[52 Pa.B. 4497]
[Saturday, August 6, 2022]
[Continued from previous Web Page] Office of Medical Assistance Programs—Contact: Eve Lickers (717) 772-6341
POLICY STATEMENTS:
Year Code Citation(s) Subject Date Issued Bulletin Number 1981 Ch. 1251 Clarification of M.A. Bulletin # 22-80-01 08/19/81 22-81-01 Ch. 1121 Info. Concerning Claims Submitted as Compounded Prescriptions 06/30/82 19-82-02 1984 Ch. 1251 Revisions to MA Chapter 1251 (Funeral Directors' Services) 05/11/84 22-84-01 1984 Ch. 1101 Third Party Resource and Copay 11/01/84 99-84-15 1985 Ch. 1141 Physician Assistant Use 04/22/85 01-85-05 Ch. 1101 Allergy Testing—Exemptions from Co-Payments 10/15/85 01-85-18
11-85-20
12-85-11
10-85-02Ch. 1101 Professional Component Billing Regarding Patient Transport 10/15/85 01-85-16 Ch. 5100 Requirements for Treatment Plans Documentation of Treatment 10/31/85 29-85-02
33-85-021986 Ch. 1141 Payment Policy for Abortion Clinic
Visits09/10/86 10-86-02
11-86-10Ch. 1101 Policy Clarification Re: Provider's Signature 09/19/86 99-86-06 Ch. 1150 Payment Policy for Consultations 10/23/86 03-86-07 Ch. 1101 Preclusion of Convicted Persons, Not Providers, from Participation or Involvement in the MA Program 10/24/86 99-86-09 Ch. 1123 Durable Medical Equipment Warranties 10/28/86 05-86-02
19-86-071987 Ch. 1101 Physicians' Responsibility when Ordering Home Health Services 01/12/87 01-87-01 Ch. 1149 Palliative Emergency Treatment 04/24/87 03-87-02
27-87-01Ch. 1187 Barber and Beauty Costs 05/15/87 35-87-04
36-87-01Ch. 1101
Ch. 1123Coverage for Motorized Wheelchairs 07/30/87 05-87-02
01-87-08
19-87-06Ch. 1123 Policy Relating to Apnea Monitors 09/02/87 01-87-15
05-87-04
19-87-09Ch. 1187 Barber and Beauty Costs 10/22/87 35-87-07
36-87-08Ch. 140 Use of the PA 162 Forms for Notification of Medical Assistance Eligibility 10/22/87 99-87-10 Ch. 5310 Medical Assistance Coverage for Recipients Residing in Community Residential Facilities 10/23/87 99-87-11 Ch. 1150 Time Limit for Claim Resubmissions and Recovery of Overpayments 11/03/87 99-87-12 1988 Ch. 1150 Place of Service Review (PSR) Program 01/04/88 01-88-01
03-88-01
04-88-01
06-88-01
08-88-01
11-88-01Ch. 1150 Place of Service Review (PSR) Program 03/04/88 01-88-02
03-88-02
04-88-02
06-88-02
08-88-02
11-88-03Ch. 140 Healthy Beginning—Presumptive Eligibility Program 04/01/88 99-88-04 Ch. 1123 List of Accredited Rehabilitation Facilities to be used for Motorized Wheelchair Evaluation 04/06/88 01-88-04
05-88-02
19-88-03Ch. 150 Medical Assistance Eligibility Change for Aliens 04/13/88 99-88-05 Ch. 1151 Revisions to Chapters 1151 and 1163 Regulations 06/29/88 11-88-02
12-88-05
13-88-05
1151-88-02
1163-88-02Ch. 1101 Policy Clarification Regarding Physician License 07/01/88 1101-88-01 Ch. 1223 Revision of Inpatient Hospital Drug and Alcohol Detoxification Payment Policy 09/09/89 01-88-11
11-88-11
1163-88Ch. 1150 Desk Reference 10/06/88 29-88-01
33-88-011989 Ch. 140 Healthy Horizons and Medicare Cost Sharing 01/04/89 99-89-02 Ch. 1150 Billing Instructions—Services Covered Only by Medicare 05/18/89 99-89-03 — Signature Requirements and Encounter Forms 05/26/89 99-89-05 Ch. 1150 Proper Use of Place of Service Codes 07/05/89 03-89-05 Ch. 1101 Policy Reminder Regarding Practitioner License Requirements 1101-89-02
03-89-08
04-89-07
07-89-02
15-89-02
31-89-02Ch. 1101 1150 Penalty for Bypassing Place of Service Review 11/03/89 01-89-09
03-89-06
04-89-05 06-89-04
08-89-04
11-89-10Ch. 1150 Michael Dallas Model Waiver Program for Technology—Dependent Children 11/03/89 99-89-13 Ch. 1247 Targeted Case Management Services 11/13/89 99-89-12
1247-89-01— Additional Category Eligible for Medicare-Cost Sharing Benefits 12/27/89 99-89-15 1990 Ch. 1121 Special Billing Instructions for Persantine 01/19/90 01-90-01 Ch. 1150
1163
1249
1121
1126AIDS Waiver Program 04/02/90 01-90-02
02-90-01
05-90-02
19-90-01
23-90-01
38-90-01
39-90-01Ch. 1150 Payment Policy for Consultations 04/27/90 1150-90-01 Ch. 1150 The Medicare Catastrophic Coverage Act of 1988 the Medicare Catastrophic Coverage Repeal Act of 1989 05/18/90 34-90-09 Ch. 1140 Provider Participation Requirements for Healthy Beginning Plus 06/12/90 1140-90-01
01-90-06
09-90-01
10-90-02
11-90-04
23-90-05
26-90-02
30-90-02
31-90-01Ch. 1163 Inpatient Hospital Services Retrospective Review Findings 07/09/90 11-90-08
12-90-03
13-90-02Ch. 1144 Certified Registered Nurse Practitioner 07/31/90 99-90-05
1144-90-01— Increase in Eligibility Guidelines 08/15/90 99-90-06 Ch. 1241 EPSDT Services 10/15/90 99-90-07
1241-90-01Ch. 1141 Allergen Immunotherapy 1991 Ch. 1141
1149
1143
1221Billing Procedures—Multiple Surgical Surgical/Obstetrical and Anesthesia Procedures 03/01/91 01-91-01
03-91-01
04-91-01
10-91-01
11-91-01
44-91-01
49-91-01Ch. 1123 Incontinence Products and Diapers 03/21/91 01-91-02
02-91-01
05-91-01
19-91-01
23-91-01Ch. 1121 Manufacturers' Rebate Program Corrections and Clarifications 05/20/91 01-91-07
02-91-03
03-91-05
04-91-05
10-91-04
11-91-06
12-91-03
19-91-05
26-91-03
28-91-02
29-91-02
30-91-02
33-91-02
49-91-03Ch. 1121 Manufacturers' Rebate Program 05/31/91 01-91-08
02-91-04
03-91-06
04-91-06
10-91-05
11-91-07
12-91-04
19-91-06
26-91-04
28-91-03
29-91-03
30-91-03
33-91-03
49-91-04— Certification of Need—Medical Assistance Patients Under the Age of 21 06/24/91 13-91-01 Ch. 1101 Lock-In Enhanced Recipient Restriction Program 07/12/91 99-91-04 — Third Party Resources Edits 608 and 616 07/26/91 99-91-05 *CH. 1101
CH. 1121
CH. 1123
CH. 1241EPSDT—OBRA '89 08/02/91 1101-91-01
1121-91-02
1123-91-01
1241-91-01Ch. 1123 Repair and Replacement of Durable Medical Equipment (DME), Orthotics and Prosthetics 10/01/91 05-91-04
19-91-14Ch. 1101
1150
1241Payments for Vaccines 11/06/91 1221-91-01 Ch. 1121 Clorazil Monitoring and Evaluation Visit 11/06/91 29-91-07
1153-91-011992 Ch. 1221 Billing for Emergency Room Services for Recipients Who Are Hospitalized On the Same Day 01/17/92 11-92-02
13-92-01
12-92-01
53-92-01Ch. 1147 Increased Fees for Vision Services 01/31/92 01-92-02
05-92-01
15-92-01
19-92-02*Ch. 1141
*Ch. 1153Clozapine Support Services 01/31/92 1141-92-01
1153-92-01
01-92-04
29-92-02
33-92-04— Independent Team—Certification of Need—Medical Assistance Patients Under the Age 21 02/21/92 13-92-03 Ch. 1149 Dental Management Fee Guidelines 02/21/92 03-92-03 Ch. 1147 Clarification of Vision Services 04/17/92 01-92-05
05-92-02
15-92-03
19-92-04Ch. 1181 Reimbursement for Hospital Reserved Bed Days During a Medicare Benefit Period 05/01/92 1181-92-04 — Qualified Medicare Beneficiary Healthy Horizons Program 06/19/92 99-92-03 Ch. 1163 Inpatient Hospital Services Retrospective Review Findings 07/03/92 11-92-11
12-92-11
13-92-07
53-92-05Ch. 1163 Automated Admission Certification 07/22/92 01-92-12
03-92-05
04-92-04Ch. 1163 Hospital Utilization Review Changes 07/22/92 06-92-01
08-92-01
11-92-12
12-92-12
13-92-08
53-92-06Ch. 1126 Increase in Hospital Special Treatment Room Support Component—Payment For Observation and Monitoring in ASC's and SPU's 08/11/92 06-92-02
08-92-02
11-92-13Ch. 1121 Norplant Coverage 12/07/92 01-92-20
10-92-10
11-92-21
30-92-06Ch. 1101 Basic Health Care for Adult General Assistance Recipients 12/23/92 99-92-07 Ch. 1121 Changes in Medical Assistance Pharmaceutical Benefits 12/23/92 01-92-19
02-92-03
03-92-08
04-92-09
10-92-09
11-92-20
12-92-16
19-92-15
26-92-05
28-92-03
29-92-03
30-92-05
33-92-04
49-92-081993 — Accessing Mental Health Services Not Currently Included in the Medical Assistance Fee Schedule for Eligible Children and Adolescents Under 21 Years of Age 01/19/93 01-93-03
29-93-02
33-93-02
41-93-01
48-93-01— Payment for Mental Health Services Provided in a Residential Treatment Facility for Eligible Individuals Under 21 Years of Age 01/19/93 01-93-04
11-93-02
13-93-02
41-93-02
53-93-02
1165-93-07— Enrollment Procedure Changes 01/22/93 29-93-01
33-93-01Ch. 1101 Interim Agreement Felix et al. v. Casey et al. 01/28/93 99-93-01
1101-93-02Ch. 1123 Reminder that Medical Equipment and Supplies Must Be Prescribed 01/29/93 01-93-02
03-93-01
04-93-01
05-93-01
07-93-01
19-93-02Ch. 1101 Additional Copayment Expenses 02/17/93 01-93-01
19-93-01
1101-93-01Ch. 1123 Prior Authorization Rental of Nebulizers 04/09/93 01-93-06
05-93-03
19-93-04Ch. 1121 Intrauterine Devices 05/13/93 01-93-09
10-93-01
11-93-04Ch. 1101
1150Voucher System for the General Assistance Basic Health Care Package Update 06/30/93 01-93-12
04-93-04
07-93-03
10-93-04
11-93-07
15-93-02
19-93-09
26-93-04
30-93-03
49-93-04*CH. 1121 CHANGES IN THE MEDICAL ASSISTANCE PHARMACEUTICAL BENEFITS 07/09/93 1121-93-01 *CH. 1149 DENTAL SERVICES FOR ADULTS 07/09/93 1149-93-01 Ch. 1150 Revised Definition for Established Patient Evaluation and Management Visit and Consultation 07/13/93 01-93-14
04-93-05*CH. 1101 BASIC HEALTH CARE FOR ADULT GENERAL ASSISTANCE RECIPIENTS (FELIX ET. AL. V. CASEY ET. AL.) STIPULATION OF SETTLEMENT 07/21/93 1101-93-03 *CH. 1101 UPDATE TO EXCEPTIONS PROCESS AND CRITERIA UNDER THE GENERAL ASSISTANCE BASIC HEALTH CARE PACKAGE 07/21/93 1101-93-04 Ch. 1147 Specific Procedure Code for Deluxe Eyeglass Frames 08/02/93 01-93-16
05-93-05
15-93-04
19-93-12Ch. 1163 Change in Automated Utilization Review Toll-Free Telephone Number 08/04/93 01-93-17
03-93-06
04-93-07
06-93-01
08-93-01
11-93-10
12-93-05
13-93-04
26-93-05
53-93-03Ch. 1241 Centers for Disease Control Blood Lead Testing 09/03/93 1241-93-01
01-93-18
10-93-06
11-93-12
17-93-02
26-93-06
49-93-06Ch. 1101 Business Arrangements Between Nursing Facilities and Pharmacy Providers 10/08/93 1101-93-05
19-93-16
25-93-01
35-93-03
36-93-03Ch. 1101
1150Payment Policy for the Professional Component of Radiology Services and Electrocardiograms 10/29/93 01-93-19
11-93-13
12-93-06
13-93-05
53-93-04Ch. 1101
1150Procedures for Submitting Invoices for Services Provided to Retroactively Eligible Newborns 12/06/93 99-93-11 Ch. 1101
1150Newborn Eligibility Update and Corrections to Previous Bulletins 12/20/93 09-93-02
11-93-15
31-93-02Ch. 1101
1150Newborn Eligibility Update 12/20/93 99-93-14 Ch. 1245 Payment for Non-emergency Transportation for Nursing Home Patients 12/27/93 18-93-01 — OBRA Procedures for Individuals with Mental retardation 12/30/93 00-93-30 1994 EVS Response Worksheet (MA 464) 01/20/94 99-94-01 Ch. 1101 General Assistance (GA) Basic Health Care Package Voucher System and Rejected Invoices 03/02/94 01-94-03
04-94-01
07-94-01
10-94-01
11-94-02
15-94-01
19-94-02
26-94-01
30-94-01
