Provider Bulletins
Medicaid
- Medicaid Prior Authorization Updates: Effective 07/01/2025
- Notice of Updated or Retired Clinical Policies (PDF)
- Resuming Concurrent Review for Inpatient Psychiatric and PRTF Admissions
- Pharmacy Update: Q0138 and J0897
- Therapeutic Behavioral Health (H2020): Same Day as Another Per Diem Service or Any Psychotherapy
- H2027 and H0038 Notification
- Same-Day Overlapping Services: Psychotherapy, Crisis, IOP
- WellCare transitions to Availity Essentials
- New Optional Supplemental Prior Authorization Form
- View 2024 Provider Summit Presentations by Topic
- Health Alert: Pertussis Cases Confirmed (PDF)
- Serving WellCare of Kentucky Enrollees Better by Speaking Their Language
- Medicaid Clinical Appeals and Grievance Mailing Address Change
- Non-Emergency Medical Transportation (NEMT) Physician Certification Statement
- MSK Provider Education Webinars
- Electronic Visit Verification (EVV) for Home Health Care Services (HHCS)
- Claims & Payment Policy: 72-Hour Rule
- Find-a-Provider Directory Communications
- Claims & Payment Policy - Pulmonary Function Testing
- New Century Health Partnership and Prior Authorization Changes
- Wayspring: Supporting Members with Substance Use Disorder (PDF)
- Medicaid Peer Support Services
- Kentucky Medicaid Managed Care Commercial Coding List
- WellCare Medicare and Medicaid Behavioral Health Admissions
- Medicaid Eligibility Renewal
- New Coding Reimbursement Guidelines & Appropriate Place of Service Billing
- Medicaid Prior Authorization Guidance - Updated May 5, 2022
- 275 Claim Attachment Transactions via EDI
- Revised Claims & Payment Policy: Leg Stent Coding Updates
- New Coding Reimbursement Guidelines & Appropriate Place of Service Billing
- New Somatus Care Management Program for patients with CKD/ESRD
- Claims & Payment Policy: Gastrointestinal Pathogen Nucleic Acid Detection Panel Testing
- KY Department of Medicaid Services Updated Prior Authorization Guidelines
- Notification of Change to Outpatient Claim Submission Requirements
- Wellcare's Provider Portal - Providers Love Our New Chat!
- Claims & Payment Policy: New Ophthalmology Medical Necessity Payment Policies
- MS-DRG Prepayment Coding Edits
- Therapy and Pain Management Implementation Delayed
- No Copays/Cost Share for Kentucky Medicaid Members
- Bed Reserve and Therapeutic Pass Reimbursement Update
- WellCare’s Provider Portal – Now with Improved Live Chat!
- Claims & Payment Policy CPP-157: Ultrasound in Pregnancy
- Claims & Payment Policy 158: Dipstick, Venipuncture, & Catheter Edits CORRECTION
- CPP-161: Polymerase Chain Reaction Respiratory Viral Panel Testing
- CPP-163: NICU Level of Care Authorization and Reimbursement Matching
- Policy Update: Short Inpatient Hospital Stays: CP.MP.182
- Claims & Payment Policy CPP-158: Dipstick, Venipuncture, & Catheter Edits
- Updates to Prior Authorization Requirements: Wound Care and Skin Substitutes
- New Portal Features: iCarePath Claim Appeals and Disputes
- Clinical Coverage Guideline: Short Inpatient Hospital Stays
- Targeted Case Management Monthly Limit Reminder
- Collateral Therapy Age Limit Reminder
- BHSO Tier II NTP Billing Coding Changes
- Drug Testing Payment Policy Updates (Effective 07012020)
- Prepayment Clinical Validations Edit Policy Notice (Effective 10152020)
- Claims & Payment Policy (#152): Pre-payment Clinical Validation
- New Portal Features: Edit your authorization online, add attachments,get real-time status and more
- Reinstatement of Prior Authorization Requirements
- New Coding Integrity Guidelines
- Maternal and Child Health Personal Concierge STEPS Program
- Claims & Payment Policy (#148): Post-Payment Review Policy
- Claims & Payment Policy (#145): Incorrect Billing for Severe Malnutrition
- SafeLink Wireless Lifeline Program
- CHFS offers resources for diagnosis/treatment of 2019-nCoV (Novel Coronavirus)
- Claims & Payment Policy (#150): 340B Drug Payment Reduction Policy
- Dialysis Claims Payment Policy
- Notice of Kentucky Medicaid Legislative Changes Impacting DME Providers
- New Urine Drug Testing Guidelines
- Updates to Prior Authorization Requirements