ALERTs

AS Modifier Utilization for CRNP & PA Claims
Dec 5, 2023  -  Effective for dates of service on or after January 1, 2024, Medicaid has updated its claim processing system to require the use of the AS modifier for applicable procedure codes when a CRNP or PA assists with surgery. Please review the attached listing of procedure codes that require the AS modifier.
Changes to Hepatitis C Prior Authorization (PA) Criteria
Dec 1, 2023  -  Effective October 1, 2022, the Alabama Medicaid Agency removed the requirement of absence of alcohol and illicit drug use by recipients for the prior approval of antiviral drugs used in the treatment of hepatitis C.
Preferred Drug List (PDL) and Pharmacy Quarterly Update
Dec 1, 2023  -  Effective January 1, 2024, the Alabama Medicaid Agency will Continue to monitor the stimulant shortage affecting ADHD medications.
New Coverage for ACIP Recommended Vaccines (for Non-Pharmacy Providers)
Nov 30, 2023  -  Effective for dates of service on or after October 1, 2023, Alabama Medicaid received approval to cover the Advisory Committee on Immunization Practices (ACIP) recommended vaccines and their administration, without cost sharing, for adults aged 19 and older.

Recent ALERTs


Date 
Dec 5, 2023 AS Modifier Utilization for CRNP & PA Claims
Dec 1, 2023 Changes to Hepatitis C Prior Authorization (PA) Criteria
Dec 1, 2023 Preferred Drug List (PDL) and Pharmacy Quarterly Update
Nov 30, 2023 New Coverage for ACIP Recommended Vaccines (for Non-Pharmacy Providers)
Nov 30, 2023 Coverage for Adult Vaccines/COVID Vaccines and Administration (Pharmacy Providers)
Nov 16, 2023 Reminder of Resumption of Ambulance Provider Requirements after the COVID-19 PHE
Nov 2, 2023 Changes to Hepatitis C Prior Authorization (PA) Criteria
Oct 31, 2023 New Coverage for Procedure Code 92229: Imaging of Retina for Disease Detection
Oct 25, 2023 Billing for Items and Services in Connection with Dental Care Provided
Oct 16, 2023 New Coverage for Novavax COVID-19 Vaccine (for Non-Pharmacy Providers)
Oct 11, 2023 Opioid Cumulative Daily Morphine Milligram Equivalents (MME) Limit – MME Decrease
Oct 10, 2023 Durable Medical Equipment (DME) Program Updates Related to Continuous Glucose Monitor (CGM) Update
Oct 4, 2023 Changes to Hepatitis C Prior Authorization (PA) Criteria
Oct 4, 2023 New Coverage for COVID-19 Vaccine (for Non-Pharmacy Providers)
Sep 22, 2023 Rate Change for EPSDT Interperiodic Evaluation and Management (E&M) Procedure Codes
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Provider ALERTs older than 6 years have been archived and are available at www.media.alabama.gov