49-94-02Ch. 1101 General Assistance (GA) Basic Health Care Package Voucher System and Rejected Invoices 03/02/94
04-49-01
07-94-01
10-94-01
11-94-02
15-94-01
19-94-02
26-94-01
30-94-01
49-94-02— 1. ACCESS to Medical Assistance for Children, Pregnant Women and Their Families (PA 600C)
2. Provider Application for Benefits (PA 600P)03/31/94 99-94-05 — Implementation of the Family Care Network: A Primary Care Case Management Program for Children and Adolescents 04/01/94 99-94-06 — Plan of Care Summary 04/01/94 01-94-05
41-94-02
48-94-02
49-94-03
50-94-02Ch. 1241 Update to Blood Lead Testing Guidelines 04/08/94 1241-94-01 Ch. 1123 Audiological Services 04/28/94 01-94-08
05-94-03
11-94-06
19-94-04
50-94-03— Billing Procedures for Partial Hospitalization Services that Exceed the Total Number of Hours 04/29/94 33-94-01 Ch. 1149 Provider Training on Completing the Dental Services Invoice (MA 300D) 05/05/94 03-94-02 — Medicare Part B Crossover 05/05/94 99-94-07 *CH. 1239 MA CASE MANAGEMENT SERVICES FOR RECIPIENTS UNDER THE AGE OF 21 05/17/94 1239-94-01
99-94-08Ch. 1249 Procedures for Prior Authorization of Home Health Services 06/10/94 23-94-04 Ch. 1121 Discontinuance of Pharmacy Vouchers for General Assistance Recipients and Enforcement of Limits 06/24/94 01-94-13
19-94-09*CH. 1121 PHARMACEUTICAL SERVICES DRUG COVERAGE FOR MEDICALLY NEEDY IN NURSING FACILITIES 06/24/94 1121-94-01 Ch. 1121 Brand Medically Necessary Drugs Prior Authorization Billing Procedure and Drug List 07/01/94 19-94-10 Ch. 1121 Brand Medically Necessary Drugs Prior Authorization Request Procedure and Drug List 07/01/94 01-94-15
03-94-03
04-94-04— Medical Case Management Recordkeeping Forms 07/06/94 99-94-11 Ch. 1147 Proper Billing of Tonography and Provocative Test for Glaucoma 07/14/94 01-94-14
15-94-03*CH. 1121 PHARMACEUTICAL SERVICES PRIOR AUTHORIZATION REQUIREMENT MULTISOURCE BRAND NAME DRUGS 08/26/94 1121-94-02
01-94-17
03-94-04
04-94-05
19-94-11*CH. 1121
CH. 1126
CH. 1129
CH. 1141
CH. 1163
CH. 1221
CH. 1225
CH. 1242TREATMENT OF INFERTILITY—DISCONTINUED COVERAGE FOR DRUGS AND RELATED SERVICES 08/30/94 1121-94-03
1126-94-01
1129-94-01
1141-94-01
1163-94-01
1221-94-01
1225-94-01
1242-94-01
99-94-13*CH. 1101 GENERAL ASSISTANCE RESTRUCTURE AS A RESULT OF ACT 49 09/02/94 1101-94-01
99-94-14Medicare Deductible and Coinsurance Amounts for Medical Supplies for Residents in a Nursing Home 09/02/94 05-94-07
19-94-13Ch. 1141
1143Selected Office Surgical Procedures Performed in the Office 09/02/94 01-94-19
04-94-06— Clarification Bulletin 18-93-01 09/23/94 18-94-01 Ch. 1150 Revised Billing Instructions for the HCFA1500 11/14/94 99-94-15 *CH. 1153 PRIOR AUTHORIZATION OF PARTIAL HOSPITALIZATION 12/30/94 1153-94-01 1995 — Signature Requirements 02/01/95 01-95-01
29-95-01
33-95-01
41-95-01
49-95-01
50-95-01— Payment of Partial Hospitalization Services After Medicare 02/14/95 33-95-02 — AIDS Waiver Program (0192 Waiver Program); the Physician's Role in Recipient Enrollment 02/23/95 01-95-02
02-95-01
10-95-01
11-95-01— Implementation of the Lancaster Community Health Plan 03/27/95 99-95-02 — Reimbursement of Nurse Aide Training and Testing Fees 04/06/95 34-95-01
35-95-01
36-95-01
1181-95-01— Nutritional Consultations under the AIDS Waiver Program (0192 Waive) 04/26/95 01-95-05
02-95-03
10-95-02
11-95-02
23-95-02
27-95-01
28-95-01
30-95-01
38-95-01
39-95-01— Changes to the Services Available Under the AIDS (0192) Waiver Program 05/12/95 01-95-06
02-95-05
05-95-02
10-95-03
11-95-03
17-95-01
19-95-03
23-95-03
27-95-02
28-95-02
30-95-02
38-95-02
39-95-02Ch. 1141 Mammography Quality Standards Act (MQSA) 06/02/95 01-95-09
10-95-05
11-95-06
12-95-02
20-95-02
30-95-05— 1. Announcement of New Forms Printing Contractor
2. Instructions on Ordering Medical Assistance (MA) Forms07/14/95 99-95-06 Ch. 1121 Prescription Payment Systems Revisions 09/22/95 01-95-14
19-95-05Ch. 1141 Payment for Cleft Palate Services for Individuals Under 21 Years of Age 10/06/95 01-95-16
03-95-03
41-95-05
50-95-05Ch. 1221 Non-Emergency Use of the Emergency Room 10/13/95 01-95-19
11-95-11
12-95-06— Announcement of the Pennsylvania Department of Aging (PDA) Waiver 10/16/95 01-95-17
05-95-04
18-95-01
19-95-06Changes to the Eligibility Verification System 11/22/95 99-95-08 — Additional Benefits Covered by the Special Pharmaceutical Benefits Program 11/30/95 01-95-22
02-95-07
05-95-06
11-95-14
13-95-03
14-95-03
19-95-08
23-95-10
26-95-03
27-95-03
29-95-06
32-95-09
33-95-07
35-95-08
36-95-08
49-95-03CH. 1163 Payment Policy for Abortion Services 12/15/95 1163-95-02 Ch. 1221 Change in Billing Procedure for Emergency Room Visits 12/28/95 01-95-23 1996 Ch. 1121 Brand Name Drugs Prior Authorization 0 Updated List 01/19/96 01-96-01
02-96-01
03-96-01
04-96-01
10-96-01
11-96-01
12-96-01
19-96-01
26-96-01
28-96-01
29-96-01
30-96-01
33-96-01
49-96-01— The Addition of Invirase to the Special Pharmaceutical Benefits Program Formulary 03/01/96 01-96-06 02-96-04
11-96-05
19-96-06 23-96-02 26-96-05 28-96-04 30-96-04 35-96-03 36-96-03 37-96-01 45-96-01 49-96-05Ch. 1141 Rate Change for Pediatric Office Visits 02/05/96 01-96-02
10-96-02
11-96-02
26-96-02
49-96-02
50-96-01— Continuity of Prior Authorized Services Between Fee-for-Service and Managed Care Plans for Individuals Under Age 21 02/29/96 99-96-01 — Revisions to Billing Instructions for the Pennsylvania Department of Aging (PDA) Waiver 04/01/96 01-96-07
05-96-02
18-96-01
19-96-07
23-96-03
28-96-05
29-96-04
33-96-04
39-96-01Ch. 1121 Procedure to Request Prior Authorization for Anti-Ulcer Drugs 04/02/96 01-96-05
02-96-03
03-96-03
04-96-03
10-96-04
11-96-04
12-96-03
26-96-04
28-96-03
29-96-03
30-96-03
33-96-03
49-96-04Ch. 1121 Procedure to Bill Anti-Ulcer Drugs Requiring Prior Authorization 04/02/96 19-96-05 Ch. 1121 Prior Authorization of Anti-Ulcer Drugs 04/02/96 01-96-08
02-96-05
03-96-04
04-96-04
10-96-05
11-96-07
12-96-05
19-96-08
26-96-06
28-96-06
29-96-05
30-96-06
33-96-05
49-96-06Ch. 1101
1150Hearing Aid Batteries Added to Medical Assistance Program Fee Schedule 04/02/96 03-96-09
05-96-03
11-96-08
19-96-09
50-96-02Procedure for Service Description 04/29/96 01-96-11
41-96-01
48-96-01
50-96-04— InterQual Intensity/Severity/Discharge (ISD) Criteria for Review of Hospital Admissions 05/22/96 01-96-13
11-96-12
13-96-01— Provider Billing Information for the Family Care Network (FCN) Program 05/23/96 99-96-04 — Implementation of Act No. 1996-35 06/14/96 99-96-05 Ch. 1141 Clarification of the Rate Change for Pediatric Office Visits Bulletin 07/19/96 01-96-16
10-96-08
11-96-15
26-96-09
49-96-08
50-96-06— HealthCare Benefits Package 12 Employability Assessment Procedure Code List 08/19/96 01-96-17
10-96-09
11-96-17
12-96-11
15-96-02
16-96-03
20-96-02
26-96-10
28-96-08
29-96-07
49-96-09— Additions to the Special Pharmaceutical Benefits Program Drug Formulary 09/03/96 01-96-18
02-96-06
05-96-05
11-96-18
13-96-04
14-96-03
19-96-15
23-96-06
26-96-11
27-96-01
29-96-08
32-96-01
33-96-06
35-96-08
36-96-08
49-96-10Ch. 1101 GA and GA-related Medical Assistance Deductible Procedures 09/30/96 06-96-03
08/96-03
11-96-20
12-96-13
13-96-06
53-95-02Ch. 1241 Statewide Implementation of the Vaccines for Children (VFC) Program 10/04/96 01-96-19
10-96-10
11-96-21
26-96-12Ch. 1149 Information on New Procedures for Submitting Evaluating Orthodontic Prior Authorization Requests 10/21/96 03-96-06 Ch. 1163
1141Neonatal Intensive Care Procedure Costs 10/25/96 01-96-20 — Healthcare Benefit Package 12 Employability Assessment Update 11/15/96 01-96-22
10-96-12
11-96-23
12-96-15
15-96-03
16-96-04
20-96-03
26-96-14
28-96-09
29-96-09
49-96-11— Implementation of the HealthChoices Program 11/18/96 99-96-08 Ch. 1141 Revision to Physician Assistant and Midwife Supervision Requirements 11/22/96 01-96-21
02-96-07
06-96-04
08-96-04
09-96-01
10-96-11
11-96-22
12-96-14
25-96-02
26-96-13
30-96-08
37-96-02
38-96-01
1141-96-01— Clarification of Act 35 Issues 12/04/96 01-96-23
10-96-13
11-96-24
12-96-16
13-96-07
14-96-04
26-96-15
28-96-10
29-96-10— Special Pharmaceutical Benefits Program Automated Claims Processing System 12/11/96 01-96-24
02-96-08
05-96-06
11-96-25
13-96-08
14-96-05
19-96-16
23-96-07
26-96-16
29-96-11
32-96-02
33-96-07
49-96-121997 Ch. 1145 Change in Recipient Access to Chiropractic Services in the Family Care Network (FCN) Program 02/12/97 99-97-02 Ch. 1121 HealthChoices Protease Inhibitors Special Billing Procedure 02/21/97 19-97-02 Ch. 1121 Prospective Drug Use Review Therapeutic Duplication Screening 02/21/97 19-97-01 — Expansion of the Pennsylvania Department of Aging (PDA) Waiver 02/28/97 23-97-01
28-97-01
29-97-01
33-97-01— Expansion of the Pennsylvania Department of Aging (PDA) Waiver 02/28/97 01-97-02
05-97-01
18-97-01
19-97-03
55-97-01— Pennsylvania Department of Aging (PDA) Waiver Program Handbook 02/28/97 35-97-03
36-97-03— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions 02/28/97 23-97-03
28-97-03
29-97-03
33-97-03— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions 02/28/97 01-97-03
05-97-02
18-97-02
19-97-04— Pennsylvania Department of Aging (PDA) Waiver Program Handbook 02/28/97 55-97-02 — Pennsylvania Department of Aging (PDA) Waiver Certification Process 02/28/97 23-97-02
28-97-02
29-97-02
33-97-02
35-97-02
36-97-02— Expansion of the Pennsylvania Department of Aging (PDA) Waiver 02/28/97 35-97-01
36-97-01Ch. 1121 Brand Name Drugs Prior Authorization Updated List 03/17/97 01-97-06
02-97-01
03-97-02
04-97-02
10-97-01
11-97-03
12-97-01
19-97-06
26-97-02
28-97-04
29-97-04
30-97-01
33-97-04
49-97-01Ch. 1121 Updates to State Maximum Allowable Cost (State MAC) List 03/21/97 01-97-04
19-97-05Ch. 1150
1141Discontinuance of the Mandatory Second Program (SOP) 03/25/97 01-97-05
03-97-01
04-97-01
06-97-01
08-97-01
11-97-02
12-97-02
26-97-01
1150-97-01Ch. 1101
1150Medical Assistance Program Fee Schedule Revision 1997 HCPCS Updates 04/10/97 05-97-03
19-97-07
23-97-04Ch. 1101
1150Medical Assistance Program Fee Schedule Revision 1997 HCPCS Updates 04/10/97 01-97-07
03-97-03
04-97-03
10-97-02
11-97-04
12-97-03
15-97-01
16-97-01
17-97-02
20-97-01
30-97-02
43-97-01
49-97-02
50-97-01Ch. 1221 Change in Billing Procedure for Emergency Room Visits 05/12/97 11-97-05
12-97-04
13-97-01Ch. 1141
1144
1241Diagnostic and Psychological Evaluations 05/28/97 01-97-08
17-97-03
41-97-01
48-97-01
49-97-03
50-97-02— Pennsylvania Department of Aging (PDA) Waiver Procedure Code Update 06/06/97 01-97-09
05-97-04
18-97-03
19-97-08
23-97-05
