WebAll Other Dental Services You Pay $0 In-Network $50 Out-of-Network $50 The maximum amount Guardian will reimburse you for dental services received Limitations and Exclusions (see your policy for further details) We will not pay Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. %PDF-1.7 % How does the plan save me money? The PCD has primary responsibility for managing your dental care. hbbd```b``v> >d(XM|&c0L*e$li6"A@Lg` hT For Apple Health clients and clients of the Developmental Disabilities Administration. Find your dentist now in Aetnas large nationwide network. 'u s1 ^ They may differ by plan. Find a dental plan thats right for you and your family, based on your needs and budget. other economic conditions. WebMetLife's Preferred Dentist Program allows you to select from a network of dentists who have agreed to charge discounted fees. CMS develops fee schedules for physicians, ambulance services, clinical laboratory services, and durable medical equipment, prosthetics, orthotics, and supplies. Virginia members: In Virginia, DMO is called DNO (Dental Network Only). WebJuly 1, 2022 to present Mobile anesthesia for dental services billing guide; Fee schedules. endstream endobj 4795 0 obj <>stream 0000038186 00000 n Please contact Member Services. {YO2GMP!BJMP(!/(q@>6 0 1 endstream endobj 4797 0 obj <>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 4798 0 obj <>stream w)A7ilBnx_^bu>3E;LU,Nhs%v1&OvC:-R/mTpm:3]q%ih*N This comprehensive listing of fee maximums is used to reimburse a physician and/or other providers on a fee-for-service basis. P|!(}!h}qsPq!F#($FikLuJs?nSG^w;jp*B3&x!W x}k}l~'W)+~KZnsN1MVqy G8O,'"Gg Q Go to the American Medical Association Web site. &~gHE}7m3_I<3I$$MYK2([{/)yRX-aE'[;"%[btE*4AwY+B1]B.. To find a retail location, search by office name. endstream endobj 4803 0 obj <>stream The information you will be accessing is provided by another organization or vendor. 0000142900 00000 n Vision hardware fee schedule is available through the ESD contract. For step-by-step instructions on completing a PA, visit our Prior authorization (PA) page. Orthodontia (adults and children) You pay 50% of covered services. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. endstream endobj 4793 0 obj <>/Metadata 104 0 R/Names 4814 0 R/Pages 4786 0 R/Perms/Filter<>/PubSec<>>>/Reference[<>/Type/SigRef>>]/SubFilter/adbe.pkcs7.detached/Type/Sig>>>>/StructTreeRoot 113 0 R/Type/Catalog>> endobj 4794 0 obj <>stream Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. xref Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Register and log in to your member website. Members cant choose a pediatric dentist as their PCD. The AMA is a third party beneficiary to this Agreement. You or your dentist may also call Member Services. You, your employees and agents are authorized to use CPT only as contained in Aetna Precertification Code Search Tool solely for your own personal use in directly participating in health care programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. hW[O8+~ You must contact us. 0000136999 00000 n Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. These rules determine rxo @ e(m#GIByY6Cs|@5'C/9GL[sN`8!@d2j 0000072009 00000 n Metropolitan Life Insurance Company, New York, NY 10166 WebPlease note all requested contact information is for the provider * Due to contractual requirements, MetLife is prevented from soliciting certain providers. Network dentists are paid contracted fees. Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors). ? If so, the primary care doctor will arrange it. MetLifes Preferred Provider Organization (PPO) plans feature the MetLife Preferred Dentist Program, which is designed to save you money on dental services.1 You can choose from thousands of participating general dentists and specialists nationwide. The secondary plan acts like a supplement to the primary plan. CPT is a registered trademark of the American Medical Association. 0000037280 00000 n %%EOF endstream endobj 4805 0 obj <>stream 163 44 The discussion, analysis, conclusions and positions reflected in the Clinical Policy Bulletins (CPBs), including any reference to a specific provider, product, process or service by name, trademark, manufacturer, constitute Aetna's opinion and are made without any intent to defame. The Apple Health PDL can be found on the agency's Apple Health PDL page. Direct Referral Dental Plan* MET185A. