Medicaid Managed Care Policies & Procedures

In accordance with La. R.S. 46:460.51, et seq., prior to adopting, approving, amending, or implementing certain policies or procedures, LDH will publish the proposed policy or procedure for the purpose of soliciting public comments. For this purpose, a policy or procedure, as defined by the statute, shall mean a requirement governing the administration of managed care organizations specific to billing guidelines, medical management and utilization review guidelines, case management guidelines, claims processing guidelines and edits, grievance and appeals procedures and process, other guidelines or manuals containing pertinent information related to operations and pre-processing claims, and core benefits and services.

The following table contains the LDH and managed care organization policies and procedures that are open for public comment.

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Item Number	Policy/Procedure	Date Posted	Comment Period Closed	Status	Document Links
2026-ABH-1433	Member transition	2/13/26	3/30/26	Pending	Member transition
2026-ABH-2349	Bariatric Surgery	2/13/26	3/30/26	Pending	Bariatric Surgery
2026-ABH-2350	BRCA Genetic Testing and Counseling	2/13/26	3/30/26	Pending	BRCA Genetic Testing and Counseling
2026-HUM-2767	CPT-9328	2/13/26	3/30/26	Pending	CPT-9328
2026-HUM-2768	CPT-9327	2/13/26	3/30/26	Pending	CPT-9327
2026-HUM-2778	Documentation Requirements for Hysterectomy and Sterilization	2/13/26	3/30/26	Pending	Documentation Requirements for Hysterectomy and Sterilization
2026-HUM-2788	Correct Coding	2/13/26	3/30/26	Pending	Correct Coding
2026-HBL-2794	Infusion Administration Facility Editing Update	2/13/26	3/30/26	Pending	Infusion Administration Facility Editing Update
2026-LHCC-329	Adverse Determinations	2/13/26	3/30/26	Pending	Adverse Determinations
2026-LHCC-497	Emergency Services Policy	2/13/26	3/30/26	Pending	Emergency Services Policy
2026-ABH-1173	Peer Support Services	2/13/26	3/30/26	Pending	Peer Support Services
2026-HBL-1286	Unlisted or Miscellaneous Codes	2/13/26	3/30/26	Pending	Unlisted or Miscellaneous Codes
2026-HUM-2792	Genetics	2/13/26	3/30/26	Pending	Genetics
2026-HUM-2793	CPT	2/13/26	3/30/26	Pending	CPT
2026-LHCC-1416	Transportation Policy	2/13/26	3/30/26	Pending	Transportation Policy
2026-HUM-2649	LA MCD PAL A	2/13/26	3/30/26	Pending	LA MCD PAL A
2026-HUM-2796	Durable Medical Equipment, Maintenance and Repair	2/13/26	3/30/26	Pending	Durable Medical Equipment, Maintenance and Repair
2026-LHCC-54	Primary Care Provider (PCP) Selection and Change	2/12/26	3/29/26	Pending	Primary Care Provider (PCP) Selection and Change
2026-HBL-819	HBL Provider Manual	2/12/26	3/29/26	Pending	HBL Provider Manual
2026-LHCC-922	Fraud, Waste, and Abuse Plan	2/12/26	3/29/26	Pending	Fraud, Waste, and Abuse Plan