28-97-05
29-97-05
33-97-05— Coverage of COMVAX 06/11/97 01-97-10
10-97-03
11-97-06
17-97-04
19-97-09
26-97-03Ch. 1101
1150Provider Produced Invoices 06/11/97 99-97-03 — HealthChoices Phase 2 Extension of Enrollment Period 06/17/97 99-97-04 Ch. 1101
1150Changes to the Medical Assistance Program 1997 HCPCS Updates 06/30/97 01-97-11
03-97-04
04-97-04
10-97-04
11-97-07
12-97-05
15-97-02
16-97-02
17-97-05
20-97-02
30-97-03
43-97-02
49-97-04
50-97-04— InterQual Intensity/Severity/Discharge (ISD) Criteria for Review of Hospital Admissions 07/01/97 01-97-12
11-97-08
12-97-06
13-97-02Ch. 1241 Training for EPSDT Expanded Services (Provider Type 50) on Completing Medical Assistance Invoices 07/07/97 50-97-03 Ch. 1241 Revised Recommended Childhood Immunization Guidelines 07/23/97 1241-97-01
01-97-13
01-97-13
10-97-05
11-97-09
17-97-06
26-97-04
49-97-05Ch. 1141 Revision to Physician Assistance and Midwife Supervision Requirements 07/30/97 01-97-14
02-97-02
06-97-02
08-97-02
09-97-01
10-97-06
11-9711
12-97-07
25-97-01
26-97-05
30-97-04
31-97-01
37-97-01
38-97-01
1141-97-01Ch. 1121 Pharmacy Recordkeeping Requirements 08/04/97 19/97/10 — Revised Social Security Administration Definition of Disability for Children 08/08/97 99-97-05 Ch. 1163 Cost Outlier Payments for Certain Burn and Neonate Cases 08/11/97 11-97-10 — Reporting Procedures for Residents Targeted Under OBRA '87 and OBRA '90 08/29/97 34-97-01
35-97-04
36-97-04Ch. 1101
1150Accurate Billing for Units of Service Based on Periods of Time 09/17/97 99-97-06 Ch. 1121 Updates to State Maximum Allowable Cost (State MAC) List 09/17/97 01-97-15
19-97-11— The Addition of Viracept to the Special Pharmaceutical Benefits Program Formulary 11/10/97 01-97-18
02-97-03
11-97-12
19-97-13
23-97-06
26-97-06
28-97-07
30-97-05
35-97-05
36-97-05
37-97-02
45-97-01
46-97-01—-. Amendment to Medical Assistance Bulletin # 99-96-08 11/20/97 99-96-11 Ch. 1121 Updates to State Maximum Allowable Cost (State MAC) List 11/21/97 01-97-17
19-97-12— Amendment to Medical Assistance Bulletin # 99-96-08 11/27/97 99-96-09 Ch. 1101
1150Billing Instructions for Medicare Part B Claims 11/27/97 99-96-10 Ch. 1147 Revisions to the HealthCare Benefits Packages Reference Chart (MA 446) 12/18/97 99-97-07 — HealthChoices Southwest Mandatory Managed Care Program Implementation Schedule 12/19/97 99-97-08 1998 Ch. 1141 Physician Services Handbook Replacement Pages 01/20/98 01-98-01 Ch.1150 Clarification of Procedures for Requesting Copies of Medical Assistance Recipients' Bills 02/27/98 99-98-01 Training for Nursing Facilities on Completing Medical Assistance Invoices 03/03/98 35-98-02
36-98-02— Medical Assistance (Medicaid) Financial Eligibility Application for Long Term Care, Supports and Services (PA 600L) 03/03/98 11-98-01
12-98-01
14-98-01
24-98-01
25-98-01
34-98-01
35-98-01
36-98-01
51-98-01
53-98-01
55-98-01
56-98-01— Second Expansion of the Pennsylvania Department of Aging PDA Waiver 03/13/98 01-98-03
05-98-02
18-98-02
19-98-02
55-98-03— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions (2nd Expansion) 03/13/98 01-98-02
05-98-01
18-98-01
19-98-01— Second Expansion of the Pennsylvania Department of Aging (PDA) Waiver 03/13/98 35-98-05
36-98-05— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions (2nd Expansion) 03/13/98 55-98-02 — Pennsylvania Department of Aging (PDA) Waiver Certification Process (2nd Expansion 03/13/98 23-98-02
28-98-02
29-98-01
33-98-01
35-98-03
36-98-03— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions (2nd Expansion) 03/13/98 35-98-04
36-98-04— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions (2nd Expansion) 03/13/98 23-98-03
28-98-03
29-98-02
33-98-02— Second Expansion of the Pennsylvania Department of Aging (PDA) Waiver 03/13/98 23-98-04
28-98-04
29-98-03
33-98-03Ch. 1101
1150Announcement of Revised Millennium Medical Assistance Claims Forms 03/16/98 99-98-02 Ch. 1101
1150Medical Assistance Program Fee Schedule Revision 1998 HCPCS Updates 03/25/98 05-98-03
04/06/98
01-98-04
03-98-01
04-98-01
10-98-01
11-98-02
12-98-02
15-98-01
16-98-01
17-98-01
20-98-01
30-98-01
43-98-01
49-98-01
50-98-01Ch. 1101
1150Revisions to and Instructions for Completing & Submitting Revised ''Millennium'' Medical Assistance (MA) Claim Forms 04/22/98 99-98-04 — Clarification of the HealthChoices Recipient Coverage Policy for Behavioral Health Services 04/30/97 01-98-05
17-98-02
41-98-01
48-98-01
49-98-02
50-98-02
53-98-02
80-98-01— Medical Assistance Surety Bonds Interim Procedures 05/01/97 23-98-06 Ch. 1163 Revision of Utilization Guidelines for Inpatient Hospital Drug and Alcohol Services under the Medical Assistance Program 05/18/98 01-98-06
11-98-03
12-98-03
17-98-03
1163-98-01— Revised Case-Mix Reimbursement System Cost Report (MA-11) 05/20/98 35-98-07 — Revised Medical and Treatment Self—Directive Statement 06/19/98 11-98-04
12-98-04
13-98-02
14-98-02
17-98-04
23-98-07
34-98-02
35-98-08
36-98-08
37-98-01
38-98-01
53-98-03Ch. 1101
Ch. 1141
Ch. 1150
Ch. 1221Regulation Changes Regarding ''Emergency Medical Condition'' 07/01/98 1101-98-01
1141-98-01
1150-98-01
1121-98-01Medical Assistance Tele-Response System 07/01/98 99-98-05 — The Addition of Viramune and Rescriptor to the Special Pharmaceutical Benefits Program Formulary 07/01/98 01-98-08
02-98-01
11-98-05
19-98-05
23-98-08
26-98-01
28-98-05
30-98-02
35-98-09
36-98-09
37-98-02
45-98-01
46-98-01Ch. 1150
1241Increase in the Fees for the Administration of Vaccines 07/01/98 01-98-09
10-98-02
11-98-06
12-98-05
49-98-03Ch. 1121 Updates to State Maximum Allowable Cost (State MAC) List 07/06/98 01-98-07
19-98-04— Preparation of Statements of Claim for Recipients Enrolled in Managed Care 07/07/98 99-98-07
258-98-01Ch. 1150 Implementation of ''Millennium'' Claims Submission 07/10/98 99-98-08 — Change in Billing Procedure for Behavioral Health Rehabilitation Services 07/10/98 01-98-10
41-98-02
48-98-02
49-98-04
50-98-03Ch. 1101 Revisions to the HealthCare Benefits Packages Reference Chart (MA 446) 07/17/98 99-98-09 Ch. 1123 Nebulizer Codes 07/24/98 01-98-11
05-98-04
10-98-03
11-98-07
12-98-06
19-98-06
23-98-09Ch. 1121 Updates to State Maximum Allowable (State MAC) List 08/14/98 01-98-12
19-98-07Ch. 1121 Brand Name Drugs Prior Authorization Updated List 08/24/98 01-98-13
02-98-02
03-98-02
04-98-02
10-98-04
11-98-08
12-98-07
19-98-08
26-98-02
28-98-07
29-98-04
30-98-03
33-98-04
49-98-05— InterQual Intensity/Sensitivity Discharge (ISD) Criteria for Review of Hospital Admissions 08/24/98 01-98-14
11-98-09
12-98-08
13-98-03— The Office of Social Program's (OSP)/Independence Waiver 09/11/98 99-98-10 — Billing Instructions for the Community Services Program for Persons with Physical Disability Waivers 09/11/98 51-98-01 Ch. 1150 Revised Billing Instructions for Medicare Part B Claims that Do Not Cross Over to Medical Assistance 09/14/98 99-98-11 Ch. 1150 Medical Assistance Program Fee Schedule Revision 1998 HCPCS Updates 09/21/98 07-98-01 Ch. 1150 Revision to Attachment Type Codes on Invoice Submissions 10/14/98 24-98-03
25-98-03
34-98-04
35-98-12
36-98-12— Change in Medical Assistance (MA) Bulletin Mailing Procedure 10/14/98 01-98-15
03-98-03
04-98-03
07-98-02
15-98-02
31-98-01
41-98-03
44-98-01
49-98-06— Statewide Expansion of the Pennsylvania Department of Aging (PDA) Waiver 11/17/98 10-98-05
11-98-10
12-98-09
13-98-04
14-98-03
17-98-05
20-98-02
23-98-10
26-98-03
28-98-08
29-98-05
33-98-05
37-98-03
41-98-04
43-98-02
45-98-02
46-98-02
48-98-03
49-98-07
51-98-03— Statewide Expansion of the Pennsylvania Department of Aging (PDA) Waiver 11/17/98 01-98-16
05-98-05
18-98-03
19-98-09
55-98-04— Statewide Expansion of the Pennsylvania Department of Aging (PDA) Waiver 11/17/98 35-98-13
36-98-13— Pennsylvania Department of Aging (PDA) Waiver Certification Process (Statewide Expansion) 11/17/98 10-98-06
11-98-11
12-98-10
13-98-05
14-98-04
17-98-06
20-98-03
23-98-11
26-98-04
23-98-09
29-98-06
33-98-06
35-98-14
36-98-14
37-98-04
41-98-05
43-98-03
45-98-03
46-98-03
48-98-04— Accurate Billing for Units of Service Based on Periods of Time 11/17/98 99-98-12 Ch. 1243 Clinical Laboratory Improvements Amendments (CLIA) Requirements 11/25/98 01-98-17
11-98-12
16-98-02
17-98-07— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions (Statewide Expansion) 12/22/98 35-98-15
36-98-15— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions (Statewide Expansion) 12/22/98 01-98-18
05-98-06
18-98-04
19-98-10— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions (Statewide Expansion) 12/22/98 10-98-07
11-98-13
12-98-11
13-98-06
14-98-05
17-98-08
20-98-04
23-98-12
26-98-05
28-98-10
29-98-07
33-98-07
37-98-05
41-98-06
43-98-04
45-98-04
46-98-04
48-98-05
49-98-09
51-98-05— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions (Statewide Expansion) 12/22/98 55-98-05 Ch. 1141
Ch. 1153Clozapine Support Services 12/29/98 33-98-08
29-98-08
01-98-19Procedure for Requesting Prior Authorization of Medical Assistance Case Management Services for Recipients Under the Age of 21 12/31/98 05-98-04 1999 Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for which Registration has been denied or approval withdrawn 01/01/99 88-99-01 — Address Change for Provider Inquiry 01/27/99 99-99-01 — Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in The Medical Assistance Program (2) Shared Health Facilities for which Registration has Been Denied or Approval Withdrawn 02/01/99 88-99-02 — Change in Procedure for Billing Administration of DT and Td Vaccines 02/09/99 01-99-02
10-99-01
11-99-02
26-99-02
49-99-01Ch. 1140 New Procedure Code for Healthy Beginnings Plus Program 02/12/99 01-99-01
11-99-01
23-99-01
26-99-01
30-99-01
31-99-01— Continued Existence of the Fee-For-Service (FFS) Delivery System in the HealthChoices Zones and Use of HealthChoices Zones and Use of Access Cards 02/12/99 99-99-03 — The addition of Sustiva (efavirenz) and Ziagen (abacavir) to the Special Pharmaceutical Benefits Program Formulary 02/15/99 01-99-03
02-99-01
11-99-03
19-99-01
23-99-02
26-99-03
28-99-01
30-99-02
35-99-01
36-99-01
37-99-01
45-99-01
46-99-01Ch. 1101
1150Medical Assistance Program Fee Schedule Revision 1999 HCPCS updates 02/26/99 99-99-02 — Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 03/01/99 88-99-03 Ch. 1225 Price Increase and Additional Services for Family Planning Clinics 03/04/99 34-99-01
35-99-02