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. Orthodontic treatment from a participating provider doesnt require referrals. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. cy Or contact Member Services for coverage details. (For example, a change made on April 16 will take effect June 1.). Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. HQK0+.y+B")RaO m!n[d]{1|9s}Z2t6BIe)U$}C`u! WebProcedure Fees. Please see your plan documents. endstream endobj 4800 0 obj <>stream H=o0w7S4oA2dhQ,QITEF}v@DN/8LBl^K]H*f:J]yDyS{dZ>L80|8xa@c7iCSY_yLdZ~2}e$LJV\+8CG09s^@wg8pn@\O9C3b\ O1^7TR6:'o9vS rp:QM{9l-k[[@szQV[*P/0chT}($^X'F-Bw)t]V[atF5]@R,hYxk,7Ge^AF*Ul. Bzb:5Gl8%bYYFMG`L"J/rrkBlF)ltPBVW oz If you need interpretation services and are enrolled in the Preferred Dentist Program (Dental 779 0 obj <> endobj License to sue CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. To find out, just call Member Services. Your benefits dont double if you are enrolled in two dental plans. hbbd```b`` Or you can contact Member Services. Ah{sX+AN=SPajl}la3)GfZC^T 0000104077 00000 n Each covered family member can select their own. Use our billing guides and fee schedules to determine if a PA is required and assist in filing claims. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Use the ProviderOne portal to see if a client is eligible for the service and the billing guides and fee schedules to determine if a PA is required. Most PCDs treat children and can refer members to a pediatric dentist, if necessary. 0000037168 00000 n The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. endstream endobj 4796 0 obj <>stream 797 0 obj <>/Filter/FlateDecode/ID[<37A34B695481DA4B83FCA71461750ABE><99A26598FF436C418BD6EB0A4885ABA5>]/Index[779 47]/Info 778 0 R/Length 98/Prev 235657/Root 780 0 R/Size 826/Type/XRef/W[1 3 1]>>stream Visit our Document submission cover sheets page to find the barcode cover sheets required with additional documentation. hbba`b``30 Ga Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. All Rights Reserved. 206 0 obj <>stream U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. HtTYo@~0IOHC WebProvider Agreement Fee Schedules (Please reference the fee schedule noted in your provider agreement, and if appropriate, check the CMS website to review the fee schedule for Medicaid and Medicare Advantage health plans.) Check your Aetna Summary of Benefits. 2023 MetLife Services and Solutions, LLC What you pay will be based on a percentage of those charges (coinsurance). CPT is a registered trademark of the American Medical Association. Hn@})R$R(8I1$o0Z?IT @m$,RRW$_yV? Please be sure to add a 1 before your mobile number, ex: 19876543210, Coinsurance You pay a percentage of covered expenses, Crowns and fixed bridgework when the teeth were prepared before your Aetna coverage began, Appliances (such as dentures) when the impression was taken before your Aetna coverage began, Root canal therapy when the tooth's pulp chamber was opened before your Aetna coverage began. Exams are covered every six months (if using a participating dentist, there is a $15 co-payment). Aetna Inc. and itsaffiliated companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Download the Pharmacy Information Authorization form (13-835A). Who can enroll in the plan? WebYour primary care dentist will provide all of your routine dental care and any copayment or discounted charges will be paid at the time of service If you need a specialty dentist, you may receive a 25 percent discount by using one of the participating specialty dentists from Information is believed to be accurate as of the production date; however, it is subject to change. WebLike most group benefits programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions of benefits, limitations Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins (CPBs). The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. They arent a PCD. For information related to withdrawal management services (previously detox), please see the agency's inpatient hospital guide. Visit the secure website, available through www.aetna.com, for more information. Do you need a barcode cover sheet? WebYou may choose one of four dental plans, offered by SafeGuard, a MetLife Company and Metropolitan Life. Check your plan documents or call Member Services for details. Web*** Your dentist says you need a full X-Ray and his usual fee is $175*** What is a participating PDP dentist? However, in order to receive maximum benefits, members must select and have care coordinated by a participating primary care dentist. Before you provide certain services, you will need to submit authorization request forms. This will let you and the dentist know what the benefit will be if the service is done. ?LkG1/p#- -vBw|4W:AB Q=,AfU3mknmwQn%z7 This applies to services for: For more details, review your plan documents. This means if you have two plans that cover two cleanings per year, you dont have four cleanings per year. 0000044288 00000 n If you do not intend to leave our site, close this message. Aetna's conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna). WebYikes, something went terribly wrong!!! 20% PPO and out-of-state; 30% non-PPO. Log in to find a dentist who accepts your coverage. WebWhen is periodontal maintenance covered? )SI{ 0BO|cEs}Oq""TV}c`u-hSwi8J", 0000035839 00000 n Find the one that's right for you. Aetna Inc. and its affiliated companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites. general dentist or specialist who meets MetLifes strict credentialing Any use of CPT outside of Aetna Clinical Policy Bulletins (CPBs) should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. As a MetLife Vision customer you can access language See Physician-related/professional services.). Our procedure fee tool provides participants of dental plans insured or administered by MetLife guidance in understanding your dental service providers fees. WebMetLifes Table of Maximum Allowable Charges or Fee Schedule applies to dental procedures performed on eligible members participating in MetLifes Preferred Dentist 825 0 obj <>stream You may not have coverage to replace teeth that were lost or extracted before your coverage began. You can see if your plan has a work-in-progress exclusion. Links to various non-Aetna sites are provided for your convenience only. and Section 504 of the Rehabilitation Act of 1973. No fee schedules, basic unit, relative values or related listings are included in CPT. 0000036485 00000 n 0000035971 00000 n G!Qj)hLN';;i2Gt#&'' 0 WebCan I get an estimate of my out-of-pocket expenses? However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. Click home to navigate to home.. Click reset to reset the application.reset to reset the application. All agency-contracted managed care organizations (MCOs) and the fee-for-service (FFS) program use the Apple Health PDL. 0000048067 00000 n Every enrolled family member may select their own primary care dentist. Just go to the Apple App Store or Google Play Store. 6p6@-_2PA p-S:{c:=q|%~nH09ML{Z 'zS'-'&w.&Xu-.@N 0000016734 00000 n Find individual dental insurance plans near you with budget-friendly coverage options and get a quote. Altamonte Springs dentists Boca Raton dentists Clearwater dentists Coral Gables dentists Coral Springs dentists Daytona Beach dentists Delray Beach dentists Englewood dentists Fort Lauderdale dentists Gainesville dentists Grove City dentists Therefore, it is crucial to verify benefits and eligibility with the Payor. Treating providers are solely responsible for dental advice and treatment of members. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Or it will be a flat dollar amount (copay). There are several types of coordination of benefits provisions. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. endstream endobj 780 0 obj <>/Metadata 30 0 R/Pages 777 0 R/StructTreeRoot 55 0 R/Type/Catalog/ViewerPreferences 798 0 R>> endobj 781 0 obj <>/MediaBox[0 0 612 792]/Parent 777 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 782 0 obj <>stream HMo0?v:JzXc/Y~ 4$8#27t9hkG~NMf]n+tAk Wh._AkJ~Mm1.O]f.ixk% (ABT iE%Jz,3X6#N]W_Q.v(>2(0CH*vy!f( 0000071744 00000 n os yI"f]Ez| y n1|8(AV0jxU&hz=Hw 9\VMwwh!B lsJB&)C|N!!Xr&K{k9i[MU[oKSk&X2EUxkvlM~W To change your PCD, log in to your member website. See Access to Baby and Child Dentistry (ABCD). Some subtypes have five tiers of coverage. Or call Member Services at the number on your ID card. 50% of costs until plan has paid $1,750, then any It sets what they can charge for covered services. endstream endobj startxref CPT only Copyright 2022 American Medical Association. Others have four tiers, three tiers or two tiers. Choose a category below to see questions and answers about Dental Maintenance Organization (DMO) coverage. By clicking on I Accept, I acknowledge and accept that: The Applied Behavior Analysis (ABA) Medical Necessity Guidehelps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. Aetna Dental members dont need a member ID card to get dental care. Please see your plan documents. You may choose a new one once a month. The ADA anticipates that the costs of providing care will substantially increase for many dental procedures. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. (For example, if you change your PCD on April 15, the change will take effect May 1. 0000072473 00000 n Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. For the Federal Dental Plans, the MetLife fee will prevail regardless of the primary carrier status. 1Birthday refers only to the month and day in a calendar year, not the year in which the person was born. 2 This rule is referred to as the birthday rule. \Jc sVB;xN"#~D=1GE SJ4{[HM`|x>~y\YgO_YQ la70'1!!7FY%^P\iRk*#L n~^IJ54g+Rq k (C8y}H7=s2TiUfS^|d yfGBak44\@j CPT only copyright 2015 American Medical Association. Download the free app today. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Reprinted with permission. Depending on your plan, you may pay for dental care in one of two ways: There are no deductibles or annual dollar maximums. startxref WebWorldwide dental coverage and plans with no deductible New Hires have 60 days to choose benefits. Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. %PDF-1.7 % Unlisted, unspecified and nonspecific codes should be avoided. %PDF-1.4 % All services deemed "never effective" are excluded from coverage. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. L0621014064[exp0622][All States]. Ho0?4$#UVCr!bf! B[@U=7Y>6.vf You may still elect to receive services from a non 0000050787 00000 n Search for a dentist by name, specialty, ZIP code or the number of miles you are willing to travel. Aetna Inc. and its affiliated companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. For previous versions, email us applehealthpharmacypolicy@hca.wa.gov. By contacting the Payor, a provider can identify which network fee schedule is being utilized for claim reimbursement and verify participation status with the plan. Copyright 2015 by the American Society of Addiction Medicine. WebCoordination of benefits provisions in dental benefits plans are a set of rules that are followed when a patient is covered by more than one dental benefits plan. It does not mean precertification as defined by Texas law, as a reliable representation of payment of care or services to fully insured HMO and PPO members. In case of a conflict between your plan documents and this information, the plan documents will govern. t|%y,$Z1/7`v||f})"h[sE\o~_z~$q-`?X \h-:tm){1U:;%j%D^TN"pX'nw]Fs3)bNiA@g4,pLk,k{s6?}J}A &\R:lf~>W1C",h+QZ{K'.52 zYtVIp`0 x{B&$M"yhZICt`0> :1r 2!iMFnAo)1%i"74/+v[0N)mgaJY[X _1d7$3H\3. This is called an extension of benefits provision. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. endstream endobj 4801 0 obj <>stream How do providers identify the correct payer? The ABA Medical Necessity Guidedoes not constitute medical advice. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. Use the billing guides and fee schedules to find rate information and the ProviderOne Billing and Resource Guide to walk through the claims process. 0000044706 00000 n Verify the spelling of the provider's last name or office name. WebThe sequestration reduction amount for each affected claim will be identified on the explanation of remittance healthcare providers receive from Humana. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Precertification Code Search Tool. You can reach them at the number on your member ID card. In addition, a member may have an opportunity for an independent external review of coverage denials based on medical necessity or regarding the experimental and investigational status when the service or supply in question for which the member is financially responsible is $500 or greater. 0000001499 00000 n *Illinois members: State laws vary with regard to out-of-network benefits. endstream endobj 205 0 obj <>/Filter/FlateDecode/Index[17 146]/Length 27/Size 163/Type/XRef/W[1 1 1]>>stream n[F$6_KZi4k Periodontal maintenance is for patients whove previously had periodontal treatment. 