2026-ABH-955	Crisis Intervention (CI) Services	2/12/26	3/29/26	Pending	Crisis Intervention (CI) Services
2026-HUM-1561	Multi-Systemic Therapy (MST)	2/12/26	3/29/26	Pending	Multi-Systemic Therapy (MST)
2026-HUM-1818	Functional Family Therapy (FFT)	2/12/26	3/29/26	Pending	Functional Family Therapy (FFT)
2026-HUM-2782	Genetics	2/12/26	3/29/26	Pending	Genetics
2026-HUM-2783	Correct Coding	2/12/26	3/29/26	Pending	Correct Coding
2026-HUM-2784	Correct Coding	2/12/26	3/29/26	Pending	Correct Coding
2026-HUM-2785	CPT - Lab/Pathology	2/12/26	3/29/26	Pending	CPT - Lab/Pathology
2026-HUM-2786	Correct Coding	2/12/26	3/29/26	Pending	Correct Coding
2026-HUM-2787	CPT-Medicine	2/12/26	3/29/26	Pending	CPT-Medicine
2026-ACLA-2789	Oxygen Concentrators	2/12/26	3/29/26	Pending	Oxygen Concentrators
2026-LHCC-899	Provider Manual PP	2/12/26	3/29/26	Pending	Provider Manual PP
2026-HUM-1535	Community Brief Crisis Support (CBCS)	2/12/26	3/29/26	Pending	Community Brief Crisis Support (CBCS)
2026-HUM-1580	Personal Care Services (PCS) for Adults with Serious Mental Illness (SMI)	2/12/26	3/29/26	Pending	Personal Care Services (PCS) for Adults with Serious Mental Illness (SMI)
2026-ACLA-1870	Behavioral Health Crisis Care	2/12/26	3/29/26	Pending	Behavioral Health Crisis Care
2026-LHCC-1912	Multi-Systemic Therapy	2/12/26	3/29/26	Pending	Multi-Systemic Therapy
2026-HUM-2180	Homebuilders	2/12/26	3/29/26	Pending	Homebuilders
2026-ACLA-2201	Therapeutic Group Homes	2/12/26	3/29/26	Pending	Therapeutic Group Homes
2026-HUM-2724	Freestanding Psychiatric Hospital for Adults ILOS	2/12/26	3/29/26	Pending	Freestanding Psychiatric Hospital for Adults ILOS
2026-ACLA-2753	Policy Emergency Department Evaluation and Management, Facility	2/12/26	3/29/26	Pending	Policy Emergency Department Evaluation and Management, Facility
2026-ABH-2761	Louisiana Visions of Hope Community Services Program	2/12/26	3/29/26	Pending	Louisiana Visions of Hope Community Services Program
2026-LHCC-725	CT/MRI Guidance for Needle Placement-CT Guidance for Radiation Fields	2/10/26	3/27/26	Pending	CT/MRI Guidance for Needle Placement-CT Guidance for Radiation Fields
2026-LHCC-768	Urgent/Emergent Criteria	2/10/26	3/27/26	Pending	Urgent/Emergent Criteria
2026-LHCC-770	Fractional Flow Reserve CT	2/10/26	3/27/26	Pending	Fractional Flow Reserve CT
2026-LHCC-1212	Spinal Cord Stimulation	2/10/26	3/27/26	Pending	Spinal Cord Stimulation
2026-LHCC-1218	Ventricular Assist Devices	2/10/26	3/27/26	Pending	Ventricular Assist Devices
2026-LHCC-1270	Urinary Incontinence Devices and Treatments	2/10/26	3/27/26	Pending	Urinary Incontinence Devices and Treatments
2026-LHCC-1271	Implantable Hypoglossal Nerve Stimulation for OSA	2/10/26	3/27/26	Pending	Implantable Hypoglossal Nerve Stimulation for OSA
2026-LHCC-1275	Oxygen Use and Concentrators	2/10/26	3/27/26	Pending	Oxygen Use and Concentrators