36-99-02Ch. 1221 Change in Podiatric Billing Procedure for Emergency Room Visits 03/22/99 04-99-01 — Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 04/01/99 88-99-04 Ch. 1101 Revised HealthCare Benefits Packages Reference Chart 04/20/99 99-99-04 Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 05/01/99 88-99-05 — Severity Two Hour Supply HealthChoices Southeast 05/28/99 19-99-02 — Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 06/01/99 88-99-06 Capital Component Payments for Post Moratorium Beds 06/28/99 35-99-05
36-99-05
1187-99-01— Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 07/01/99 88-99-07 Ch. 1121 Prescriptions NOT received by the Medical Assistance (MA) Recipient 07/05/99 19-99-04 Ch. 1149 Increased Fees for Selected Pediatric Dental Services 07/09/99 33-99-01 — The Addition of Agenerase (amprenavir) To the Special Pharmaceutical Benefits Program Formulary 07/09/99 01-99-04
02-99-02
11-99-04
19-99-03
23-99-03
26-99-04
28-99-04
30-99-03
35-99-03
36-99-03
37-99-02
45-99-02
46-99-02Ch. 1121 Updates to State Maximum Allowable Cost (State MAC) 07/16/99 01-99-05
19-99-05— Millennium Compliance 07/27/99 99-99-05 Ch. 1150
1163Training for Inpatient Facilities on Completing the UB-92 Invoice 07/27/99 11-99-06
12-99-02
13-99-01
53-99-01— Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 08/01/99 88-99-08 — Additions and Corrections of Fee Increases for Specific Services Rendered by Outpatient Psychiatric clinics, Psychiatric partial Hospitalization Programs, and Outpatient Drug and Alcohol clinics 08/30/99 28-99-05
29-99-03
33-99-02Ch. 1150
1241Clarification of Enrollment and Billing Procedures for Physical, Speech, and Occupational Therapy 08/30/99 43-99-01
50-99-01— Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdraw 09/01/99 88-99-09 Ch. 1101 ''Payment in Full'' 09/17/99 99-99-06 Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 10/01/99 88-99-10 Ch. 1145 Change in Recipient Access to Chiropractic Services in the Managed Care Delivery System 10/22/99 99-99-07 — Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 11/01/99 88-99-11 Ch. 1147 Medical Assistance (MA) Payment Policy for Eyeglasses Coverage 11/05/99 01-99-06
05-99-01
15-99-01Ch. 1121 Prior Authorization of Viagra and Other Drugs for Erectile Dysfunction Treatment Criteria, Limits and Procedures 11/22/99 99-99-08 Ch. 1225 Price Increase and Additional Services for Family Planning Clinics 11/22/99 30-99-04 Ch. 1121 Fee Increase for the ParaGuard IUD 11/22/99 01-99-07
10-99-02
11-99-07Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 12/01/99 88-99-12 Ch. 1241 Coverage of Medically Necessary Services and Equipment for Children in Early Intervention or Special Education Programs 12/03/99 01-99-08
05-99-02
11-99-08
17-99-01
23-99-04
43-99-02
50-99-02Ch. 1241 Clarification of Enrollment and Billing Procedures for EPSDT Expanded Services Providers of Physical Therapy, Speech Therapy and Occupational Therapy 12/10/99 50-99-04 Ch. 1121 Prescription Refills Maintenance Medications 12/10/99 19-99-06 Ch. 1142 Expanded Procedures Codes for Provider Type 31 Midwives2000 Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 12/29/99
—
01/01/0031-99-02
88-00-01— Expansion of Special Pharmaceutical Benefits Clozaril Program 01/28/00 01-00-01,
02-00-01
05-00-01,
11-00-01
13-00-01
14-00-01
19-00-01
23-00-01
26-00-01
29-00-01
33-00-01
35-00-01
36-00-01
49-00-01— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 02/01/00 88-00-02 — Revised Billing Instructions for the Community Services Program for Persons with Physical Disabilities (CSPPPD) Waivers 02/15/00 51-00-01 — Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 03/01/00 88-00-03 — Changes in Terminology in Medical Assistance Program Fee Schedule for Type of Service/Procedure Code AG/W1855 03/13/00 28-00-01 Ch. 1121 Updated State Maximum Allowable Cost (MAC) List 03/17/00 01-00-02
19-00-02— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 04/01/00 88-00-04 — Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 05/01/00 88-00-05 — Continued Existence of the Fee-for-Service (FFS) Delivery System in HealthChoices Zones and Use of ACCESS Cards 05/24/00 99-00-01 Ch. 1121 Prior Authorization List of Brand Name Drugs 05/25/00 01-00-04
02-00-02
03-00-01
04-00-01
10-00-01
11-00-02
12-00-01
19-00-05
26-00-02
28-00-02
29-00-02
30-00-01
33-00-01
49-00-02Ch. 1121 Updated State Maximum Allowable Cost (MAC) List 05/26/00 01-00-03
19-00-04— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 06/01/00 88-00-06 Ch. 1141 Elimination of Physician Attestation Requirement 06/22/00 01-00-05
11-00-03— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 07/01/00 88-00-07 Ch. 1251 Increased Fees for Funeral Director Services 07/03/00 22-00-01 — Implementation of the Medical Assistance Programs' Internet website www.dpw.state.pa.us/omap 07/07/00 99-00-02 Ch. 1145 Change in Recipient Access to Chiropractic Services in the Managed Care Delivery System 07/12/00 99-00-03 Ch. 1121 Updated State Maximum Allowable Cost (MAC) List 07/19/00 01-00-06
19-00-06— Medicheck List: (1) Providers, Entities
and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn08/01/00 88-00-08 Ch. 1121 Clarification of Billing Instructions for Methadone Maintenance Services 08/21/00 28-00-03 — Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 09/01/00 88-00-09 Ch. 1141
1163Increased Fees for Selected Neonatal Intensive Care Procedure Codes and the Addition of a New Neonatal Intensive Care Procedure Code 09/01/00 01-00-07 — Prior Authorization Interim Supply of Medication HealthChoices Southwest (Revised) 09/07/00 19-00-07 — Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 10/01/00 88-00-10 Ch. 1150 Clarification of the 1150 Administrative Waiver Process also known as the Program Exception Process for Prosthetic and Orthotic Providers 10/04/00 01-00-08
05-00-02
19-00-08— Application for Health Care Coverage 10/13/00 99-00-04 — Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 11/01/00 88-00-11 Ch. 1241 Pennsylvania Vaccines for Children (VFC) Program 11/15/00 01-00-10
10-00-03
11-00-05
26-00-04— HealthCare Benefits Package 12 Updated Employability Assessment Procedure Code List 11/15/00 01-00-09
10-00-02
11-00-04
12-00-02
15-00-01
16-00-01
20-00-01
26-00-03
28-00-04
29-00-03
49-00-03Ch. 1243 Change in Payment Amount and Payment Method for the HIV-1 Viral Load Test (CPT Code 87536) 11/17/00 11-00-06
12-00-03
16-00-02— The Addition of Kaletra (lopinavir/ritonavir) to the Special Pharmaceutical Benefits Program Formulary 11/21/00 01-00-11
02-00-03
11-00-07
19-00-09
23-00-02
26-00-05
28-00-05
30-00-02
35-00-02
36-00-02
37-00-01
45-00-01
46-00-01— Consent Forms for the Release of Confidential Information 11/28/00 99-00-05 — Revised Target Resident Reporting Form (MA 408)* 11/28/00 34-00-02
35-00-05
36-00-04Ch. 1141 Medical Assistance (MA) Payment Policy for Multivisceral Transplants 11/28/00 01-00-12
11-00-08
17-00-02Ch. 1221 Voluntary Managed Care Organization's Payment Responsibility for Emergency Room Services 11/28/00 17-00-03 — Admissions Notice Packet (MA 401) 11/28/00 24-00-01
25-00-01
34-00-01
35-00-03
36-00-01— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 12/01/00 88-00-12 — Revised Billing Instructions: Specified Medical Assistance (MA) Services in MA Voluntary Managed Care 12/08/00 01-00-14
03-00-02
04-00-02
05-00-03
08-00-01
10-00-04
11-00-09
12-00-04
16-00-03
17-00-04
20-00-02
23-00-03
31-00-01
40-00-01
41-00-02
44-00-01
45-00-02
49-00-05
50-00-03Ch. 1121 Updated State Maximum Allowable Cost (MAC) List 12/11/00 01-00-15
19-00-10Ch. 1101
1150Medical Assistance Program Fee Schedule Revision 1999/2000 HCPCS Updates 12/22/00 99-00-06 — Freedom of Choice for Medical Assistance Recipients Requiring Behavioral Health Services 12/29/00 01-00-16
29-00-05
33-00-04
41-00-03
48-00-02
49-00-06
50-00-04Ch. 1149 Dental Fee Increase and Medical Assistance Program Fee Schedule Revisions 12/29/00 03-00-03 — Prior Authorization of Therapeutic Staff Support (TSS) Services 12/29/00 01-00-13
29-00-04
33-00-03
41-00-01
48-00-01
49-00-04
50-00-022001 — Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 01/01/01 88-01-01 Ch. 1121 Diabetes Outpatient Self-Management Training and Education 01/15/01 99-01-01 Ch. 1121 List of Brand Name Drugs Requiring Prior Authorization 01/30/01 01-01-01
02-01-01
03-01-01
04-01-01
10-01-01
11-01-01
12-01-01
19-01-01
26-01-01
28-01-01
29-01-01
30-01-01
33-01-01
49-01-01Ch. 1101
1150Delete Procedure Codes with Type of Service 35 from the Medical Assistance Program Fee Schedule 02/01/01 10-01-02
11-01-02
26-01-02Ch. 1149 Issuance of a Replacement Page to the January 1, 2001 Medical Assistance Program Fee Schedule for Dental Services 02/01/01 03-01-02 — Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 02/01/01 88-01-02 Ch. 1101
1223Clarification of Coverage for Motorized Wheelchairs and Other Durable Medical Equipment 02/16/01 01-01-02
05-01-01
17-01-01
19-01-02
49-01-02
50-01-01
1101-01-01
1123-01-01Ch. 1149 Addition of Selected Periodontal Services to the Medical Assistance Program Fee Schedule 02/28/01 03-01-03 — Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 03/01/01 88-01-03 — Expanded Hours of Operation for the Provider Services Toll-Free Inquiry Lines 03/28/01 99-01-02 — Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 04/01/01 88-01-04 Ch. 1150
1141Medical Assistance (MA) Payment Policy for Multivisceral Transplants 04/06/01 01-01-03
11-01-03
17-01-02— Behavioral Specialist Consultant and Mobile Therapist 04/26/01 01-01-04
17-01-03
29-01-02
33-01-02
41-01-01
48-01-01
49-01-03
50-01-02Ch. 1149 Implementation of the ADA Claim Form—Version 2000 and Revised Billing Instructions for Assistant Surgeons 04/27/01 03-01-04 Ch. 1101
1150Medical Assistance Program Fee Schedule Revision 2001 HCPCS Updates 04/27/01 99-01-03 — Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 05/01/01 88-01-05 — Automated Clearinghouse (ACH)—Electronic Funds Transfer 05/04/01 99-01-04 — Consent Forms for the Release of Confidential Information 05/18/01 99-01-05 — Additional Place-of-Service (Office) for Psychotherapy 06-01-01 01-01-09
41-01-06— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 06/01/01 88-01-06 — Revisions to Policies and Procedures Relating to Mobile Therapy, Behavioral Specialist Consultant and Therapeutic Staff Support Services 06/01/01 01-01-05
29-01-03
33-01-03
41-01-02
48-01-02
49-01-04
50-01-03— Section V—Billing Information Nursing Facility Services Handbook 06/04/01 35-01-01
