[48 Pa.B. 5943]
[Saturday, September 22, 2018]
[Continued from previous Web Page]
Year Code Citation(s) Subject Date Issued Bulletin
Number— Special Pharmaceutical Benefits Program (SPBP)—Addition of CD4 Tests to the List of Outpatient Laboratory Services for SP1 Card Holders 08/03/09 01-09-33
08-09-34
09-09-35
21-09-03
24-09-33
28-09-03
31-09-36Ch. 1105.
1150Revised Medical Assessment Form
(PA 635)8/10/09 31-09-38
19-09-01
09-09-34Ch. 1121 Prior Authorization of Skeletal Muscle Relaxants—Pharmacy Services 08/10/09 01-09-35
09-09-37
27-09-32
02-09-31
11-09-31
30-09-31
03-09-31
14-09-31
31-09-38
08-09-36
24-09-35
32-09-31Ch. 1121 Prior Authorization of Narcotic Analgesics—Pharmacy Services 08/10-09 01-09-34
09-09-36
27-09-31
02-09-30
11-09-30
30-09-30
03-09-30
14-09-30
31-09-37
08-09-35
24-09-34
32-09-30Ch. 1101
Ch. 1150Changes to Procedure Codes for the
Administration Fees for Kinrix® (DTaP-IPV) and Rotarix® (Rotavirus Vaccines)08/13/09 01-09-38
08-09-39
09-09-40
31-09-41
33-09-03Ch. 1101
1150.
1141
1221SelectPlan for Women Program
Formulary09/01/09 01-09-39
08-09-40
09-09-41
24-09-38
28-09-04
31-09-42
33-09-04Ch. 1121 SUBJECT Prior Authorization of Atypical Antipsychotics—Pharmacy Services 09/01/09 01-09-36
09-09-38
27-09-33
02-09-32
11-09-32
30-09-32
03-09-32
14-09-32
31-09-39
08-09-37
24-09-36
32-09-32Ch. 1101.
1150
1141
1221SelectPlan for Women Program—
Addition of Covered Services09/08/09 01-09-40
08-09-41
09-09-42
24-09-39
28-09-05
31-09-43
33-09-05Ch. 1150
1241
Ch. 1121Structured Screening for Developmental
Delays and Autism Spectrum Disorders
Prior Authorization of Neulasta—Pharmacy Services09/08/09
09/17/0999-09-07
01-09-29
02-09-26
03-09-26
08-09-30
09-09-30
11-09-26
14-09-26
24-09-29
27-09-27
30-09-26
31-09-31
32-09-26Ch. 1121 Prior Authorization of Conventional (Typical) Antipsychotics—Pharmacy Services 09/21/09 01-09-37
09-09-39
27-09-34
02-09-33
11-09-33
30-09-33
03-09-33
14-09-33
31-09-40
08-09-38
24-09-37
32-09-33Ch. 1121 Available Resources: 2009 Novel Influenza Virus A (H1N1) 09/24/09 01-09-41
08-09-42
09-09-43
31-09-44
33-09-06Ch. 1141 Revisions to the Medical Assistance Program Fee Schedule Rates for Select Services 10/05/09 99-09-09 Ch. 1150 Billing for the Administration of the Influenza A (H1N1) 2009 Monovalent Vaccine 10-9-09 99-09-10 Ch. 1101
1141
1142
1143
1144
1145.