0000037307 00000 n In Illinois, DMO plans provide limited out-of-network benefits. Actual If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Refer to the current Physician-related/professional services for information regarding blood, blood products, and related services. endstream endobj 4804 0 obj <>stream We need to authorize the use of a different provider before treatment. Your benefits plan determines coverage. To receive maximum benefits, members must choose a participating primary care dentist to coordinate their care with in-network providers. 4812 0 obj <>/Filter/FlateDecode/ID[]/Index[4792 37]/Info 4791 0 R/Length 101/Prev 537656/Root 4793 0 R/Size 4829/Type/XRef/W[1 3 1]>>stream Life, home, auto, AD&D, LTD, & FSA benefits, Overview of prior authorization (PA), claims & billing, Step-by-step guide for prior authorization (PA), Program benefit packages & scope of services, Community behavioral support (CBHS) services, First Steps (maternity support & infant care), Ground emergency medical transportation (GEMT), Home health care services: electronic visit verification, Substance use disorder (SUD) consent management guidance, Enroll as a health care professional practicing under a group or facility, Enroll as a billing agent or clearinghouse, Find next steps for new Medicaid providers, Washington Prescription Drug Program (WPDP), Governor's Indian Health Advisory Council, Analytics, research & measurement (ARM) data dashboard suite, Foundational Community Supports provider map, Medicaid maternal & child health measures, Washington State All Payer Claims Database (WA-APCD), Personal injury, casualty recoveries & special needs trusts, Information about novel coronavirus (COVID-19), Information about novel coronavirus (COVID-19) webpage, Medical Assistance Customer Service Center (MACSC) online, April 1, 2023 to present ABCD billing guide, October 1, 2022 to March 31, 2023 ABCD billing guide, July 1, 2022 to September 30, 2022 ABCD billing guide, July 1, 2022 to present Acute physical medicine and rehabilitation billing guide, October 1, 2020 to June 30, 2022 Acute physical medicine and rehabilitation billing guide, January 1, 2020 to September 30, 2020 Acute physical medicine and rehabilitation billing guide, View all acute physical medicine and rehabilitation billing guides, July 1, 2022 to present Alien Medical Program billing guide, January 1, 2022 to June 30, 2022 Alien Medical Program billing guide, April 1, 2021 to December 31, 2021 Alien Medical Program billing guide, View all Alien Medical Program emergency assistance billing guides, January 1, 2021 to present Ambulance transportation billing guide, July 1, 2020 to December 31, 2020 Ambulance transportation billing guide, April 1, 2020 to June 30, 2020 Ambulance transportation billing guide, View all Ambulance transportation billing guides, July 1, 2022 to present Ground Emergency Medical Transportation (GEMT) billing guide, October 1, 2020 to June 30, 2022 Ground Emergency Medical Transportation (GEMT) billing guide, January 1, 2020 to September 30, 2020 Ground Emergency Medical Transportation (GEMT) billing guide, July 1, 2021 to present Ambulance transportation, February 29, 2020 to June 30, 2021 Ambulance transportation, July 1, 2019 to February 28, 2020 Ambulance transportation, December 1, 2016 to June 30, 2019 Ambulance transportation, January 1, 2006 to November 30, 2016 Ambulance transportation, July 1, 2022 to present ACS billing guide, July 1, 2021 to June 30, 2022 ASC billing guide, October 1, 2020 to June 30, 2021 ASC billing guide, April 1, 2023 to present -- ASC fee schedule, October 1, 2022 to present March 31, 2023 -- ASC fee schedule, April 1, 2022 to September 30, 2022 ASC fee schedule, October 1, 2021 to March 31, 2022 ASC fee schedule, March 1, 2021 to September 30, 2021 ASC fee schedule, April 24, 2023 to present - ABA billing guide, April 1, 2023 to April 23, 2023 ABA billing guide, January 1, 2023 to March 31, 2023 ABA billing guide, July 1, 2022 to present ABA fee schedule, July 1, 2021 to June 30, 2022 ABA fee schedule, July 1, 2020 to June 30, 2021 ABA fee schedule, ABA COE fee-for-service provider directory, July 1, 2022 to present Blood bank fee schedule, July 1, 2021 to June 30, 2022 Blood bank fee schedule, July 1, 2020 to June 30, 2021 Blood bank fee schedule, View all Blood Bank services fee schedules, Substance-Using Pregnant People (SUPP) program billing guide, January 1, 2022 to December 31, 2022 CUP program billing guide, October 1, 2020 to December 31, 2021 CUP