36-01-01Ch. 1142 Reissue Expanded Procedure Codes for Independent Certified Nurse Midwives 06/15/01 01-01-08
31-01-01— Addition of Behavioral Health Rehabilitation Service to the Medical Assistance (MA) Program Fee Schedule 06/21/01 01-01-07
29-01-05
33-01-05
41-01-04
48-01-04
49-01-06
50-01-05Office of Medical Assistance Programs (OMAP) Fraud and Abuse Hotline 06/27/01 99-01-06 Ch. 1243 Training for Outpatient Laboratories on Completing the MA 319 and HCFA 1500 Invoices 06/29/01 11-01-04
16-01-01Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 07/01/01 88-01-07 Ch. 1241 Revision to the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program 07/01/01 01-01-10
10-01-03
11-01-05
17-01-04
26-01-03
49-01-07Ch. 1121 Medicaid Drug Rebate Program Participating Drug Labelers Updated List 07/12/01 01-01-11
02-01-02
03-01-05
04-01-02
10-01-04
11-01-06
12-01-02
19-01-03
26-01-04
28-01-02
29-01-06
30-01-02
33-01-06
49-01-08— Long Term Care Toll Free Inquiry Lines 07/16/01 24-01-01
25-01-01
34-01-01
35-01-02
36-01-02— The Use of Restraint and Seclusion in Psychiatric Residential Treatment Facilities (RTF) 07/23/01 53-01-01 Ch. 1145 Recipient Access to Chiropractic Services in the Managed Care Delivery System 07/31/01 99-01-07 — Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 08/01/01 88-01-08 Ch. 1121 Updated State Maximum Allowable Cost (MAC) List 08/09/01 01-01-12
19-01-04— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 09/01/01 88-01-09 Ch. 1101 Revised HealthCare Benefits Packages Reference Chart 09-10-01 99-01-08 Ch. 1121 ON-LINE Pharmacy Extended Reversal Implementation 09/11/01 19-01-05 — Billing for Clozaril and Clozapine in the Voluntary HMOs 09/25/01 01-01-14
19-01-06— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 10/01/01 88-01-10 — The Addition of Geodon Iziprasidone to the Special Pharmaceutical Benefits Program Formulary for Atypical Antipsychotic Medications 10/25/01 01-01-15
02-01-03
05-01-02
11-01-08
13-01-01
14-01-02
19-01-07
23-01-01
26-01-06
27-01-01
29-01-08
32-01-01
33-01-07
35-01-03
36-01-03
49-01-10— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 11/01/01 88-01-11 — Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 12/01/01 88-01-12 — The Addition of Viread (tenofir Disoproxil fumarate) to the Special Pharmaceutical Benefits Program Formulary 12/07/01 01-01-16
02-01-04
11-01-09
19-01-08
23-01-02
26-01-07
28-01-04
30-01-03
35-01-04
36-01-04
37-01-01
45-01-01
46-01-01Ch. 1149 Revision to Medical Assistance Dental Services 12/19/01 03-01-06 — MCO-FFS Split Billing for Inpatient Services 12/20/01 11-01-10
12-01-04
17-01-05— Medical Assistance for Workers with Disabilities (MAWD) 12/21/01 99-01-11 Ch. 1121 Prior Authorization of Sustained/Controlled Release Oxycodone/OxyContin 12/11/01 99-01-10 — Breast and Cervical Cancer Prevention and Treatment Program 12/26/01 99-01-12 Ch. 1249 Discontinuance of Prior Authorization Requirement for Home Health Postpartum Visits 12/27/01 01-01-19
11-01-11
23-01-03Ch. 1150 Ordering Medical Assistance Forms and Invoices 12/27/01 99-01-09 Ch. 1141
1150Increased Reimbursement for Anesthesia Procedure 12/27/01 01-01-14
44-01-01— Billing for Protease Inhibitors for HealthChoices Southeast MCOs 12/27/01 01-01-18
19-01-19Ch. 1123 Coverage of Enteral Nutritional Supplements 12/28/01 99-01-13 2002 — Discontinuance of Hard Copies of Medicheck List 01/01/02 88-02-01 Ch. 1121 Discontinuance Prior Authorization of Proton Pump Inhibitors and Prostaglandins 01/03/02 99-02-01 Ch. 1249 Revisions to the Home Health Agency Enrollment Process 01/04/02 23-02-01 Ch. 1121 Coverage of Tobacco Cessation Drug Products and Counseling Services 01/16/02 99-02-02 Ch. 1241 Revision to the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program 01/22/02 01-02-01
10-02-01
11-02-01
17-02-01
26-02-01
49-02-01Ch. 1121 Updated State Maximum Allowable Cost (MAC) List 01/28/02 01-02-02
19-02-01Ch. 1121 List of Brand Name Drugs Requiring Prior Authorization 01/30/02 01-02-03
02-02-01
03-02-01
04-02-01
10-02-02
11-02-02
12-02-01
19-02-02
26-02-02
28-02-01
29-02-01
30-02-01
33-02-01
49-02-02— The Michael Dallas Waiver 01/30/02 99-02-03 Ch. 1221 Diabetes Outpatient Self-Management Training and Education 02/06/02 99-02-04 Ch. 1130 BPI Retrospective Review of Hospice Services 02/21/02 01-02-04
17-02-02
37-02-01— Electronic Submission of the Cost Report (MA-11) Form for Reporting Periods Ending 12/21/2011 and Thereafter 02/21/02 35-02-01
36-02-01— Reissue of Medical Assistance (MA) Bulletin Addition of Behavioral Health Rehabilitation Service to the MA Program Fee Schedule 03/06/02 01-02-05
29-02-02
33-02-02
41-02-01
48-02-01
49-02-03
50-02-01— Urgent Care Transportation Requests through the Medical Assistance Transportation Program (MATP) 03/14/02 99-02-05 — Stopping Accidental Falls in Elders (SAFE) 03/21/02 01-02-06
11-02-03
12-02-02
13-02-41
14-02-01
35-02-02
36-02-02— Documentation and Medical Record Keeping Requirements 03/21/02 29-02-03
33-02-03
41-02-02— Medical Assistance Estate Recovery Program Brochure 04/03/22 34-02-01
35-02-03
36-02-03— Reminder to Providers Who Prescribe Behavioral Health Rehabilitation Services of Documentation Requirements 04/03/02 01-02-07
29-02-04
33-02-04
41-02-03
48-02-02
50-02-02
09-02-04Ch. 1123 Exceptional Durable Medical Equipment (DME) 04/04/02 01-02-08
05-02-01
17-02-03
19-02-03
35-02-04
36-02-04— Breast and Cervical Cancer Prevention and Treatment Program 05/03/02 99-02-06 — Clarification and Update to Bulletin 36-91-01 Regarding Invoice Exception Process for Long Term Care Facilities 05/21/02 25-02-01
35-02-05
36-02-05— Performance Expectations and Recommended Guidelines for the County Child and Adolescent Services System Program (CASSP) 06/06/02 OMHSAS-02-02 — Health Insurance Portability & Accountability Act (HIPAA) 06/25/02 99-02-07 — Electronic Provider Enrollment Automation Program (ePEAP) 07/18/02 99-02-08 — Section VII—Utilization Management Review Nursing Facility Services Handbook 07/18/02 35-02-06
36-02-06Ch. 1101 Revision to the HealthCare Benefits Packages Reference Chart (MA 446) 07/18/02 99-02-09 Ch. 1145 Change in Recipient Access to Chiropractic Services in the Managed Care Delivery System 08/12/02 99-02-10 — Residential Treatment facility Services Provided in a Secure Setting 10/01/02 01-02-11
11-02-04
12-02-03
13-02-02
17-02-04
41-02-04
50-02-03
53-02-01— Prior Authorization Interim Supply of Medication HealthChoices Lehigh/Capital Region 10/10/02 19-02-06 — Community Care (COMMCARE) Waiver Provider
Type 5910/16/02 05-02-04
17-02-05
19-02-07
23-02-02
28-02-03
29-02-05
38-02-01
39-02-01
41-02-05
43-02-01
51-02-01
55-02-01
56-02-01
59-02-01— Outpatient Drug and Alcohol Clinics with Provisional Licenses 10/16/02 28-02-02 Ch. 1241 Addition of Procedure Code 90732 to Medical Assistance Fee Schedule for Administration of Pneumococcal Vaccine 11/18/02 01-02-13
10-02-04
11-02-06
17-02-07
26-02-04
49-02-06Ch. 1241 2002 Recommended Childhood Immunizations Schedule 11/18/02 01-02-12
10-02-03
11-02-05
17-02-06
26-02-03
49-02-05— Continued Existence of the Fee-for-Service (FFS) Delivery System in HealthChoices Zones and Use of ACCESS Cards 11/27/02 99-02-11 Ch. 1101
1150Medical Assistance Program Fee Schedule Revisions: HIPAA Compliant Procedure Codes 11/27/02 99-02-12 Ch. 1121 Misrepresentation of Prescriber on the Drug Claim 11/27/02 19-02-08 Ch. 1101 The Bureau of Program Integrity and the Medical Assistance Provider Self-Audit Protocol 12/02/02 99-02-13 — Home Health Agency Services Fee Increase and Medical Assistance Program Fee Schedule Revisions 12/20/02 23-02-03 — Prior Authorization Update for Interim Supply of Medication HealthChoices Southeast Region 12/27/02 19-02-09 2003 — Additional Place of Service (Office) For Psychotherapy 01/06/03 01-03-01
41-03-01Ch. 1149 Elimination of the Use of the Dental Service Invoice (MA 300D) and Providing Training on Completion of The ADA Claim Form (Version 2000) 01/08/03 03-03-01 Ch. 1147 Expanded Procedure Codes for Provider Type 15 Optometrist 01/13/03 15-03-01 Ch. 1101 Revised Healthcare Benefit Packages Reference Chart 01/13/03 99-03-02 — Availability of Training for Completion of Provider Behavioral Health Rehabilitation Services Reports 01/31/03 01-03-02
29-03-01
33-03-01
41-03-02
48-03-01
49-03-01
50-03-01Ch. 1121 Updated State Maximum Allowable Cost (MAC) List 03/03/03 01-03-03
19-03-01— Introduction of the HIPAA Ready Provider Electronic Solutions Software and Statewide Training Seminars 03/11/03 99-03-03 Ch. 1241 2003 Recommended Childhood Immunization Schedule 03/31/03 01-03-04
10-03-01
11-03-01
17-03-01
26-03-01
49-03-02Ch. 1163 Billing Procedures for Change in Delivery Systems during a Hospital Stay and Subsequent Hospital Admission 04/04/03 11-03-02
12-03-01
13-03-01
17-03-02Ch. 1249 Revised Prior Authorization and Program Exception Pages for the Home Health Services Handbook 04/08/03 23-03-01 Ch. 1123 Information on Accredited Rehabilitation Facilities to be Used for Motorized Wheelchair Evaluation 04/14/03 01-03-05
05-03-02
19-03-03Ch. 1150 Elimination of the Use of the Medical Services Invoice 04/24/03 99-03-05 Ch. 1150 Medical Assistance Program Fee Schedule Revision 05/01/03 05-03-01
19-03-02Ch. 1150 Revisions to the Prior Authorization and Program Exception Notices 05/08/03 99-03-04 Ch. 1149 Medical Assistance Program Fee Schedule for Dental Services Revisions 05/12/03 03-03-02 Ch. 1144 Pharmaceutical Services Prescribed and/or Dispensed by a Certified Registered Nurse Practitioner (CRNP) 05/12/03 99-03-06 Ch. 1241 Coverage of Pediarix and Addition of Procedure Code 90723 to Medical Assistance Fee Schedule for Administration of Pediarix Vaccine 05/15/03 01-03-06
10-03-02
11-03-03
17-03-03
26-03-02
49-03-03— Process to Handle Residential Treatment Facility (RTF) Reports of Death, Serious Injury or Attempted Suicide (Serious Occurrences) 06/13/03 53-03-01 — Change of Protocol for Certain Provider Appeals. Appeals must be sent to Bureau of Hearings and Appeals 07/29/03 99-03-08 — Requirement for Medical Assistance (MA) Providers to Submit Accurate and Complete Encounter Data to MA Managed Care Organizations 08/01/03 99-03-10 — The Addition of Fuzeon (enfuvirtide) and Abilify (aripiprazole to the Special Pharmaceutical Benefits Program 08/01/03 99-03-11 — Obligation of Medical Assistance Providers Participating in the Managed Care Delivery System to Comply with MA Regulations 08/01/03 99-03-09 Ch. 1149 Continuity of Care for Orthodontia Treatment—From Managed Care to Fee-For-Service 08/11/03 03-03-03 — Nursing Facility Responsibility to Notify HealthChoices and Voluntary Program MCOs of the Admission of an MCO Enrolled Member 08/27/03 35-03-02