1147
1149Revision of the PROMISe® Individual
Practitioner Enrollment Application and Implementation of Credentialing for Certain
Providers Types10/16/09 99-09-08 Ch. 1121 Prior Authorization of Proton Pump Inhibitors (PPIs)—Pharmacy Services 10/20/09 01-09-42
08-09-43
14-09-34
30-09-34
02-09-34
09-09-44
24-09-40
31-09-45
03-09-34
11-09-34
27-09-35
32-09-34Ch. 1121 Fall 2009 Preferred Drug List (PDL) and Quantity Limits Update—Pharmacy Services 11/02/09 01-09-43
09-09-45
27-09-36
02-09-35
11-09-35
30-09-35
03-09-35
14-09-35
31-09-46
08-09-44
24-09-41
32-09-35Ch. 1141
1145Recipient Access to Chiropractic
Services11/30/09 99-09-11 Ch. 1121 Steroids, Topical Low Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-51
09-09-53
27-09-44
02-09-43
11-09-43
30-09-43
03-09-43
14-09-43
31-09-54
08-09-52
24-09-49
32-09-43Ch. 1121 Ophthalmic Antibiotics Updated Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-58
09-09-59
27-09-50
02-09-49
11-09-49
30-09-49
03-09-49
14-09-49
31-09-60
08-09-58
24-09-55
32-09-49Ch. 1121 Steroids, Topical High Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-54
09-09-55
27-09-46
02-09-45
11-09-45
30-09-45
03-09-45
14-09-45
31-09-56
08-09-54
24-09-51
32-09-45Ch. 1121 Platelet Aggregation Inhibitors Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-47
09-09-49
27-09-40
02-09-39
11-09-39
30-09-39
03-09-39
14-09-39
31-09-50
08-09-48
24-09-45
32-09-39Ch. 1121 Pharmacy Services Fall 2009 Preferred Drug List (PDL) Pharmacy Update—Bronchodilators, Beta Agonists Updated Handbook Pages 11/02/09 01-09-48
09-09-50
27-09-41
02-09-40
11-09-40
30-09-40
03-09-40
14-09-40
31-09-51
08-09-49
24-09-46
32-09-40Ch. 1121 Antivirals, Topical Updated Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-57
09-09-58
27-09-49
02-09-48
11-09-48
30-09-48
03-09-48
14-09-48
31-09-59
08-09-57
24-09-54
32-09-48Ch. 1121 Ophthalmic Anti-Inflammatories New Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-49
09-09-51
27-09-42
02-09-41
11-09-41
30-09-41
03-09-41
14-09-41
31-09-52
08-09-50
24-09-47
32-09-41Ch. 1121 Pancreatic Enzymes Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-50
09-09-52
27-09-43
02-09-42
11-09-42
30-09-42
03-09-42
14-09-42
31-09-53
08-09-51
24-09-48
32-09-42Ch. 1121 Steroids, Topical Very High Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-55
09-09-56
27-09-47
02-09-46
11-09-46
30-09-46
03-09-46
14-09-46
31-09-57
08-09-55
24-09-52
32-09-46Ch. 1121 Fall 2009 Preferred Drug List (PDL) and Quantity Limits Update—Pharmacy Services 11/02/09 01-09-44
09-09-46
27-09-37
02-09-36
11-09-36
30-09-36
03-09-36
14-09-36
31-09-47
08-09-45
24-09-42
32-09-36Ch. 1121 Steroids, Topical Medium Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-52
09-09-54
27-09-45
02-09-44
11-09-44
30-09-44
03-09-44
14-09-44
31-09-55
08-09-53
24-09-50
32-09-44Ch. 1121 Antidepressants, Other Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-45
09-09-47
27-09-38
02-09-47
11-09-37
30-09-37
03-09-47
14-09-37
31-09-48
08-09-46
24-09-43
32-09-37Ch. 1121 Antifungals, Oral Updated Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-46
09-09-48
27-09-39
02-09-38
11-09-38
30-09-38
03-09-38
14-09-38
31-09-49
08-09-47
24-09-44
