A New Provider Communication has been posted for PHARMACY and DME providers:

• 2023 Coding Changes for Continuous Glucose Monitoring

The following manual has been updated for All Providers:

• General Policy

A New Section has been added: Licensed Mental Health Counselor and Licensed Marriage and Family Therapist (LMHP).
A New manual has been posted:

• Procedure Codes and Fee Schedule

A New Provider Communication has been posted for PHARMACY providers:

• Pharmacy Billing Guidance Exceptions for Non-Enrolled Prescribers in Medicaid

The following Manual has been updated for Applied Behavior Analysis (ABA) providers:

• Policy Guidelines
  
  

The FEE SCHEDULES have been updated for the following providers:

• Midwife
• Nurse Practitioner
• Ordered Ambulatory
• Physician: Medicine

A New Provider Communication has been posted for PHARMACY providers:

• Delay in Update to Coordination of Benefits (COB) Submissions for Medicaid Fee-for-Service (FFS) Pharmacy Billing

A New Provider Communication has been posted for PHARMACY providers:

• Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program

A New Provider Communication has been posted for PHARMACY providers:

• NYS Medicaid Fee-For-Service (FFS) Retroactive Lump Sum Payment for the ATB 1% Increase in Pharmacy Dispensing Fee Payment

The following Policies have been updated for CLINIC providers:

• Policy Guidelines

The following Policies have been updated for LABORATORY providers:

• Policy Guidelines

The following Policies have been updated for PHARMACY providers:

• Policy Guidelines

A New Provider Communication has been posted for PHARMACY providers:

• Medicaid Pharmacy Prior Authorization Programs Update

The following Manuals have been updated for Applied Behavior Analysis (ABA) providers:

• Policy Guidelines
  
  

The following Manuals have been updated for LABORATORY providers:

• Fee Schedule

Three New Provider Communication has been posted for PHARMACY providers:

• Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program
• New York State Medicaid Policy and Billing Guidance for Pharmacy Reimbursement of COVID-19 Oral Antivirals
• Pharmacy Professional Dispensing Fee Update

A New Provider Communication has been posted for PHARMACY providers:

• New York State Medicaid Pharmacy Coverage of Polio Vaccine

The FEE SCHEDULES have been updated for the following providers:

• Midwife
• Nurse Practitioner
• Ordered Ambulatory
• Pharmacy
• Physician: Medicine
• Physician: Drugs
• Physician: Radiology
• Podiatry

The following Manuals have been updated for LABORATORY providers:

• Fee Schedule

The following Manual has been updated for PHARMACY providers:

• Billing Guidelines

The following Manuals have been updated for LABORATORY providers:

• Fee Schedule

The FEE SCHEDULES have been updated for the following providers:

• Nurse Practitioner
• Ordered Ambulatory
• Physician: Medicine

The following Manuals have been updated for LABORATORY providers:

• Fee Schedule

The following Manuals have been updated for MIDWIFE providers:

• Fee Schedule

The following Manuals have been updated for PDN providers:

• Fee Schedule

The following Manuals have been updated for ORDERED AMBULATORY providers:

• Fee Schedule

The following Manuals have been updated for ORDERED AMBULATORY providers:

• Fee Schedule

The PROCEDURE CODES have been updated for the following providers:

• Physician: Medicine and Drugs
• Physician: Radiology

The FEE SCHEDULES have been updated for the following providers:

• Nurse Practitioner
• Ordered Ambulatory
• Pharmacy
• Physician: Medicine
• Physician: Drugs
• Physician: Radiology

A New Provider Communication has been posted for PDN providers:

• Electronic Visit Verification (EVV) Implementation - Private Duty Nursing (PDN)

The following Manual has been updated for FREE STANDING OR HOSPITAL BASED ORDERED AMBULATORY providers:

• Billing Guidelines

The following Manuals have been updated for TRANSPORTATION providers:

• Fee Schedule

The following Policies have been updated for PHARMACY providers:

• Policy Guidelines

The following manual has been updated on the ProDUR-ECCA D.0 Provider Manual page for PHARMACY providers:

• ProDUR-ECCA D.0 Provider Manual

The following manuals have been updated for DENTAL providers:

• Handicapping Labio-Lingual Deviation (HLD) Index Report

The following Manuals have been updated for PHYSICIAN providers:

• Policy Guidelines

The following Manuals have been updated for HEARING AID providers:

• Procedure Codes
• Policy Guidelines

The FEE SCHEDULES have been updated for the following providers:

• Free Standing or Hospital Based Ordered Ambulatory
• Midwife
• Nurse Practitioner
• Pharmacy
• Physician Anesthesia
• Physician Drug
• Physician Medicine
• Physician Radiology
• Physician Surgery
• Podiatry
• Vision Care

The following manual has been updated on the ProDUR-ECCA D.0 Provider Manual page for PHARMACY providers:

• ProDUR-ECCA D.0 Provider Manual

A New Provider Communication has been posted for DME providers:

• Fee for Service DMEPOS Medical Supply Quantity Update

The following manual has been updated on the ProDUR-ECCA D.0 Provider Manual page for PHARMACY providers:

• ProDUR-ECCA D.0 Provider Manual

The following Manuals have been updated for LABORATORY providers:

• Fee Schedule

The following Manuals have been updated for RADIOLOGY providers

• Consult^TM Enhanced Review Process
• Consult^TM HealthHelp IVR System Process