2026-HUM-1606	Louisiana UM Program Description	2/10/26	3/27/26	Pending	Louisiana UM Program Description
2026-LHCC-1764	Single Photon Emission Computed Tomography SPECT	2/10/26	3/27/26	Pending	Single Photon Emission Computed Tomography SPECT
2026-LHCC-1819	Burn Surgery	2/10/26	3/27/26	Pending	Burn Surgery
2026-LHCC-1821	Selective Dorsal Rhizotomy for Spasticity in CP	2/10/26	3/27/26	Pending	Selective Dorsal Rhizotomy for Spasticity in CP
2026-LHCC-1823	Mechanical Stretch devices	2/10/26	3/27/26	Pending	Mechanical Stretch devices
2026-LHCC-1824	Electric Tumor Treatment Fields	2/10/26	3/27/26	Pending	Electric Tumor Treatment Fields
2026-LHCC-1825	Proton and Neutron Beam Therapies	2/10/26	3/27/26	Pending	Proton and Neutron Beam Therapies
2026-LHCC-1837	Obstetrical Home Care Programs	2/10/26	3/27/26	Pending	Obstetrical Home Care Programs
2026-LHCC-1844	Transplant Service Documentation Requirements	2/10/26	3/27/26	Pending	Transplant Service Documentation Requirements
2026-LHCC-1905	Stereotactic Body Radiation Therapy	2/10/26	3/27/26	Pending	Stereotactic Body Radiation Therapy
2026-LHCC-1906	Facility-Based Sleep Studies for OSA	2/10/26	3/27/26	Pending	Facility-Based Sleep Studies for OSA
2026-LHCC-1907	Hyperhidrousis Treatments	2/10/26	3/27/26	Pending	Hyperhidrousis Treatments
2026-LHCC-1910	Implantable Intrathecal or Epidural Pain Pump	2/10/26	3/27/26	Pending	Implantable Intrathecal or Epidural Pain Pump
2026-LHCC-1948	Implantable Loop recorder	2/10/26	3/27/26	Pending	Implantable Loop recorder
2026-HUM-2797	Clinical Trials	2/10/26	3/27/26	Pending	Clinical Trials
2026-HUM-1543	EPSDT Personal Care Services (PCS)	2/10/26	3/27/26	Pending	EPSDT Personal Care Services (PCS)
2026-HUM-1590	Chiropractic ILOS	2/10/26	3/27/26	Pending	Chiropractic ILOS
2026-HUM-1664	Pediatric Day Health Care Clinical Coverage Policy	2/10/26	3/27/26	Pending	Pediatric Day Health Care Clinical Coverage Policy
2026-HUM-1669	Wound Care Clinical Coverage policy	2/10/26	3/27/26	Pending	Wound Care Clinical Coverage policy
2026-HUM-2686	Revenue Codes	2/10/26	3/27/26	Pending	Revenue Codes
2026-HUM-2754	CPT Evaluation and Management Service	2/10/26	3/27/26	Pending	CPT Evaluation and Management Service
2026-ABH-2762	Multiple Gestation	2/10/26	3/27/26	Pending	Multiple Gestation
2026-ABH-2763	Skyrizi	2/10/26	3/27/26	Pending	Skyrizi
2026-LHCC-608	Appeal of UM Decision	2/10/26	3/27/26	Pending	Appeal of UM Decision
2026-LHCC-1522	Notification of Pregnancy (NOP) Policy	2/10/26	3/27/26	Pending	Notification of Pregnancy (NOP) Policy
2026-LHCC-1841	MNC Policy for CPST and PSR	2/10/26	3/27/26	Pending	MNC Policy for CPST and PSR
2026-HUM-2608	Outpatient Lactation Support ILOS	2/10/26	3/27/26	Pending	Outpatient Lactation Support ILOS
2026-HUM-2718	Chiropractic Billing Guide	2/10/26	3/27/26	Pending	Chiropractic Billing Guide
2026-ACLA-2720	Home Delivered Meals	2/10/26	3/27/26	Pending	Home Delivered Meals