32-09-38Ch. 1121 Bone Resorption Suppression and Related Agents Updated Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-56
09-09-57
27-09-48
02-09-47
11-09-47
30-09-47
03-09-47
14-09-47
31-09-58
08-09-56
24-09-53
32-09-47Ch. 1143 Correction to Medical Assistance Bulletin 14-06-04 for Podiatrists 11/30/09 14-09-50 Ch. 1121 Prior Authorization and Quantity Limits of Botulinum Toxins Pharmacy Services 12/11/09 01-09-61
09-09-62
27-09-53
02-09-52
11-09-52
30-09-52
03-09-52
14-09-52
31-09-63
08-09-61
24-09-58
32-09-52Ch. 1121 Preferred Drug List (PDL) New Drugs To Market Handbook Pages Pharmacy Services 12/11/09 01-09-60
09-09-61
27-09-52
02-09-51
11-09-51
30-09-51
03-09-51
14-09-51
31-09-62
08-09-60
24-09-57
32-09-51— Prone Restraints in Children's Facilities 12/19/09 3800-09-02 — Strategies and Practices to Eliminate The Use of Unnecessary Restraints 12/19/09 3800-09-01 Ch. 1101
1150
1241Hiberix®, Haemophilus Influenzae
Type b (Hib) Vaccine12/31/09 01-09-62
08-09-61
09-09-62
31-09-64
33-09-072010 — Special Pharmaceutical Benefits Program (SPBP)-Implementation of the Revised HIV/AIDS Formulary for SP1 Cardholders 01/25/10 08-10-02
09-10-02
24-10-02
31-10-02Ch. 1121 List of Drugs With Established Quantity Limits/Daily Dose Limits—Pharmacy Services 01/29/10 01-10-01
09-10-01
27-10-01
02-10-01
11-10-01
30-10-01
03-10-01
14-10-01
31-10-01
08-10-01
24-10-01
32-10-01Ch. 1121 Prior Authorization of Erythropoiesis Stimulating Proteins—Pharmacy Services 01/29/10 01-10-03
09-10-04
27-10-02
02-10-01
11-10-01
30-10-01
03-10-01
14-10-01
31-10-01
08-10-01
24-10-01
32-10-01Ch. 1121 Prior Authorization of Incretin Mimetic/Enhancer Hypoglycemics—Pharmacy Services 02/05/10 01-10-05
09-10-06
27-10-04
02-10-04
11-10-04
30-10-04
03-10-04
14-10-04
31-10-07
08-10-06
24-10-05
32-10-04Ch. 1150 Health Care Benefit Package 12 Updated Employability Assessment Procedure Code List 2-5-10 01-10-02
08-10-03
09-10-03
18-10-01
28-10-01
29-10-01
31-10-03Ch. 1147 Medical Assistance Program Outpatient Fee Schedule Procedure Code Changes for Vision Services 02/15/10 18-10-02
31-10-05Ch. 1150 Medical Assistance Program Fee Schedule Revisions 02/19/10 99-10-01 Ch. 1101
1150
12412010 Recommended Childhood and
Adolescent Immunization Schedules03/15/10 01-10-06
08-10-07
09-10-07
31-10-09
33-10-01Ch. 1141
1144
Ch. 1121Application of Topical Fluoride
Varnish by Physicians and CRNPs
Prior Authorization of Neulasta—Pharmacy Services03/15/10
04/01/1009-10-08
31-10-08
01-10-07
09-10-09
27-10-05
02-10-05
11-10-05
30-10-05
03-10-05
14-10-05
31-10-10
08-10-08
24-10-06
32-10-05Ch. 1121 Oral Buprenorphine Agents Updated Handbook Pages—Pharmacy Services 04/03/10 01-10-04
09-10-05
27-10-03
02-10-03
11-10-03
30-10-03
03-10-03
14-10-03
31-10-06
08-10-05
24-10-04
32-10-03— Implementation of New Physical Health Managed Care Organizations in the HealthChoices Southeast and Lehigh/Capital Zones 04/23/10 99-10-02 Ch. 1121 Analgesics, Narcotic Long Acting Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/01/10 01-10-15
09-10-17
27-10-12
02-10-12
11-10-12
30-10-12
03-10-13
14-10-12
31-10-18
08-10-16
24-10-13
32-10-12Ch. 1121 Fibromyalgia Agents Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/03/10 01-10-10
09-10-12
27-10-08
02-10-08
11-10-08
30-10-08
03-10-08
14-10-08
