ALERTs

Coverage Update for 96127, Extended to Pregnant and Postpartum Recipients over 21
Nov 24, 2025  -  Effective January 1, 2026, the Alabama Medicaid Agency will update coverage of procedure code 96127 to allow for prenatal and postpartum depression screening to pregnant recipients over the age of 21.
Reminder - Maternity Bonus Payment Opportunities
Nov 12, 2025  -  Effective October 1, 2024, Maternity Care Providers (MCPs) are reimbursed for the specified MCP bonus payments at the following rates:
Changes to Non-Pharmacy Prior Authorization Process
Nov 12, 2025  -  Beginning January 1, 2026, the Alabama Medicaid Agency (Medicaid) will implement changes to the prior authorization (PA) process for non-pharmacy PAs to comply with the CMS Interoperability and Prior Authorization Final Rule. This Final Rule does not apply to pharmacy PA requests.
REVISED - Continuous Glucose Monitor Policy Updates
Oct 24, 2025  -  Effective October 1, 2025, Continuous Glucose Monitors (CGMs) will be covered through the Durable Medical Equipment (DME) Program with prior authorization (PA) for recipients (children and adults) with one of the following: type 1 diabetes mellitus and type 2 diabetes mellitus AND are insulin treated with multiple (three or more) daily injections of insulin.

Recent ALERTs


Date 
Nov 24, 2025 Coverage Update for 96127, Extended to Pregnant and Postpartum Recipients over 21
Nov 12, 2025 Reminder - Maternity Bonus Payment Opportunities
Nov 12, 2025 Changes to Non-Pharmacy Prior Authorization Process
Oct 24, 2025 REVISED - Continuous Glucose Monitor Policy Updates
Oct 24, 2025 Partial Gainwell System Outage – Scheduled Maintenance
Oct 22, 2025 Laboratory Fee Schedule
Oct 6, 2025 EPSDT Services for Justice Involved Youth
Sep 26, 2025 RSV Prevention in Children Criteria for the 2025–2026 Season
Sep 26, 2025 Continuous Glucose Monitor Policy Updates
Sep 24, 2025 Presumptive Eligibility for Pregnancy (PEP), Effective October 1, 2025
Sep 24, 2025 Prior Authorization Management
Sep 23, 2025 Coverage of G0330 for ASCs
Sep 22, 2025 Rate Increases for ACHN Participation and Primary Care Bump
Sep 22, 2025 Dental Participation Payment
Sep 20, 2025 MMIS Systems Scheduled Maintenance COMPLETE
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Provider ALERTs older than 6 years have been archived and are available at www.media.alabama.gov