2026-HBL-2752	EXPRESS CDE Chisholm ABA	2/10/26	3/27/26	Pending	EXPRESS CDE Chisholm ABA
2026-LHCC-129	Provider Directory and Electronic Files from Portico	2/10/26	3/27/26	Pending	Provider Directory and Electronic Files from Portico
2026-LHCC-131	Vendor Management, JOC Attendees	2/10/26	3/27/26	Pending	Vendor Management, JOC Attendees
2026-LHCC-606	Grievance Process	2/10/26	3/27/26	Pending	Grievance Process
2026-LHCC-634	Encounter Data	2/10/26	3/27/26	Pending	Encounter Data
2026-LHCC-926	Provider Appointment Accessibility Standards	2/10/26	3/27/26	Pending	Provider Appointment Accessibility Standards
2026-LHCC-1877	Provider Directory for Members	2/10/26	3/27/26	Pending	Provider Directory for Members
2026-LHCC-1925	Specialty Pharmacy Program	2/10/26	3/27/26	Pending	Specialty Pharmacy Program
2026-UHC-2251	Private Duty Nursing (PDN) and Extended Home Health (EhH)	2/10/26	3/27/26	Pending	Private Duty Nursing (PDN) and Extended Home Health (EhH)
2026-LHCC-829	Interrater Reliability - Act 421	2/9/26	3/26/26	Pending	Interrater Reliability - Act 421
2026-HUM-2730	CPT	2/9/26	3/26/26	Pending	CPT
2026-HUM-2731	Correct Coding	2/9/26	3/26/26	Pending	Correct Coding
2026-HUM-2732	CPT Evaluation and Management Services	2/9/26	3/26/26	Pending	CPT Evaluation and Management Services
2026-HUM-2733	CPT Evaluation and Management Services	2/9/26	3/26/26	Pending	CPT Evaluation and Management Services
2026-HUM-2734	CPT Evaluation and Management Services	2/9/26	3/26/26	Pending	CPT Evaluation and Management Services
2026-HUM-2735	CPT Evaluation and Management Services	2/9/26	3/26/26	Pending	CPT Evaluation and Management Services
2026-HUM-2736	Units	2/9/26	3/26/26	Pending	Units
2026-HUM-2741	Drugs & Biologicals  HCPCS	2/9/26	3/26/26	Pending	Drugs & Biologicals  HCPCS
2025-LHCC-754	Sinus & Maxillofacial CT limited or localized f/u Sinus CT	2/3/26	3/20/26	Pending	Sinus & Maxillofacial CT limited or localized f/u Sinus CT
2025-LHCC-755	Spinal Canal MRA	2/3/26	3/20/26	Pending	Spinal Canal MRA
2025-LHCC-756	Temporal Bone, Mastoid, Orbits, Sella, Internal Auditory Cancal CT	2/3/26	3/20/26	Pending	Temporal Bone, Mastoid, Orbits, Sella, Internal Auditory Cancal CT
2025-LHCC-757	Temporomandibular Joint (TMJ) MRI	2/3/26	3/20/26	Pending	Temporomandibular Joint (TMJ) MRI
2025-LHCC-758	Thoracic Spine CT	2/3/26	3/20/26	Pending	Thoracic Spine CT
2025-LHCC-759	Thoracic Spine MRI	2/3/26	3/20/26	Pending	Thoracic Spine MRI
2025-LHCC-763	Unlisted Studies	2/3/26	3/20/26	Pending	Unlisted Studies
2025-LHCC-764	Upper Extremity CT (Hand, Wrist, Long bone, or Shoulder CT)	2/3/26	3/20/26	Pending	Upper Extremity CT (Hand, Wrist, Long bone, or Shoulder CT)
2025-LHCC-765	Upper Extremity CT Angiography	2/3/26	3/20/26	Pending	Upper Extremity CT Angiography
2025-LHCC-766	Upper Extremity MRA/MRV	2/3/26	3/20/26	Pending	Upper Extremity MRA/MRV