31-10-13
08-10-11
24-10-09
32-10-08Ch. 1121 Spring 2010 Preferred Drug List (PDL) Quantity Limits Update—Pharmacy Services 05/03/10 01-10-08
09-10-10
27-10-06
02-10-06
11-10-06
30-10-06
03-10-06
14-10-06
31-10-11
08-10-09
24-10-07
32-10-06Ch. 1121 Oral Immunosuppressive Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/03/10 01-10-12
09-10-14
27-10-10
02-10-10
11-10-10
30-10-10
03-10-10
14-10-10
31-10-15
08-10-13
24-10-11
32-10-10— Limitation on Allowable Other Medical Expenses Related to Nursing Facility Services 05/03/10 03-10-02 Ch. 1121 Multiple Sclerosis Agents Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/03/10 01-10-13
09-10-15
27-10-11
02-10-11
11-10-11
30-10-11
03-10-11
14-10-11
31-10-16
08-10-14
24-10-12
32-10-11Ch. 1121 Hepatitis C Agents Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/03/10 01-10-11
09-10-13
27-10-09
02-10-09
11-10-09
30-10-09
03-10-09
14-10-09
31-10-14
08-10-12
24-10-10
32-10-09Ch. 1121 Antidepressants, Other Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/03/10 01-10-09
09-10-11
27-10-07
02-10-07
11-10-07
30-10-07
03-10-07
14-10-07
31-10-12
08-10-10
24-10-08
32-10-07Ch. 1150
1121Updated Recommendations for
Gardasil® Quadrivalent Human Papillomavirus (HPV) Vaccine05/03/10 01-10-14
08-10-15
09-10-16
31-10-17
33-10-02Ch. 1121 Oral Anticonvulsants Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/21/10 01-10-18
09-10-20
27-10-15
02-10-15
11-10-15
30-10-15
03-10-16
14-10-15
31-10-21
08-10-19
24-10-16
32-10-15Ch. 1121 Angiotensin Modulator Combinations Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/21/10 01-10-17
09-10-19
27-10-14
02-10-14
11-10-14
30-10-14
03-10-15
14-10-14
31-10-20
08-10-18
24-10-15
32-10-14Ch. 1121 Pulmonary Arterial hypertension Agents, Oral and Inhaled Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/21/10 01-10-16
09-10-18
27-10-13
02-10-13
11-10-13
30-10-13
03-10-14
14-10-13
31-10-19
08-10-17
24-10-14
32-10-13Ch. 1121 Analgesics, Narcotic Short Acting Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/21/10 01-10-19
09-10-21
27-10-16
02-10-16
11-10-16
30-10-16
03-10-17
14-10-16
31-10-22
08-10-20
24-10-17
32-10-16Ch. 1101
1150Announcing the Federally Mandated
Change to Electronic Healthcare Transactions for Healthcare and Pharmacy Transactions06/08/10 99-10-07 Ch. 1101
1150
1241Revisions to the Early and Periodic
Screening, Diagnosis and Treatment
(EPSDT) Program Periodicity Schedule06/14/10 99-10-06 Ch. 1150 2009 HCPCS Updates and Other Procedure Code and Procedure Code/Modifier Combination Changes 06/14/10 99-10-05 Ch. 1150 Health Care Benefit Package 12 Updated Employability Assessment Procedure Code List 07/09/10 01-10-20
08-10-21
09-10-22
18-10-03
28-10-02
29-10-02
31-10-23Ch. 41 Change of Protocol for Certain Provider Appeals 07/09/10 99-10-08 Ch. 1101
1102
1121
1123
1149
1151
1163
1181
1187
1230
1243Policy Clarification Regarding Written Prescriptions—Statement of Policy 07/17/10 99-10-03
1101-10-01
1102-10-01
1121-10-01
1123-10-01
1149-10-01
1151-10-01
1163-10-01
1181-10-01
1187-10-01
1230-10-01
1243-10-01Ch. 1121 Prior Authorization of Spiriva (Bronchodilators, Anticholinergic)—Pharmacy Services 07/29/10 01-10-21
09-10-23
27-10-17
02-10-17
11-10-17
30-10-17
03-10-18