36-03-02— Revisions to the Medical Evaluation Form 08/27/03 11-03-04
24-03-01
25-03-01
34-03-01
35-03-01
36-03-01Ch. 1101 Liability for Cost Sharing for Recipients Enrolled in Medical Assistance through Fee for Service or Managed Care and a Private Third Party Insurer 09/01/03 99-03-12 — Continuity of Care for Recipients Transferring Between and Among Fee for Service and Managed Care Organizations 09/01/03 99-03-13 Ch. 1121 Updated Maximum Allowable Cost (MAC) List 09/03/03 01-03-07
19-03-04
49-03-04Ch. 1241 Elimination of the Pennsylvania Children's Check-up (EPSDT) Form (MA-517) 09/05/03 01-03-08
10-03-03
11-03-05
17-03-04
26-03-03
49-03-05Ch. 1121 Medicaid Drug Rebate Program Participating Drug Labelers Updated List 10/01/03 01-03-09
02-03-02
03-03-04
04-03-01
10-03-03
11-03-06
12-03-02
19-03-05
26-03-04
28-03-01
29-03-02
30-03-01
33-03-02
49-03-06— Elimination of the Requirement for the Outpatient Drug and Alcohol Clinic's Supervisory Physician to Perform a Comprehensive Medical Examination Within 15 Days Following the Intake and Before the Provision of Treatment 10/01/03 28-03-02 Ch. 1101
1150Replacing and End-dating Local Procedure Codes 10/01/03 99-03-14 — The Addition of Reyataz (atazanavir sulfate) and Emtriva (emtricitabine) to the Special Pharmaceutical Benefits Program 10/15/03 99-03-16 — Special Pharmaceutical Benefits Program Time Sensitive Expansion Tiers Structure 10/17/03 99-03-19 — Changes to Electronic Claims Format 10/17/03 99-03-17 — Revisions to Medical Evaluation Form (MA 51) 10/17/03 01-03-10
11-03-07
24-03-02
25-03-02
34-03-02
35-03-03
36-03-03
99-03-17Ch. 1101
1150Medical Assistance Program Fee Schedule Revision 2002 HCPCS Updates 10/17/03 99-03-18 Ch. 1149 Supernumerary Tooth Enumeration and Quadrant Designation on the American Dental Association Claim Form (ADA Claim Form—Version 2000) 10/31/03 03-03-05 — Introduction to the Provider Reimbursement and Operations Management Information System (PROMISe) 10/31/03 99-03-20 — Clarification of Procedures for Requesting Copies of Medical Assistance Recipients' Bills 11/01/03 99-03-15 Ch. 1101
1150Medical Assistance Program Fee Schedule Revision 11/01/03 05-03-04
19-03-06— Health Insurance Portability and Accountability Act (HIPAA) Transaction and Code Sets Updates 12/01/03 99-03-21 — The Addition of Lexiva (fosamprenavir) to the Special Pharmaceutical Benefits Program 12/03/03 99-03-23 2005 Ch. 1101
1150Revisions to Prior Authorization of Drugs for Erectile Dysfunction 01/10/05 99-05-02 — Alternative Sanction Guidelines for ICF/MR Medical Assistance Certification 01/28/05 00-04-15 Ch. 1101
11502004 HCPCS Updates and Other Revisions to the Medical Assistance Fee Schedule 02/05/05 99-05-04 Ch. 1121 List of Brand Name Drugs Requiring Prior Authorization 02/10/05 01-05-01
08-05-01
09-05-02
11-05-01
14-05-01
21-05-01
24-05-02
27-05-01
31-02-02Ch. 1121 Updated State Maximum Allowable Cost (MAC) List 02/10/05 0905-01
24-05-01
31-05-01Ch. 1101 Change in Effective Date for Prior 1150 Authorization of Drugs That Exceed 1121 Established Quantity Limits and Brand Name Single Source Non-Steroidal Ant-Inflammatory Drugs (NSAIDS) 04/26/05 99-05-09 — Implementation of the ACCESS Plus Program 05/23/05 99-05-11 Ch. 1241 2005 Recommended Childhood & Adolescents Immunization Schedule 05/26/05 33-05-01 — Integrated Children's Service Initiative 06/09/05 00-05-05 — Announcement of the National Provider Identifier Number 06/10/05 99-05-13 — Revised Maximum Participation Project Consent for Release of Information Form (PA 1723) 06/15/05 99-05-12 Ch. 1121 Non-Coverage of Drugs for the Treatment of Erectile Dysfunction for Sex Offenders 06/15/05 08-05-03
09-05-04
11-05-02
24-05-03
27-05-03
31-05-04Ch. 1101
1150Corrections to MA Bulletin 99-05-04: Addition of HCPCS Codes to Medical Assistance Programs Fee Schedule 06/20/05 99-05-10 — Psychological/Psychiatric/Clinical Re-Evaluations and Re-Authorizations or Behavioral Health Rehabilitation (BHR) Services for Children and Adolescents with Behavioral Health Needs Compounded by Developmental Disorders 06/24/05 07-05-01
08-05-04
09-05-05
11-05-03
19-05-01
31-05-05— Nursing Facility Assessments/Supplemental Payments 06/24/05 03-05-01 Ch. 1128 Clarification and Instructions for Providers Who Bill Medical Assistance for Dialysis Services When Medicare is the Primary Insurer 06/29/05 30-05-01 Ch. 1121 Revisions to Payment for the Drug Cost Component of Brand Name and Generic Drugs 08/05/05 09-05-06
24-05-06
25-05-01
31-05-06Ch. 1121 Prior Authorization of Drugs That Exceed Established Quantity Limits—Phase 1 Enforcement 08/10/05 99-05-14 Ch. 1121 Revisions to the State Maximum Allowable Cost for Pharmaceutical Services 08/18/05 09-05-07
24-05-07
25-05-02
31-05-07Ch. 1149 Dental Fee Increase for Anesthesia and Behavior Management Services 08/22/08 27-05-02 Ch. 1101 Copayment Changes for Brand Name and Generic Prescription Drugs 08/26/05 24-05-05 — Electronic Submission for the Cost Report (MA-11) Form for Reporting Periods Ending 06/30/2005 and Thereafter 08-26-05 03-05-02 Ch. 1101
1150Medical Assistance Program Fee Schedule Procedure Code Changes for Behavioral Health Services 09/08/05 08-05-05
09-05-08
11-05-04
16-05-01
17-05-01
19-05-02
21-05-02
31-05-08
34-05-01Ch. 1101
11502005 HCPCS Updates and Other Revisions to the Medical Assistance Fee Schedule; Prior Authorization Requirements 09/12/05 99-05-15 Ch. 1121 Prior Authorization of Drugs That Exceed Established Quantity Limits—Phase 2 Enforcement 09/16/05 99-05-17 Ch. 1249 Medical Assistance Program Fee Schedule Procedure Code Changes for Home Health Agency Services 09-16-05 05-05-01 Ch. 1121 Preferred Drug List 09/19/05 99-05-18 — $10,000 Lifetime Limit on Other Medical Expenses Related to Facility Services 09/20/05 03-05-03 — Long Term Care Resource Transfer Penalty 09/20/05 99-05-16 Ch. 1101 Medical Assistance Program Fee 1150 Schedule Procedure Code Changes for Healthy Beginnings Plus Program Services 09/23/05 01-05-03
05-05-02
08-05-06
31-05-09
33-0502
47-05-01Ch. 1101
1150Revised Outpatient Service Authorization Request Form (MA-97) 09/26/05 99-05-19 Ch. 1121 Preferred Drug List—Phase 1 10/07/05 02-05-01
03-05-04
08-05-08
09-05-10
11-05-05
14-05-02
24-05-08
27-05-04
30-05-02
31-05-11
32-05-02Ch. 1225 Medical Assistance Program Fee Schedule Procedure Code Changes for Family Planning Clinic Services 10/14/05 08-05-09 Ch. 1101
1150
1241Meningococcal Conjugate Vaccine Menactra (MCV4) 10/14/05 01-05-05
08-05-10
09-05-11
31-05-12
33-05-04Ch. 1241 Revisions to the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Periodicity Schedule 10/25/05 01-05-04
08-05-07
09-05-09
31-05-10
33-05-03Ch. 1128 Medical Assistance Program Fee Schedule Procedure Code Changes for Renal Dialysis Services 10/27/05 30-05-03
31-05-13Ch. 1101 Medical Assistance Program Fee 1150 Schedule Procedure Code Changes for Case Management Services 10/27/05 21-05-03 Ch. 1225 Medical Assistance Program Fee Schedule Procedure Code Changes for Federally Qualified Health Centers and Rural Health Clinics 10/27/05 08-05-11 Ch. 1101
1150Medical Assistance Program Fee Schedule Procedure Code Changes for Medical Foster Care Services 10/27/05 40-05-01 Ch. 1243 Medical Assistance Program Fee Schedule Procedure Code Changes for Laboratory Services 11/01/05 01-05-06
28-05-01Ch. 125 Title XIX Medical Assistance Program Family Planning Clinic Fee Schedule 11/1/05 08-05-12 Ch. 1121 Tabs for the—Prior Authorization of Pharmaceutical Services—Handbook 11/4/05 02-05-02
03-05-05
08-05-13
09-05-12
11-05-06
14-05-03
24-05-09
27-05-05
30-05-04
31-05-14
32-05-03Ch. 1121 Preferred Drug List—Phase 2 11/08/05 02-05-03
03-05-06
08-05-14
09-05-13
11-05-07
14-05-04
24-05-10
27-05-06
30-05-05
31-05-15
32-05-03Ch. 1121 Scope of Coverage of Pharmacy Services for Dual Eligibles in the Medical Assistance (MA) Program 11/17/05 99-05-21 Ch. 1123 Addition of Prosthetic, Orthotic and Medical Supply Procedure Codes to the Medical Assistance Fee Schedule 11/21/05 24-05-11
25-05-03— Rescind MAB 40-05-02 and Reissue the Medical Assistance Program Fee Schedule Procedure Code Changes for Provider Mileage 11/22/05 31-05-16
27-05-07
14-05-05
15-05-01
18-05-01
05-05-03
08-05-15
33-05-05
09-05-14Ch. 1121 Preferred Drug List—Phase 3 12/01/05 02-05-04
03-05-07
08-05-16
09-05-15
11-05-08
14-05-06
24-05-12
27-05-06
30-05-06
31-05-06
32-05-04Ch. 1123 Medical Assistance Program Fee Schedule Procedure Code Changes for Durable Medical Equipment, Medical Supplies, Vision Supplies and Hearing Supplies 12/01/05 05-05-04
24-05-13
25-05-04Ch. 1101 Changes to the Program Exception 1150 Process as a Result of End-Dating Local Procedure Codes 12/01/05 99-05-22 Ch. 1144 Clarification of Enrollment Policy for CRNPs 12/16/05 09-05-16 Ch. 1121 Prior Authorization of Prilosec Over-the-Counter (OTC) and Loratadine OTC for Dual Eligibles 12/23/05 02-05-05
03-05-08
08-05-17
09-05-17
11-05-09
14-05-07
24-05-13
27-05-07
30-05-07
31-05-18
32-05-05Ch. 1241 Medical Assistance Program Fee Schedule Procedure Code Changes for Occupational Therapy Services 12/27/05 17-05-02 Ch. 1145 Medical Assistance Program Fee Schedule Procedure Code Changes for Chiropractic Services 12/27/05 15-05-02 Ch. 1121 Pen and Ink Change-Medical Assistance Handbook, Prior Authorization of Pharmaceutical Services, Preferred Drug List 12/30/05 02-05-06
03-05-09
08-05-18
09-05-18
11-05-10
14-05-08
24-05-04
27-05-08
30-05-08
31-05-19
32-05-062006 Ch. 1123 Fee Increase for Enteral Nutritional Supplements 12/29/06 24-06-15
25-06-02Ch. 1243 Medical Assistance Program Fee Schedule Additions of Four Laboratory Codes 12/27/06 01-06-15
08-06-21
28-06-01Ch. 1101
11502006 HCPCS Updates; Prior Authorization Requirements 12/19/06 99-06-17 Ch. 1101
1150Medical Assistance Program Fee Schedule Revision 12/19/06 99-06-18 — Implementation of the CMS-1500 Health Insurance Claim Form (Version 08/05) 12/18/06 99-06-16 Ch. 1241 Rotavirus Vaccine 12/15/06 01-06-14
08-06-20
09-06-19
31-06-26
33-06-07Ch. 1101 Change to copayment requirements for recipients eligible under the Breast and Cervical Cancer Prevention and Treatment coverage group and Titles IV-B & IV-E Foster Care and Adoption Assistance 12/10/06 99-06-12 Ch. 1101 Clarification of Exclusions from Copayment Requirements 12/10/06 99-06-13 Ch. 1121 Preferred Drug List—Quarterly Update 12/08/06 02-06-10