2025-LHCC-767	Upper Extremity MRI (Hand, Wrist, Elbow, Long bone, or Shoulder MRI)	2/3/26	3/20/26	Pending	Upper Extremity MRI (Hand, Wrist, Elbow, Long bone, or Shoulder MRI)
2025-LHCC-769	Cardiac Resynchonization Terapy (CRT)	2/3/26	3/20/26	Pending	Cardiac Resynchonization Terapy (CRT)
2025-LHCC-771	Heart Catheterization	2/3/26	3/20/26	Pending	Heart Catheterization
2025-LHCC-772	Implantable Cardioverter Defibrillator (ICD)	2/3/26	3/20/26	Pending	Implantable Cardioverter Defibrillator (ICD)
2025-LHCC-773	Pacemaker	2/3/26	3/20/26	Pending	Pacemaker
2025-LHCC-775	Stress Echocardiography	2/3/26	3/20/26	Pending	Stress Echocardiography
2025-LHCC-776	Transesophageal (TEE) Echo	2/3/26	3/20/26	Pending	Transesophageal (TEE) Echo
2025-LHCC-778	Transthoracic (TTE) Echo	2/3/26	3/20/26	Pending	Transthoracic (TTE) Echo
2025-LHCC-852	Heart (Cardiac) PET with CT for Attenuation	2/3/26	3/20/26	Pending	Heart (Cardiac) PET with CT for Attenuation
2025-LHCC-732	Heart (cardiac) PET	2/2/26	3/19/26	Pending	Heart (cardiac) PET
2025-LHCC-735	Low Dose CT for Lung Cancer Screening	2/2/26	3/19/26	Pending	Low Dose CT for Lung Cancer Screening
2025-LHCC-736	Lower Extremity CT (foot, ankle, leg or hip CT)	2/2/26	3/19/26	Pending	Lower Extremity CT (foot, ankle, leg or hip CT)
2025-LHCC-737	Lower Extremity CT Angiography	2/2/26	3/19/26	Pending	Lower Extremity CT Angiography
2025-LHCC-738	Lower Extremity MRA/MRV	2/2/26	3/19/26	Pending	Lower Extremity MRA/MRV
2025-LHCC-739	Lower Extremity MRI (foot, ankle, knee, leg, or hip MRI)	2/2/26	3/19/26	Pending	Lower Extremity MRI (foot, ankle, knee, leg, or hip MRI)
2025-LHCC-740	Lumbar Spine CT	2/2/26	3/19/26	Pending	Lumbar Spine CT
2025-LHCC-741	Lumbar Spine MRI	2/2/26	3/19/26	Pending	Lumbar Spine MRI
2025-LHCC-742	Myocardial Perfusion Imaging (Nuclear Cardiac Imaging Study)	2/2/26	3/19/26	Pending	Myocardial Perfusion Imaging (Nuclear Cardiac Imaging Study)
2025-LHCC-743	Low Field MRI	2/2/26	3/19/26	Pending	Low Field MRI
2025-LHCC-744	MUGA (Multiple Gated Acquisition) Scan	2/2/26	3/19/26	Pending	MUGA (Multiple Gated Acquisition) Scan
2025-LHCC-745	Neck CT (soft tissue)	2/2/26	3/19/26	Pending	Neck CT (soft tissue)
2025-LHCC-746	Neck CTA	2/2/26	3/19/26	Pending	Neck CTA
2025_LHCC-747	Neck MRA/MRV	2/2/26	3/19/26	Pending	Neck MRA/MRV
2025-LHCC-748	Oncology PET Scans	2/2/26	3/19/26	Pending	Oncology PET Scans
2025-LHCC-749	Pelvis CT	2/2/26	3/19/26	Pending	Pelvis CT
2025-LHCC-750	Pelvis CT Angiography	2/2/26	3/19/26	Pending	Pelvis CT Angiography
2025-LHCC-751	Pelvis MRA	2/2/26	3/19/26	Pending	Pelvis MRA
2025-LHCC-752	Pelvis MRI	2/2/26	3/19/26	Pending	Pelvis MRI
2025-LHCC-753	Orbit, Face, Neck, Sinus MRI	2/2/26	3/19/26	Pending	Orbit, Face, Neck, Sinus MRI
2025-LHCC-706	Brain (Head) MRA/MRV	2/2/26	3/19/26	Pending	Brain (Head) MRA/MRV
2025-LHCC-707	Brain (Head) MRI/Brain (Head) MRI w Internal Auditory Canal	2/2/26	3/19/26	Pending	Brain (Head) MRI/Brain (Head) MRI w Internal Auditory Canal