14-10-17
31-10-25
08-10-22
24-10-18
32-10-17Ch. 1101 SelectPlan For Women—Update to Covered Services 07/30/10 01-10-22
08-10-24
09-10-21
24-10-19
28-10-03
31-10-26
33-10-03Ch. 1225 Changes to the Provision of Hemoglobin Laboratory Services by Family Planning Clinics 07/30/10 08-10-23 Ch. 1121 Electronic Prescribing for Providers That Have ePrescribing Software 08/04/10 03-10-19
09-10-25
14-10-18
18-10-04
24-10-20
27-10-18
31-10-24
33-10-04Ch. 1121 Prior Authorization of Analgesics, Narcotic Long Acting—Pharmacy Services 08/27/10 01-10-26
09-10-28
27-10-21
02-10-20
11-10-20
30-10-20
03-10-22
14-10-21
31-10-29
08-10-27
24-10-23
32-10-20Ch. 1121 Prior Authorization of Analgesics, Narcotic Short Acting—Pharmacy Services 08/27/10 01-10-25
09-10-27
27-10-20
02-10-19
11-10-19
30-10-19
03-10-21
14-10-20
31-10-28
08-10-26
24-10-22
32-10-19Ch. 1121 Updated List of Drugs With Established Quantity Limits/Daily Dose Limits—Pharmacy Services 08/27/10 01-10-23
09-10-26
27-10-19
02-10-18
11-10-18
30-10-18
03-10-20
14-10-19
31-10-27
08-10-25
24-10-21
32-10-18Ch. 1101
1150
1241Updates to the Medical Assistance Program Fee Schedule for the Administration of the Vaccines Prevnar 13®, Cervarix®, Twinrix®, Recombivax HB®, and Menveo® 08/30/10 01-10-27
08-10-28
09-10-29
31-10-30
33-10-05Ch. 1150 Revisions to the Medical Assistance Program Fee Schedule Rates for Select Services 08/30/10 99/10/09 Ch. 1121
—Retrospective Drug Use Review—Pharmacy Services
Specialty Pharmacy Drug Program—Updated List of Covered Drugs—Pharmacy Services09/01/10
09/27/1099-10-10
99-10-11Ch. 1145 Recipient Access to Chiropractic Services 10/08/10 99-10-12 Ch. 1121 Antipsychotics Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-33
09-10-35
27-10-25
02-10-24
11-10-24
30-10-24
03-10-26
14-10-25
31-10-36
08-10-34
24-10-27
32-10-24Ch. 1121 Analgesics/Anesthetics, Topical Agents Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-29
09-10-31
27-10-21
02-10-20
11-10-20
30-10-20
03-10-22
14-10-21
31-10-32
08-10-30
24-10-23
32-10-20Ch. 1121 Intranasal Rhinitis Agents Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-41
09-10-43
27-10-33
02-10-32
11-10-32
30-10-32
03-10-34
14-10-33
31-10-44
08-10-42
24-10-35
32-10-32Ch. 1121 Oral Fluoroquinolones Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-39
09-10-41
27-10-31
02-10-30
11-10-30
30-10-30
03-10-32
14-10-31
31-10-42
08-10-40
24-10-33
32-10-30Ch. 1121 Fall 2010 Preferred Drug List (PDL) and Quantity Limits Update—Pharmacy Services 11/05/10 01-10-28
09-10-30
27-10-20
02-10-19
11-10-19
30-10-19
03-10-21
14-10-20
31-10-31
08-10-29
24-10-22
32-10-19Ch. 1121 Inhaled Glucocorticoids Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-40
09-10-42
27-10-32
02-10-31
11-10-31
30-10-31
03-10-33
14-10-32
31-10-43
08-10-41
24-10-34
32-10-31Ch. 1121 Antihyperuricemics Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-31
09-10-33
27-10-23
02-10-22
11-10-22
30-10-22
03-10-24
14-10-23
31-10-34
08-10-32
24-10-25
32-10-22Ch. 1121 Bronchodilators, Beta Agonists Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-37
09-10-39
27-10-29
02-10-28
11-10-28
30-10-28
03-10-30
14-10-29
31-10-40
08-10-38
24-10-31
32-10-28Ch. 1121 Antivirals, Oral Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-34