women program billing guide, July 1, 2019 to September 30, 2020 CUP women program billing guide, Inpatient Prospective Payment System (IPPS), October 1, 2020 to present Childbirth education billing guide, April 1, 2019 to September 30, 2020 Childbirth education billing guide, October 1, 2017 to March 31, 2019 Childbirth education billing guide, View all childbirth education billing guides, January 1, 2007 to present Childbirth education, July 1, 2022 to present Chiropractic services billing guide, October 1, 2020 to June 30, 2022 Chiropractic services billing guide, January 1, 2020 to September 30, 2020 Chiropractic services billing guide, View all chiropractic services for children billing guides, July 1, 2022 to present Chiropractic services for children fee schedule, July 1, 2021 to June 30, 2022 Chiropractic services for children fee schedule, July 1, 2020 to June 30, 2021 Chiropractic services for children fee schedule, View all chiropractic services for children fee schedules, April 1, 2023 to present CRT products and services billing guide, July 1, 2022 to March 31, 2023 CRT products and services billing guide, January 1, 2022 to June 30, 2022 CRT products and services billing guide, July 1, 2022 to present CRT fee schedule, April 1, 2022 to June 30, 2022 CRT fee schedule, July 1, 2021 to March 31, 22 CRT fee schedule, October 1, 2022 to present Social services blanket code crosswalk, September 1, 2021 to September 30, 2022 Social services blanket codes, November 17, 2020 to August 31, 2021 Social services blanket codes, July 1, 2022 to present COVID-19 fee schedule, January 1, 2022 to June 30, 2022 COVID-19 fee schedule, July 1, 2021 to December 31, 2021 COVID-19 fee schedule, April 12, 2023 to present - Apple Health COVID-19 vaccine policy, December9, 2022to April 11, 2023 Apple Health COVID-19 vaccine policy, November 21, 2022 to December 8, 2022- Apple Health COVID - 19 vaccine policy, April 24, 2023 to present Apple Health Monoclonal Antibody Treatment COVID-19 clinical policy, December 16, 2022 to April 23, 2023 Apple Health Monoclonal Antibody Treatment COVID-19 clinical policy, September 14, 2022 to December 15, 2022 Apple Health Monoclonal Antibody Treatment COVID-19 clinical policy, August 19, 2022 to September 13, 2022 Apple Health Monoclonal Antibody Treatment COVID-19 clinical policy, May 10, 2022 to August 18, 2022 Apple Health Monoclonal Antibody Treatment COVID-19 clinical policy, April 12, 2022 to May 9, 2022 Apple Health Monoclonal Antibody Treatment COVID-19 clinical policy, March 23, 2022 to April 11, 2022 Apple Health Monoclonal Antibody Treatment COVID-19 clinical policy, View all Monoclonal Antibody Treatment COVID-19 clinical policies, May 12, 2023 to present - Apple Health COVID-19 testing clinical policy, November 21, 2022 to May 11, 2023 Apple Health COVID-19 testing clinical policy, March 4, 2022 to November 20, 2022 Apple Health COVID-19 testing clinical policy, View all COVID-19 testing clinical policies, Access to Baby and Child Dentistry (ABCD), April 1, 2023 to present Dental-related services program billing guide, January 1, 2023 to March 31, 2023 Dental-related services program billing guide, October 1, 2022 to December 31, 2022 Dental-related services program billing guide, July 1, 2022 to present Oral Health Connections pilot project billing guide, January 1, 2022 to June 30, 2022 Oral Health Connections pilot project billing guide, October 1, 2020 to December 31, 2021 Oral Health Connections pilot project billing guide, View all OHC pilot project billing guides, July 1, 2022 to present Mobile anesthesia for dental services billing guide, January 1, 2023 to present Dental program fee schedule, October 1, 2022 to December 31, 2022 Dental program fee schedule, July 1, 2022 to September 30, 2022 Dental program fee schedule, July 1, 2022 to present Diabetes education program billing guide, July 1, 2021 to June 30, 2022 Diabetes education program billing guide, April 1, 2021 to June 30, 2021 Diabetes education program billing guide, View all Diabetes Education Program billing guides, July 1, 2022 to present Diabetes education, July 1, 2021 to June 30, 2022 Diabetes education, July 1, 2020 to June 30, 2021 Diabetes education, View all diabetes education fee schedules, Medical Equipment and Supplies billing guide, January 1, 2019 to March 31, 2019 DME and non-CRT wheelchairs billing guide, October 1, 2018 to