09-06-18
24-06-14
31-06-25
03-06-16
11-06-09
27-06-13
32-06-08
08-06-19
14-06-11
30-06-08— Mobile Mental Health Treatment 11/30/06 08-06-18 Ch. 1153 Clarification of Payment Policy for Abortion Services 11/28/06 99-06-15 — Instructions for Registering Your National Provider Identifier (NPI) Number to the Department of Public Welfare 11/22/06 99-06-14 Ch. 1245 Reimbursement for Non-Emergency Transportation Services 11/17/06 03-06-15 Ch. 1245 Implementation of ACCESS Plus Referral Requirements 10/20/06 99-06-11 — Medical Invoice UB-04 09/22/06 01-06-12
02-06-09
03-06-13Ch. 1241 Pennsylvania Vaccines for Children Program Update 09-22-06 01-06-11
08-06-17
09-06-17
31-06-23
33-06-06Ch. 1163 Medical Assistance Payment for Services of Teaching Physicians in Hospitals, Clinics and Emergency Rooms 09/16/06 1141-06-01
01-06-13
31-06-24Ch. 1121 Preferred Drug List—Quarterly Update 08/28/06 02-06-08
03-06-11
08-06-16
09-06-16
11-06-08
14-06-10
24-06-12
27-06-12
30-06-07
31-06-22
32-06-07— Revision to Minimum Staff Qualifications of Therapeutic Staff Support (TSS) Workers 08/24/06 08-06-15
09-06-15
11-06-07
19-06-04
31-06-21— The Addition of Atripla (efavirenz/emtricitabine/tenofovir) and Prezista (darunavir) to the Special Pharmaceutical Benefits Program 08/21/06 09-06-14
21-06-02
24-06-11
31-06-20Ch. 1121 Hepatitis A Vaccine 08/18/06 01-06-10
08-06-14
09-06-12
31-06-19
33-06-05Ch. 1241 Measles, Mumps, Rubella and Varicella (MMRV) Vaccine 08/10/06 01-06-09
08-06-13
09-06-11
31-06-18
33-06-04— Federal Medicaid Citizenship and Identity Eligibility Requirements for Medical Assistance Nursing Home Applicants or Recipients 07/28/06 03-06-10 Ch. 1101
1150
141Medical Assistance Program Fee Schedule Revisions for Medical and Radiological Procedure Codes 07/27/06 01-06-08
03-06-09
08-06-12
14-06-09
29-06-01
31-06-17Ch. 1153 Federal Medicaid Citizenship and Identity Eligibility Requirements 07/24/06 99-06-07 — Notification of Medicare Appeals Project and Billing Reminders for Home Health Services 07/20/06 05-06-01 Ch. 1101
1150Medical Assistance Program Fee Schedule Change 06/23/06 01-06-07
08-06-11
17-06-02
20-06-02
31-06-16Ch. 1163
1221Medical Assistance Program Fee Schedule Procedure Code Changes for Acute Care General Hospitals and Hospitals Based Medical Clinics 06/17/06 01-06-05 Ch. 1163
1221Medical Assistance Program Fee Schedule Procedure Code Changes for Medical Rehabilitation Units of General Hospitals and Rehabilitation Hospitals 06/17/06 01-06-06 Ch. 1101
1150Medical Assistance Program Fee Schedule Procedure Code Changes 06/17/06 99-06-06 Ch. 1123 Medical Assistance Program Fee Schedule Revision for Oxygen and Oxygen Equipment 06/06/06 24-06-10
25-06-01Ch. 1241 Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis (Tdap) Vaccine 06/01/06 01-06-04
08-06-10
09-06-10
31-06-15
33-06-03Ch. 1121 Medicaid Drug Rebate Program Participating Drug Labelers Updated List 05/05/06 08-06-09
09-06-09
24-06-09
31-06-14Ch. 1123 Ventilator Dependent Respiratory (VDR) Program Preparing Table of Supply and Equipment Costs 04/28/06 03-06-08 Ch. 1121 Preferred Drug List—Quarterly Update 04/24/06 02-06-07
11-06-06
30-06-06
03-06-07
14-06-08
31-06-13
08-06-08
24-06-08
32-06-05
09-06-07
27-06-10Ch. 1121 Prior Authorization of Revatio 04/24/06 02-06-06
11-06-05
30-06-05
03-06-06
14-06-07
31-06-12
08-06-07
24-06-07
32-06-05
09-06-07
27-06-10Ch. 1150 Prudent Payment of Claims 04/20/06 99-06-04 Ch. 1241 2006 Recommended Childhood and Adolescent Immunization Schedule 04/16/06 01-06-03
08-06-06
09-06-05
31-06-11
33-06-02— Continued Existence of the Fee-for-Service (FFS) Delivery System in HealthChoices Zones and Use of ACCESS Cards 04/14/06 99-06-05 Ch. 1149 Elimination of Post-Operative Review of Endodontic Therapy for Individuals 21 Years of Age and Older 03/21/06 27-06-09 Ch. 1121 Prior Authorization of Botox, Synagis and Xolair 03/09/06 02-06-05
03-06-04
08-06-05
09-06-04
11-06-04
14-06-06
24-06-05
27-06-08
30-06-03
31-06-08
32-06-03— Special Pharmaceutical Benefits Program Revisions to Payment Methodology 03/07/06 19-06-03
24-06-06
31-06-10Ch. 1121 Federal Clarification—Elimination of Medicaid Coverage of Drugs for Treatment of Erectile Dysfunction 03/07/06 03-06-03
02-06-04
08-06-04
09-06-13
11-06-03
14-06-05
24-06-04
27-06-07
30-06-03
31-06-08
32-06-03Ch. 1150 Corrections to MA Bulletin 99-05-15 Addition of 2005 HCPCS Codes to Medical Assistance Programs Fee Schedule 03/01/06 99-06-02 Ch. 1127 Medical Assistance Program Fee Schedule Procedure Code Changes for Birth Centers 02/28/06 47-06-01 Ch. 1221 Medical Assistance Program Fee Schedule Procedure Code Changes for Independent Medical-Surgical Clinic Services 02/28/06 08-06-03 Ch. 1121 Pen and Ink Change—Preferred Drug List (PDL), Phase 4 02/20/06 27-06-06 Ch. 1130 Medical Assistance Program Fee Schedule Procedure Code Changes for Hospice Services 01/27/06 06-06-01
31-06-06Ch. 1150 Disenrollment of Dual Eligibles from Physical Health Managed Care 01/27/06 99-06-01 Ch. 1141 Medical Assistance Program Fee Schedule Procedure Code Changes for Physician Services 01/27/06 31-06-05 Ch. 1143 Medical Assistance Program Fee Schedule Procedure Code Changes for Podiatry Services 01/27/06 14-06-04 Ch. 1121 Prior Authorization of Drugs that Exceed Est. Quantity Limits—Phase 3 Enforcement and Additional Drugs with Quantity Limits 01/27/06 02-06-03
03-06-02
08-06-02
09-06-02
11-06-02
14-06-03
24-06-02
27-06-05
30-06-02
31-06-04
32-06-02Ch. 1142 Medical Assistance Program Fee Schedule Procedure Code Changes for Certified Nurse Midwife Services 01/27/06 33-06-01 Ch. 1144 Medical Assistance Program Fee Schedule Procedure Code Changes for Certified Registered Nurse Practitioner Services 01/27/06 09-06-03 Ch. 1121 Preferred Drug List—Phase 4 01/25/06 02-06-02
03-06-01
08-06-01
09-06-01
11-06-01
14-06-02
24-06-01
27-06-04
30-06-01
31-06-03
32-06-01Ch. 1221 Removal of Prior Authorization Requirement for Sleep Studies 01/12/06 01-06-02
31-06-02— Dental Behavior Management Fee Increase 01/03/06 27-06-01 Ch. 1149
1101
1150Medical Assistance Program Fee Schedule Changes for Orthodontic and Cleft Palate Services: Fee Increases, Procedure Code Changes and New Prior Authorization Requirements 01/03/06 27-06-03
17-06-01
19-06-01
20-06-01
21-06-01Ch. 1163 Place of Service Review Procedures 01/03/06 14-06-01
01-06-01
02-06-01
31-06-01
27-06-02Ch. 1150 Prudent Payment of Claims 04/03/06 99-06-04 2007 — ''Issuance of an Updated MA Program Outpatient Fee Schedule for Durable Medical Equipment, Medical Supplies, Orthotics, Prosthetics, Vision and Hearing Supplies'' included in MA Bulletin 05-05-04, et al titled ''Medical Assistance Program Fee Schedule Procedure'' 12/28/07 01-07-12
05-07-03
18-07-02
20-07-06
24-07-15
25-07-07
31-07-21— Medical Assistance Program Fee Schedule Revision 12/21/07 99-07-21 — Revision to Medical Assistance Program Fee Schedule for Federally Qualified Health Centers and Rural Health Clinics 12/21/07 08-07-16 Ch. 1150 The Addition of Isentress (raltegravir) to the Special Pharmaceutical Benefits Program 12/21/07 09-07-16
21-07-04
24-07-16
31-07-22— Nursing Facility Documentation Requirements for Movable Equipment That is Rented or Leased 12/07/07 03-07-10 — Error Reconciliation Recommendations for the National Provider Identifier (NPI) 12/01/07 99-07-20 Ch. 1123 MA Program Outpatient Fee Schedule Revisions for Speech Generating Devices 11/29/07 24-07-11
25-07-05
31-07-18Ch. 1121 Preferred Drug List—Fall Update—Part 2 11/29/07 02-07-06
11-07-07
30-07-07
03-07-09
14-07-06
31-07-20
08-07-15
24-07-14
32-07-07
09-07-14
27-07-09Ch. 1149 Fee Increase for Select Dental Procedure Codes 11/01/07 27-07-08 Ch. 1101 Childhood Nutrition and Weight Management Services for Recipients Under 21 Years of Age 11/01/07 99-07-19 Ch. 1121 Preferred Drug List—Fall 2007 Update 11/01/07 02-07-05
11-07-06
30-07-05
03-07-08
14-07-05
31-07-17
08-07-14
24-07-13
32-07-06
09-07-12
27-07-07Ch. 1141 Fee Increases for Select Office Visit and Office Consultation Procedure Codes 11/01/07 09-07-13
31-07-16
33-07-04Ch. 1121 Delay in Implementation of the Tamper—Resistant Pad Requirements 10/29/07 99-07-18 Ch. 1121 Special Pharmaceutical Benefits Program (SPBP) Income Ceiling for HIV Applicants 10/15/07 09-07-10
21-07-03
24-07-10
31-07-14Ch. 1121 Tamper Resistant Prescription Pads 09/28/07 99-07-16 Ch. 1123 2007 Power Mobility Device HCPCS Updates; Prior Authorization Requirements 09/19/07 99-07-15 — Peer Review Committee 09/14/07 99-07-14 Ch. 1145 Change in Recipient Access to Chiropractic Services 09/14/07 15-07-01 Ch. 1241 Correction of Billing Instructions for Physical and Occupational Therapy Evaluations, and Evaluations of Speech, Language, Voice, Communication and/or Auditory Processing 09/14/07 01-07-09
08-07-13
17-07-01
20-07-04
31-07-13— Updated Regarding False Claims Provisions of Deficit Reduction Act of 2005—Employee Education About False Claims Recovery 09/07/07 99-07-13 Ch. 1163 Medicare Inpatient Pricing Logic Modification 08/17/07 01-07-08 Ch. 1123 Provider Specialty 220 (Hearing Aid Dispenser Requirement and Updated Medical Assistance Program Fee Schedule for Hearing Aid Supplies 08/03/07 01-07-07
24-07-09
31-07-12
20-07-03
25-07-04— Clarification of Act 169, also known as the Older Adult Protective Services Act (OAPSA), in regard to hiring Practices for inpatient and residential facilities 08/02/07 OMHSAS-07-01 Ch. 1121 Preferred Drug List—May 2007 Technical Correction 07/31/07 02-07-04
11-07-05
30-07-04
03-07-07
14-07-04
31-07-11
08-07-12
24-07-08
32-07-05
09-07-09
27-07-06Ch. 1121 Preferred Drug List—Updates to Prior Authorization of Pharmaceutical Services Handbook Pages 07/27/07 02-07-03
11-07-04
30-07-03
03-07-06
14-07-03
31-07-10
08-07-11
24-07-07
32-07-04
09-07-08
27-07-05Ch. 1149 Discontinuance of the Prior Authorization Requirement for Dental Procedure Codes D7140 and D7210 07/11/07 27-07-04 Ch. 1249 Rescission of the Statement of Policy Clarifying the Conditions Under Which Medical Assistance Recipients May Be Considered Homebound 07/10/07 1249-07-04
99-07-12Ch. 1123 Special Pharmaceutical Benefits Program (SPBP) Income Ceiling Increase for HIV Applicants 07/01/07 09-07-05
21-07-02
24-07-04
31-07-07— Revised MA Bulletin 03-07-01: Billing Instructions—