09-10-36
27-10-26
02-10-25
11-10-25
30-10-25
03-10-27
14-10-26
31-10-37
08-10-35
24-10-28
32-10-25Ch. 1121 Macrolides/Ketolides Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10/42
09-10-44
27-10-34
02-10-33
11-10-33
30-10-33
03-10-35
14-10-34
31-10-45
08-10-43
24-10-36
32-10-33Ch. 1121 Antibiotics, Inhaled Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-30
09-10-32
27-10-22
02-10-21
11-10-21
30-10-21
03-10-23
14-10-22
31-10-33
08-10-31
24-10-24
32-10-21Ch. 1121 Bone Resorption Suppression and Related Agents Handbook Pages—Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-30
09-10-32
27-10-22
02-10-21
11-10-21
30-10-21
03-10-23
14-10-22
31-10-33
08-10-31
24-10-24
32-10-21Ch. 1121 Bile Salts Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-35
09-10-37
27-10-27
02-10-26
11-10-26
30-10-26
03-10-28
14-10-27
31-10-38
08-10-36
24-10-29
32-10-26Ch. 1121 Antiparasitics, Topical Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-32
09-10-34
27-10-24
02-10-23
11-10-23
30-10-23
03-10-25
14-10-24
31-10-35
08-10-33
24-10-26
32-10-23Ch. 1121 Cytokine and CAM Antagonists Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-38
09-10-40
27-10-30
02-10-29
11-10-29
30-10-29
03-10-31
14-10-30
31-10-41
08-10-39
24-10-32
32-10-29Ch. 1121 Alzheimer's Agents Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/12/10 01-10-49
09-10-51
27-10-41
02-10-40
11-10-40
30-10-40
03-10-42
14-10-41
31-10-52
08-10-50
24-10-43
32-10-40Ch. 1121 Ophthalmic Antibiotics Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/12/10 01-10-44
09-10-46
02-10-35
11-10-35
30-10-35
03-10-37
14-10-36
31-10-47
08-10-45
24-10-38
32-10-35Ch. 1121 Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Handbook Pages—Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/12/10 01-10-43
09-10-45
27-10-35
02-10-34
11-10-34
30-10-34
03-10-36
14-10-35
31-10-46
08-10-44
24-10-37
32-10-34Ch. 1101
1121Requirement for Prescribing Provider
National Provider Identifier (NPI) Number on Outpatient Pharmacy Claims—Pharmacy Services11/12/10 99-10-13 Ch. 1121 Cephalosporins Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/12/10 01-10-48
09-10-50
27-10-40
02-10-39
11-10-39
30-10-39
03-10-41
14-10-40
31-10-51
08-10-49
24-10-42
32-10-39Ch. 1121 Stimulants and Related Agents Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/12/10 01-10-47
09-10-49
27-10-39
02-10-38
11-10-38
30-10-38
03-10-40
14-10-39
31-10-50
08-10-48
24-10-41
32-10-38Ch.1121 Platelet Aggregation Inhibitors Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/12/10 01-10-46
09-10-48
27-10-38
02-10-37
11-10-37
30-10-37
03-10-39
14-10-38
31-10-49
08-10-47
24-10-40
32-10-37Ch. 1121 Ophthalmic Anti-Inflammatories Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/12/10 01-10-45
09-10-47
27-10-37
02-10-36
11-10-36
30-10-36
03-10-38
14-10-37
31-10-48
08-10-46
24-10-39
32-10-36Ch. 1129 Dental Encounter payment for Dental Services Rendered by Rural Health Clinics and Federally Qualified Health Centers 11/15/10 08-10-50 Ch. 1245
1187Payment for Non-Emergency Transportation Services 11/24/10 03-10-43
26-10-01Ch. 1121 Incretin Mimetic/Enhancer Hypoglycemics Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 12/01/10 01-10-50
09-10-51
