Humana Medicaid has implemented a new claim processing edit for therapy services for the state of Indiana. In this article, I will answer the following questions

UnitedHealthcare Community Plan has published 2 Reimbursement Policies, one for providers who submit claims on a 1500-claim form (Professional) and one for providers who submit claims on a UB-04 claim form (Facility). The policies list which CPT codes are and are not covered by the different state’s Medicaid program. To access the policy for providers who submit claims on a 1500-claim form, click To access the policy for providers who submit claims on a UB-04 claim form, click I hope you found this article helpful to your practice or organization. Thank you for being a Gold Member!

Here are 2 updates regarding telehealth services being expanded to outpatient therapy services. Effective March 30, 2020, NC Medicaid is temporarily modifying its Telemedicine and Telepsychiatry Clinical Coverage Policy to better enable the delivery of remote care to Medicaid and NC Health Choice beneficiaries. These temporary changes will be retroactive to March 10, 2020, and will end the earlier of the cancellation of the North Carolina state of emergency declaration or when this policy is rescinded. Click HERE to read the special bulletin and its application to outpatient physical, occupational and speech therapy services. Blue Cross Blue Shield (BCBS) of North Carolina

The North Carolina Physical Therapy Association has provided updated Reimbursement and Practice Updates Related to the Covid-19 Pandemic. To access the update, click HERE.

Florida Medicaid has expanded telehealth coverage to the following: • Behavior analysis services • Therapy services • Specified behavioral health services • Early intervention services Click HERE to access the article.

On March 20, 2020, South Dakota Medicaid has added temporary coverage of occupational therapy and physical therapy via telemedicine for patients at high risk for COVID-19 or under quarantine or social distancing during a declared emergency for COVID-19. Therapy services may only utilize telemedicine if the patient and provider have previously met for in-person services. Use of telemedicine for the convenience of the provider or recipient is not covered. South Dakota Medicaid has updated the Telemedicine Billing and Policy Manual to allow coverage for CPT codes 97530, 97110, and 97112. Telemedicine coverage is also available for school districtsunder CPT codes