Skip to Main Content
Medicaid
Important Prior Authorization Updates: Effective February 1, 2026 (PDF) Notice of Updated or Retired Clinical Policies (PDF) 2025 Continuity of Care (CoC) Program Announcing partnership with Healthmap Solutions Best Practices to Address Disparities in Tobacco Cessation (PDF) Notice of Updated or Retired Clinical Policies- Effective 8/15/25 (PDF) Tobacco Cessation Benefits (PDF) Optum Provider Portal Upgrades (PDF) H2027 and H0038 Limits Policy Resumption of Utilization Management Policies for Behavioral Health Services WellCare of Kentucky Behavioral Health Pre-certification Phone Line Medicaid Prior Authorization Updates: Effective 07/01/2025 Notice of Updated or Retired Clinical Policies - Effective 5/15/25 (PDF) 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