27-10-42
02-10-41
11-10-42
30-10-41
03-10-44
14-10-42
31-10-53
08-10-51
24-10-44
32-10-41Ch. 1101 Missed Appointments 12/01/10 99-10-14 Ch. 1101
1150
1241Medical Assistance Program Coverage of the 2010-2011 Influenza Vaccines 12/01/10 99-10-16 Ch. 1121 Oral Buprenorphine Agents Updated Handbook Pages—Pharmacy Services 12/13/10 01-10-51
09-10-52
27-10-42
02-10-42
11-10-42
30-10-42
03-10-45
14-10-43
31-10-54
08-10-52
24-10-45
32-10-42Ch. 1121 Hypoglycemics, TZDs Updated Handbook Pages Pharmacy Services 12/20/10 01-10-52
09-10-53
27-10-43
02-10-43
11-10-43
30-10-43
03-10-46
14-10-44
31-10-55
08-10-53
24-10-46
32-10-43Ch. 1121 Prior Authorization of Topamax/Topiramate Oral Anticonvulsants Updated Handbook Pages Pharmacy Services 12/24/10 01-10-53
09-10-54
27-10-44
02-10-44
11-10-44
30-10-44
03-10-47
14-10-45
31-10-56
08-10-54
24-10-47
32-10-44Ch. 1121 Prior Authorization of Methadone in Analgesics, Narcotic Long Acting Updated Handbook Pages Pharmacy Services 12/24/10 01-10-54
09-10-55
27-10-45
02-10-45
11-10-45
30-10-45
03-10-48
14-10-46
31-10-57
08-10-55
24-10-48
32-10-45— Complex Case Planning 12/28/10 00-10-02 2011 Ch. 1150 2010 HCPCS Updates and Other Procedure Code and Procedure Code/Modifier Combination Changes 01/03/11 99-11-01 Ch. 1123 Change in Billing of Repairs and Replacements for Durable Medical Equipment 01/14/11 24-11-01 Ch. 1101
1150Medical Assistance Electronic Health Records (EHR) Incentive Program For Eligible Professionals 01/25/11 08-11-02
09-11-01
27-11-01
31-11-01
33-11-01Ch. 1101
1150Medical Assistance Electronic Health Records (EHR) Incentive Program for Eligible Hospitals 01/28/11 01-11-01 Ch. 1225 Rescind MA Program Fee Increase for Oral Contraceptives Dispensed by Family Planning Clinics 02/09/11 08-11-03 Ch. 1241 2011 Recommended Childhood and Adolescent Immunization Schedules 03/18/11 01-11-04
08-11-06
09-11-05
31-11-05
33-11-04Ch. 1101
1150MA Program Outpatient Fee Schedule Decrease for Select Incontinence Products 04/05/11 24-11-02
25-11-02— Electronic Prescribing Internet-based Application for Enrolled Medicaid Prescribers 04/08/11 03-11-01
09-11-02
14-11-01
18-11-01
24-11-03
27-11-02
31-11-02
33-11-03Ch. 1150 Health Care Benefit Package 12 Updated Employability Assessment Procedure Code List 04/13/11 01-11-02
08-11-04
09-11-03
18-11-02
28-11-01
29-11-01
31-11-03Ch. 1101 SelectPlan for Women Program—Update to Covered Services 04/13/11 01-11-03
08-11-05
09-11-04
24-11-04
28-11-02
31-11-04
33-11-03Ch. 1101
1150Medical Assistance Electronic Health Record (EHR) Incentive Program Application Process for Eligible Professionals (EP) 05/13/11 08-11-07
09-11-06
27-11-03
31-11-06
33-11-05Ch. 1101
1150Medical Assistance Electronic Health (EHR) Incentive Program Application Process For Eligible Hospitals 05/13/11 01-11-05 Ch. 1121 Prior Authorization of Androgenic Agents—Pharmacy Services 05/26/11 01-11-06
09-11-07
27-11-04
02-11-01
11-11-01
30-11-01
03-11-02
14-11-02
31-11-07
08-11-08
24-11-05
32-11-01Ch. 1121 Prior Authorization of Angiotensin Modulators—Pharmacy Services 05/26/11 01-11-10
09-11-11
27-11-08
02-11-05
11-11-05
30-11-05
03-11-06
14-11-06
31-11-11
08-11-12
24-11-09
32-11-05
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