2025-LHCC-709	Brain PET Scan	2/2/26	3/19/26	Pending	Brain PET Scan
2025-LHCC-711	Breast MRI	2/2/26	3/19/26	Pending	Breast MRI
2025-LHCC-712	CT Coronary Angiography (CCTA)	2/2/26	3/19/26	Pending	CT Coronary Angiography (CCTA)
2025-LHCC-713	Cerebral Perfusion CT	2/2/26	3/19/26	Pending	Cerebral Perfusion CT
2025-LHCC-715	Cervical Spine CT	2/2/26	3/19/26	Pending	Cervical Spine CT
2025-LHCC-716	Cervical Spine MRI	2/2/26	3/19/26	Pending	Cervical Spine MRI
2025-LHCC-717	Chest (Thorax) CT	2/2/26	3/19/26	Pending	Chest (Thorax) CT
2025-LHCC-718	Chest (Thorax) MRI	2/2/26	3/19/26	Pending	Chest (Thorax) MRI
2025-LHCC-719	Chest CTA	2/2/26	3/19/26	Pending	Chest CTA
2025-LHCC-720	Chest MRA	2/2/26	3/19/26	Pending	Chest MRA
2025-LHCC-721	CT (Virtual) Colonoscopy	2/2/26	3/19/26	Pending	CT (Virtual) Colonoscopy
2025-LHCC-722	CT (Virtual) Colonoscopy	2/2/26	3/19/26	Pending	CT (Virtual) Colonoscopy
2025-LHCC-723	CT Bone Density Study	2/2/26	3/19/26	Pending	CT Bone Density Study
2025-LHCC-726	Coronary Artery Calcium Scoring by: EBCT or Non-Contrast CCT	2/2/26	3/19/26	Pending	Coronary Artery Calcium Scoring by: EBCT or Non-Contrast CCT
2025-LHCC-727	Fetal MRI	2/2/26	3/19/26	Pending	Fetal MRI
2025-LHCC-728	Functional Brain MRI	2/2/26	3/19/26	Pending	Functional Brain MRI
2025-LHCC-729	CT Heart CT heart Congenital	2/2/26	3/19/26	Pending	CT Heart CT heart Congenital
2025-LHCC-730	Heart MRI	2/2/26	3/19/26	Pending	Heart MRI
2025-ACLA-1954	Cochlear Implants	1/29/26	3/15/26	Pending	Cochlear Implants
2025-ACLA-2313	Microwave Thermotherapy Lung Kidney Tumors	1/29/26	3/15/26	Pending	Microwave Thermotherapy Lung Kidney Tumors
2025-ACLA-2314	Prostatic Urethral Lift UroLift Benign Prostatic Hypertrophy	1/29/26	3/15/26	Pending	Prostatic Urethral Lift UroLift Benign Prostatic Hypertrophy
2025-ACLA-2319	Opioid Treatment	1/29/26	3/15/26	Pending	Opioid Treatment
2025-LHCC-695	Abdomen CT	1/27/26	3/13/26	Pending	Abdomen CT
2025-LHCC-696	Abdomen CT Angiography	1/27/26	3/13/26	Pending	Abdomen CT Angiography
2025-LHCC-697	Abdomen MRA (Angiography)	1/27/26	3/13/26	Pending	Abdomen MRA (Angiography)
2025-LHCC-698	Abdomen MRI	1/27/26	3/13/26	Pending	Abdomen MRI
2025-LHCC-699	Abdomen/Pelvis CT Combo	1/27/26	3/13/26	Pending	Abdomen/Pelvis CT Combo
2025-LHCC-700	Abdomen/Pelvis CTA	1/27/26	3/13/26	Pending	Abdomen/Pelvis CTA
2025-LHCC-701	CTA Aortogram with Runoff	1/27/26	3/13/26	Pending	CTA Aortogram with Runoff
2025-LHCC-703	Bone Marrow MRI	1/27/26	3/13/26	Pending	Bone Marrow MRI
2025-LHCC-704	Brain (Head) CT	1/27/26	3/13/26	Pending	Brain (Head) CT
2025-LHCC-705	Brain (Head) CTA	1/27/26	3/13/26	Pending	Brain (Head) CTA
2025-LHCC-708	708-Brain (Head) MRS	1/27/26	3/13/26	Pending	Brain (Head) MRS
2025-UHC-826	Surgery of the Elbow	1/9/26	2/23/26	Pending	Surgery of the Elbow
2025-UHC-1830	Hysterectomy	1/9/26	2/23/26	Pending	Hysterectomy