December 31, 2018 DME and non-CRT wheelchairs billing guide, July 1, 2018 to September 30, 2018 DME and non-CRT wheelchairs billing guide, Medical Equipment and Supplies fee schedules, January 1, 2019 to March 31, 2019 Other DME fee schedule, January 1, 2019 to March 31, 2019 Wheelchairs and accessories fee schedule, View all DME social services blanket codes, April 1, 2023 to present ESPDT Well-child program billing guide, January 1, 2023 to March 31, 2023 ESPDT program billing guide, July 1, 2022 to December 31, 2022 EPSDT program billing guide, July 1, 2022 to present EPSDT fee schedule, July 1, 2021 to June 30, 2022 EPSDT fee schedule, July 1, 2020 to June 30, 2021 EPSDT fee schedule, March 1, 2023 to present Enteral nutrition billing guide, September 1, 2022 to February 28, 2023 Enteral nutrition billing guide, July 1, 2022 to August 31, 2022 Enteral nutrition billing guide, View all enteral nutrition billing guides, March 1, 2023 to present Enteral nutrition fee schedule, July 1, 2022 to February 28, 2023 Enteral nutrition fee schedule, July 1, 2021 to June 30, 2022 Enteral nutrition fee schedule, January 1, 2023 to present Family planning billing guide, July 1, 2022 to December 31, 2022 Family planning billing guide, February 1, 2022 to June 30, 2022 Family planning billing guide, January 1, 2023 to present Family planning fee schedule, October 1, 2022 to December 31, 2022 Family planning fee schedule, July 1, 2022 to September 30, 2022 Family planning fee schedule, July 1, 2022 to present SRHP fee schedule, October 1, 2021 to June 30, 2022 SRHP fee schedule, Physician-Related Services/Health Care Professional Services Billing Guide, Physician administered drugs fee schedule, Family planning only program telemedicine services offered during the COVID-19 outbreak, Family planning client application (form 13-781), April 1, 2023 to present FQHC billing guide, January 1, 2023 to March 31, 2023 FQHC billing guide, October 1, 2022 to December 31, 2022 FQHC billing guide, April 1, 2023 to present FQHC encounter rates, January 1, 2023to March 31, 2023 FQHC encounter rates, October 1, 2022 to December 31, 2022 FQHC encounter rates, April 1, 2023 to present FQHC enhancement rates, January 1, 2023 to March 31, 2023 FQHC enhancement rates, October 1, 2022 to December 31, 2022 FQHC enhancement rates, August 1, 2022 to present Habilitative services program billing guide, July 1, 2022 to July 31, 2022 Habilitative services program billing guide, January 1, 2022 to June 30, 2022 Habilitative services program billing guide, View all habilitative services billing guides, July 1, 2022 to present Habilitative services, July 1, 2021 to June 30, 2022 Habilitative services, January 1, 2021 to June 30, 2021 Habilitative services, View all habilitative services fee schedules, April 1, 2022 to present Hearing hardware billing guide, November 1, 2020 to March 31, 2022 Hearing hardware billing guide, October 1, 2020 to October 31, 2020 Hearing hardware billing guide, July 1, 2022 to present Hearing hardware fee schedule, April 1, 2022 to June 30, 2022 Hearing hardware fee schedule, July 1, 2021 to March 30, 2022 Hearing hardware fee schedule, April 1, 2022 to present HIV/AIDS case management billing guide, April 1, 2021 to March 31, 2022 HIV/AIDS case management billing guide, October 1, 2020 to March 31, 2021 HIV/AIDS case management billing guide, July 1, 2018 to present HIV/AIDS case management, January 1, 2023 to present Home health (acute care services) billing guide, July 1, 2022 to December 31, 2022 Home health (acute care services) billing guide, April 1, 2022 to June 30, 2022 Home health (acute care services) billing guide, View all home health services billing guides, January 1, 2023 to present Home health fee schedule, July 1, 2022 to December 31, 2022 Home health fee schedule, January 1, 2022 to June 30, 2022 Home health fee schedule, View all home health services fee schedules, January 1, 2023 to present Home Infusion therapy billing guide, November 16, 2022 to December 31, 2022 Home Infusion therapy billing guide, October 1, 2021 to November 15, 2022 Home Infusion therapy billing guide, View all home infusion therapy and nutrition billing guides, January 1, 2023 to present Home infusion therapy/parenteral nutrition fee schedule, October 1, 2022 to December 31, 2022 Home infusion therapy/parenteral nutrition fee schedule, July 1, 2022 to September 