary |
| 2019-Pharmacy Benefits Management Services-22 | Appendix D – Contact Information | 12/12/19 | 1/26/20 | Appendix D – Contact Information |
| 2019-Pharmacy Benefits Management Services-23 | Appendix E – Louisiana Medicaid Single Preferred Drug List (PDL) Fee-for-Service and Managed Care Organizations | 12/12/19 | 1/26/20 | Appendix E – Louisiana Medicaid Single Preferred Drug List (PDL) Fee-for-Service and Managed Care Organizations |
| 2019-Pharmacy Benefits Management Services-24 | Appendix F – Reserved | 12/12/19 | 1/26/20 | Appendix F – Reserved |
| 2019-Pharmacy Benefits Management Services-25 | Appendix G – Reserved | 12/12/19 | 1/26/20 | Appendix G – Reserved |
| 2019-Pharmacy Benefits Management Services-26 | Appendix H – Reserved | 12/12/19 | 1/26/20 | Appendix H – Reserved |
| 2019-Pharmacy Benefits Management Services-27 | Appendix I – Reserved | 12/12/19 | 1/26/20 | Appendix I – Reserved |
| 2019-Pharmacy Benefits Management Services-28 | Appendix J – Reserved | 12/12/19 | 1/26/20 | Appendix J – Reserved |
| 2019-Pharmacy Benefits Management Services-29 | Appendix K – Reserved | 12/12/19 | 1/26/20 | Appendix K – Reserved |
| 2019-Pharmacy Benefits Management Services-30 | Appendix L – Reserved | 12/12/19 | 1/26/20 | Appendix L – Reserved |
| 2019-Pharmacy Benefits Management Services-31 | Appendix M – Reserved | 12/12/19 | 1/26/20 | Appendix M – Reserved |
| 2019-Pharmacy Benefits Management Services-32 | Appendix N – Reserved | 12/12/19 | 1/26/20 | Appendix N – Reserved |
| 2019-Professional Services-1 | Professional Services – Section 5.1 – Covered Services - Acute Hospital Pre-Certification | 12/6/19 | 1/20/20 | Acute Hospital Pre-Certification |
| 2019-Professional Services-2 | Professional Services – Section 5.1 – Covered Services - Adjunct Services | 12/6/19 | 1/20/20 | Adjunct Services |
| 2019-Professional Services-3 | Professional Services – Section 5.1 - Covered Services - Covered Services - Advanced Practice Registered Nurses: Clinical Nurse Specialists, Certified Nurse Practitioners and Nurse Midwives | 12/6/19 | 1/20/20 | Advanced Practice Registered Nurses: Clinical Nurse Specialists, Certified Nurse Practitioners and Nurse Midwives |
| 2019-Professional Services-4 | Professional Services – Section 5.1 – Covered Services - Allergy Testing | 12/6/19 | 1/20/20 | Allergy Testing |
| 2019-Professional Services-5 | Professional Services – Section 5.1 – Covered Services - Bariatric Surgery | 12/6/19 | 1/20/20 | Bariatric Surgery |
| 2019-Professional Services-6 | Professional Services – Section 5.1 – Covered Services - Breast Reconstruction | 12/6/19 | 1/20/20 | Breast Reconstruction |
| 2019-Professional Services-7 | Professional Services – Section 5.1 – Covered Services - Chiropractic Services | 12/6/19 | 1/20/20 | Chiropractic Services |
| 2019-Professional Services-8 | Professional Services – Section 5.1 – Covered Services - Cochlear Implants | 12/6/19 | 1/20/20 | Cochlear Implants |
| 2019-Professional Services-9 | Professional Services – Section 5.1 – Covered Services - Critical Care Services | 12/6/19 | 1/20/20 | Critical Care Services |
| 2019-Professional Services-10 | Professional Services – Section 5.1 – Covered Services - Diabetes Self-Management Training | 12/6/19 | 1/20/20 | Diabetes Self-Management Training |
| 2019-Professional Services-11 | Professional Services – Section 5.1 – Covered Services - Early and Periodic Screening, Diagnosis and Treatment (EPSDT) | 12/6/19 | 1/20/20 | Early and Periodic Screening, Diagnosis and Treatment (EPSDT) |
| 2019-Professional Services-12 | Professional Services – Section 5.1 – Covered Services - Genetic Testing | 12/6/19 | 1/20/20 | Genetic Testing |
| 2019-Professional Services-13 | Professional Services – Section 5.1 – Covered Services - Global Surgery Period | 12/6/19 | 1/20/20 | Global Surgery Period |
| 2019-Professional Services-14 | Professional Services – Section 5.1 – Covered Services - Gynecology | 12/6/19 | 1/20/20 | Gynecology |
| 2019-Professional Services-15 | Professional Services – Section 5.1 – Covered Services – Hyperbaric Oxygen Therapy | 12/6/19 | 1/20/20 | Hyperbaric Oxygen Therapy |
| 2019-Professional Services-16 | Professional Services – Section 5.1 – Covered Services - Immunizations | 12/6/19 | 1/20/20 | Immunizations |
| 2019-BH-1 | Behavioral Health Services - Section 2.4 - Addiction Services | 11/7/19 | 12/22/19 | Section 2.4 |
| 2019-BH-2 | Behavioral Health Services - Section 2.5 - Coordinated System of Care | 11/7/19 | 12/22/19 | Section 2.5 |
| 2019-RHC-2 | Chapter 40 – Rural Health Clinics/40.4 Reimbursement | 10/3/19 | 11/17/19 | Section 40.4 |
| 2019-RHC-1 | Chapter 40 – Rural Health Clinics/40.1 Covered Services | 10/3/19 | 11/17/19 | Section 40.1 |
| 2019-FQHC-2 | Chapter 22 – Federally Qualified Health Centers/22.4 Reimbursement | 10/3/19 | 11/17/19 | Section 22.4 |
| 2019-FQHC-1 | Chapter 22 – Federally Qualified Health Centers/22.1 Covered Services | 10/3/19 | 11/17/19 | Section 22.1 |
| 2019-ABA-2 | Applied Behavior Analysis – Section 4.6 – Coordination of Care | 10/1/19 | 11/15/19 | Section 4.6 |
| 2019-ABA-1 | Applied Behavior Analysis – Section 4.1 – Covered Services | 10/1/19 | 11/15/19 | Section 4.1 |
| 2019-CCW-1 | Community Choices Waiver – Section 7.3 – Recipient Requirements | 9/24/19 | 11/8/19 | Section 7.3 |
| 2019-ADHC-1 | Adult Day Health Care – Section 9.2 – Recipient Requirements | 9/24/19 | 11/8/19 | Section 9.2 |
Medicaid Provider Manuals - Public Comment Archive (2019-2021)
The intent of the provider services manual is to present useful information and guidance to providers participating in the Louisiana Medicaid Program. The first chapter, "General Information and Administration" contains information applicable to all providers. Each remaining chapter is dedicated to a specific program or service and outlines the policies, procedures, qualifications, services and limitations to that service or program. Click here to view current provider manuals. Below are items previously posted for public comment:
RELATED INFO
- Previously posted for public comment
- Previously posted for public comment (2022)
- Public comments submitted