30, 2022 Home infusion therapy/parenteral nutrition fee schedule, View all home infusion therapy/parenteral nutrition fee schedules, July 1, 2022 to present Hospice services billing guide, October 1, 2020 to June 30, 2022 Hospice services billing guide, January 1, 2020 to September 30, 2020 Hospice services billing guide, October 1, 2021 to September 30, 2022 Hospice fee schedule, October 1, 2020 to September 30, 2021 Hospice fee schedule, January 1, 2020 to July 1, 2020 Hospital-based inpatient detoxification billing guide, July 1, 2019 to December 31, 2019 Hospital-based inpatient detoxification billing guide, January 1, 2019 to June 30, 2019 Hospital-based inpatient detoxification billing guide, View all hospital-based inpatient detoxification billing guides, January 1, 2023 to present Inpatient hospital services billing guide, October 1, 2022 to December 31, 2022 Inpatient hospital services billing guide, July 1, 2022 to September 30, 2022 Inpatient hospital services billing guide, View all inpatient hospital billing guides, Guidance for billing MCOs for services provided to newborns, RAC Eligibility Codes for Healthy Options Blind/Disabled (HOBD) Clients, November 1, 2022 to present Interpreter services billing guide, April 1, 2022 to October 31, 2022 Interpreter services billing guide, October 1, 2021 to March 31, 2022 Interpreter services billing guide, July 1, 2022 to present Kidney center services billing guide, January 1, 2022 to June 30, 2022 Kidney center services billing guide, January 1, 2021 to December 31, 2021 Kidney center services billing guide, View all kidney center services billing guides, April 1, 2023 to present Kidney centers fee schedule, January 1, 2023 to March 31, 2023 Kidney centers fee schedule, October 1, 2022 to December 31, 2022 Kidney centers fee schedule, View all kidney center services fee schedules, July 1, 2022 to present Long-term care program billing guide, October 1, 2020 to June 30, 2022 Long-term care program billing guide, January 1, 2020 to September 30, 2020 Long-term care program billing guide, View all long-term acute care billing guides, August 1, 2022 to present MSS/ICM billing guide, July 1, 2022 to July 31, 2022 MSS/ICM billing guide, January 1, 2021 to June 30, 2022 MSS/ICM billing guide, July 1, 2020 to present MSS/ICM fee schedule, January 1, 2020 to June 30, 2020 MSS/ICM fee schedule, October 1, 2015 to December 31, 2019 MSS/ICM fee schedule, March 24, 2023 to present Medical Equipment and Supplies Billing Guide, October 21, 2022 to March 23, 2023 Medical Equipment and Supplies Billing Guide, October 1, 2022 to October 20, 2022 Medical Equipment and Supplies Billing Guide, View all Medical equipment and supplies billing guides, April 1, 2023 to present Medical Equipment and Supplies fee schedule, October 1, 2022 to March 31, 2023 Medical Equipment and Supplies fee schedule, July 1, 2022 to September 30, 2022 Medical Equipment and Supplies fee schedule, View all medical equipment and supplies fee schedules, April 1, 2023 to present Medical nutrition therapy billing guide, February 17, 2023 to March 31, 2023 Medical nutrition therapy billing guide, August 1, 2022 to February 16, 2023 Medical nutrition therapy billing guide, View all medical nutrition therapy billing guides, July 1, 2022 to present Medical nutrition therapy fee schedule, July 1, 2021 to June 30, 2022 Medical nutrition therapy fee schedule, July 1, 2020 to June 30, 2021 Medical nutrition therapy fee schedule, View all medical nutrition therapy fee schedules, April 1, 2023 to present - Mental health services billing guide, January 1, 2023 to March 31, 2023 Mental health services billing guide, October 1, 2022 to December 31, 2022 Mental health services billing guide, View all mental health services billing guides, April 1, 2023 to present Mental health and psychology services fee schedule, January 1, 2023 to March 31, 2023 Mental health and psychology services fee schedule, July 1, 2022 to December 31, 2022 Mental health and psychology services fee schedule, View all mental health services fee schedules, January 1, 2023 to present Specialized mental health fee schedule, July 1, 2022 to December 31, 2022 Specialized mental health fee schedule, January 1, 2022 to June 30, 2022 Specialized mental health fee schedule, View all specialized mental health services fee schedules.
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