Medicare Non-Coverage for Medicare Eligible Nursing Facility Residents06/29/07 03-07-05 Ch. 1101 The Elimination of Paper Vouchers 06/14/07 99-07-10 — Revised Citizenship and Identify Information Form 06/08/07 99-07-09 Ch. 1123 Requirements for Coverage of Enteral Nutritional Supplements and Issuance of Enteral Nutritional Supplements MA Program Outpatient Fee Schedule 06/01/07 08-07-10
09-07-07
24-07-06
25-07-03
31-07-09Ch. 1121 Preferred Drug List—July 2007 Quarterly Update 06/01/07 02-07-02
03-07-03
08-07-08
09-07-06
11-07-02
14-07-02
24-07-05
27-07-03
30-07-02
31-07-08
32-07-03Ch. 1101 Co-pay/Deductibles on Exceptional Durable Medical Equipment (DME) 06/01/07 03-07-04 — Responsibility of MA Providers to Provide Requested Medical/Psychological Information to the Disability Advocacy Program (DAP) 05/18/07 99-07-08 — Instructions for Using Your National Provider Identifier (NPI) Number to Bill the Department of Public Welfare (DPW) and Contingency Plan 05/18/07 99-07-07 Ch. 1150 Medical Assistance Program Fee Schedule Revision; Change to Conversion Factor for Anesthesia Services 05/10/07 31-07-05
32-07-0001Ch. 1243 Medical Assistance Program Fee Schedule Revision of Two Laboratory Procedure Codes 05/03/07 01-07-04
08-07-02
28-07-01Ch. 1121 Preferred Drug List—Quarterly Update 05/01/07 02-07-01
03-07-02
08-07-07
09-07-04
11-07-01
14-07-01
24-07-03
27-07-02
30-07-01
31-07-06
32-07-02Ch. 1101 Clarification Regarding the Definition of Medically Necessary—Statement of Policy 04/21/07 99-07-04
1101-07-03Ch. 1221 Pen and Ink Change—Medical Assistance Bulletin 'Medical Assistance Program Fee Schedule Procedure Code Changes For Family Planning Clinic Services' 03/30/07 08-07-06
08-05-09Ch. 1241 2007 Recommended Childhood and Adolescent Immunization Schedules 03/23/07 01-07-05
08-07-04
09-07-02
31-07-03
33-07-01Ch. 1149 Discontinuance of the Dental Services Handbook 03/23/07 27-07-1 Ch. 1241 Gardasil®, Human Papillomavirus (HPV) Vaccine 03/23/07 01-07-02
08-07-05
09-07-03
31-07-04
33-07-02Ch. 1129 Revision to Medical Assistance Program Local to National Provider Code Crosswalk for Federally Qualified Health Centers and Rural Health Clinics 03/23/07 08-07-03 Ch. 1123 Medical Assistance Program Fee Schedule Procedure Code Changes For Hearing Aid Supplies 03/01/07 01-07-02
20-07-01
31-07-01Ch. 1123 Provider Specialty 220 (Hearing Aid Dispenser) Requirement 03/01/07 01-07-03
20-07-02
24-07-01
25-07-01
31-07-02Ch. 1245 Clarification of Procedure Codes and Modifiers to be Used When Billing For Ambulance Services 02/20/07 26-07-01 — Replace MA Bulletin 03-06-12: Billing Instructions—
Medicare Non-Coverage For Medicare Eligible Nursing Facility Residents02/20/07 03-07-01 Ch. 1221 Correction to Title XIX Medical Assistance Program Family Planning Clinic Fee Schedule 02/06/07 08-07-01 Ch. 1123 Behavioral Health Fee For Service (BH-FFS) Transfer from Office of Medical Assistance Programs (OMAP) To Office of Mental Health and Substance Abuse Services (OMHSAS) 01/31/07 OMHSAS-06-07 — Revised Medical Assessment Form (PA 635) 01/12/07 01-07-01
19-07-01
09-07-01Ch. 1150 Policy Reinforcement Regarding Billing For Tobacco Cessation Counseling Services 01/04/07 99-07-02 — False Act Claims Provisions of Deficit Reduction Act of 2005 Employee Education About False Claims Recovery 01/02/07 99-07-01 2008 Ch. 1121 Preferred Drug List—Fall 2007 Update Part 2 Technical Correction 01/11/08 02-07-08
03-07-11
08-07-17
09-07-17
11-07-08
14-07-07
24-07-17
27-07-10
30-07-08
31-07-23
32-07-08Ch. 1149 Implementation of ADA Claim Form—Version 2006 and Elimination of Dental Prior Authorization Forms 01/11/08 17-08-01
19-08-01
20-08-01
21-08-01
27-08-01Ch. 1163 Preventable Serious Adverse Events 01/14/08 01-07-11 Ch. 1121 Legend Attachment to Medical Assistance Bulletin 01-07-12, et al 01/31/08 01-08-01
05-08-01
18-08-01
20-08-01
24-08-01
25-08-01
31-08-01Ch. 1101 Implementation of Select Plan for Women 02/01/08 01-08-02
08-08-02
09-08-02
24-08-03
28-08-01
31-08-03
33-08-01Ch. 1241 Clarification of Childhood Nutrition and Weight Management Services for Recipients Under 21 Years of Age 02/15/08 99-08-01 Ch. 1241 The Addition of Selzentry (maraviroc) and Intelence (etavirine) to the Special Pharmaceutical Benefits Program 02/29/08 09-08-03
24-08-04
21-08-01
31-08-04Ch. 1121 Medical Necessity Guidelines for Lyrica for Fibromyalgia 03/05/08 02-08-01
03-08-01
08-08-01
09-08-01
11-08-01
14-08-01
24-08-02
27-08-02
30-08-01
31-08-02
32-08-01Ch. 1141 Medical Assistance Program Outpatient Fee Schedule Changes for Select Chemotherapy Administration Procedure Codes 03/14/08 01-08-03
08-08-03
31-08-05Ch. 1101
1150MA Program Fee Schedule Changes—2007 HCPCS Updates; Addition of Procedure Codes and Modifiers; Prior Authorization 03/14/08 99-08-04 Ch. 1141
1126Medical Assistance Program Outpatient Fee Schedule Changes for Select Office Visit Procedure Codes 03/14/08 31-08-06
09-08-04
33-08-02Ch. 1121 Tamper Resistant Prescription Pads 03/21/08 99-08-03 Ch. 1241 2008 Recommended Childhood and Adolescent Immunization Schedules 03/21/08 01-08-04
08-08-04
09-08-05
31-08-07
33-08-07Ch. 1101 Select Plan for Women Program—Addition of Covered Services 04/23/08 01-08-05
08-08-06
09-08-07
24-08-06
28-08-03
31-08-09
33-08-04Ch. 1150 Prudent Payment of Claims—Updated 04/25/08 99-08-05 Ch. 1121 Preferred Drug List—Spring 2008 Update 06/02/08 02-08-03
03-08-03
08-08-07
09-08-08
11-08-03
14-08-03
24-08-07
27-08-04
30-08-03
31-08-10
32-08-03— Revised Error Reconciliation Recommendations for the National Provider Index (NPI) 06/05/08 99-08-07 Ch. 1149 ADA Claim Form—Version 2006 and Discontinuance of P.O. Box 8186 06/16/08 17-08-02 Ch. 1123 Nursing Facility Documentation Requirements for Moveable Equipment That is Rented or Leased 07/07/08 03-08-04 Ch. 1101 Fee-For-Service Coverage for Recipients in Health Care Benefits Package 12 07/16/08 99-08-09 Ch. 1121 Prior Authorization of Early Refills of Prescriptions 07/18/08 02-08-04
11-08-04
30-08-08
03-08-08
08-08-11
09-08-12
14-08-04
24-08-08
27-08-07
31-08-15
32-08-04Ch. 1150
Ch. 1141
Ch. 1147Medical Assistance Program Fee
Increase for Select Ophthalmological
Examinations07/22/08 18-08-04
31-08-12Ch. 1150
Ch. 1249Medical Assistance (MA) Program Fee
Increases for Select Home Health Agency Services07/22/08 05-08-02 Ch. 1150
Ch. 1141
Ch. 1147Medical Assistance Program Fee
Increases for Select Office Visits and
Consultations for Vision Services07/22/08 18-08-03 Ch. 1150
Ch. 1249Medical Assistance Program Fee
Increases for Select Private Duty/Shift Nursing Services to MA Recipients Under 21 Years of Age07/22/08 05-08-03
16-08-01Ch. 1150
Ch. 1149Medical Assistance Program Fee
Increases for Select Dental Services07/22/08 27-08-06 Ch. 1150 Medical Assistance Program Fee
Increases for Select Office Visits and Consultations07/22/08 09-08-09
31-08-11
33-08-05Ch. 1150
Ch. 1243Medical Assistance Program Fee
Schedule Changes for Select Laboratory Procedure Codes07/22/08 08-08-09
09-08-10
28-08-04
31-08-13
33-08-06Ch. 1150
Ch. 1141Medical Assistance Program Outpatient
Fee Schedule Increase for a Select Colonoscopy Procedure07/22/08 01-08-07 Ch. 1150 Fee Increases for Select Healthy Beginnings Plus Services 07/25/08 05-08-04
08-08-13
31-08-17
33-08-08
47-08-11Ch. 1150
Ch. 1241Screening for Developmental Delays
and Autism Spectrum Disorders07/25/08 99-08-10 Ch. 1145 Recipient Access to Chiropractic Services 08/04/08 99-08-11 Ch. 1150 Prior Authorization of Advanced Radiologic Imaging Services 08/05/08 99-08-08 Ch. 1121 Prior Authorization of Tysabri 08/25/08 02-08-07
11-08-07
30-08-07
03-08-07
14-08-06
31-08-20
08-08-16
24-08-11
32-08-08
09-08-16Ch. 1121 Prior Authorization of Letaris, Methadone, and Myobloc 08/25/08 02-08-05
11-08-05
30-08-05
03-08-05
14-08-05
31-08-18
08-08-14
24-08-09
32-08-06
09-08-14
27-08-08Ch. 1121 Prior Authorization of Atypical Antipsychotics, Cough and Cold Medications, and Stimulants and Related Agents 08/25/08 02-08-06
11-08-06
30-08-06
03-08-06
14-08-06
31-08-19
08-08-15
24-08-10
32-08-07
09-08-15
27-08-09Ch. 1150
Ch. 1225Medical Assistance Program Family
Planning Clinic Select Fee Increases and Updates08/29/08 08-08-08 Ch. 1101
Ch. 1150
Ch. 1221Select Plan for Women Updated
Covered Services Chart09/05/08 01-08-09
08-08-17
09-08-17
24-08-12
28-08-06
31-08-21
33-08-09Ch. 1121 Prior Authorization of Erythropoiesis Stimulating Proteins 09/10/08 02-08-08
11-08-08
30-08-08
03-08-09
14-08-08
31-08-22
08-08-18
24-08-13
32-08-10
09-08-18
27-08-11Ch. 1163 Payment Policy for Hospital Readmissions 09/12/08 01-08-10 Ch. 1241 Updates for Early Periodic Screening, Diagnosis and Treatment Program 09/18/08 99-08-13 Ch. 1150
Ch. 1121Reminder of Implementation of Tamper
Resistant Prescription Pad Requirements09/24/08 99-08-14 Ch. 1121 Synagis—Updated Guidelines to Determine Medical Necessity 10/10/08 02-08-10
11-08-10
30-08-10
03-08-11
14-08-10
31-08-24
08-08-20
24-08-15
32-08-12
09-08-20
27-08-13Ch. 1121 Cytokine and CAM Antagonists—Updated Guidelines to Determine Medical Necessity 10/10/08 02-08-09
11-08-09
30-08-09
03-08-10
14-08-09
31-08-23
08-08-19
24-08-14
32-08-11
09-08-19
27-08-12Ch. 1141
1163Increase to Maximum Medical Assistance Payment to Practitioners for Services Provided During a Period of Hospitalization 10/20/08 09-08-16 Ch. 1101
1150Implementation of Claim Check 10/20/08 99-08-17 — Specialty Pharmacy Drug Program 10/20/08 99-09-01 Ch. 1121 Non-Payment of Anti-dementia Drugs for Children Less Than 18 Years of Age 10/20/08 99-08-15 Ch. 1121 Preferred Drug List 2008 Update 10/31/08 02-08-11
03-08-12
08-08-21
09-08-21
11-08-11
14-08-11
24-08-16
27-08-14
30-08-11
31-08-25
32-08-13Ch. 1101
Ch. 1150Implementation of Claim Check 10/02/08 99-08-17 Ch. 1121 Grandfathering of Prescriptions for Non-Preferred Atypical Antipsychotics for Children Under Six (6) Years of Age 11/07/08 02-08-12
11-08-12
30-08-12
03-08-13
14-08-12
31-08-26
08-08-22
24-08-17
32-08-14
09-08-22
27-08-15Ch. 1150
Ch. 1147Addition of Procedure Code 67820 to
Optometrist Medical Assistance Program Outpatient Fee Schedule11/14/08 18-08-07 Ch. 1150 Preventable Serious Adverse Events 11/26/08 01-08-11 — Special Pharmaceutical Benefits Program (SPBP)—Updated Eligibility Criteria for SP1 Card Holders 12/05/08 08-08-23
09-08-23
24-08-18
01-08-04
31-08-27Ch. 1150
Ch. 1147Addition of Procedure Codes to the
Medical Assistance Program Fee Schedule for Office Visits for Optometrists12/29/08 18-09-01 2009 Ch. 1150
Ch. 1123
Ch. 1147Removal of Prior Authorization
Requirement for Eyeglass Lenses02/09/09 18-09-02
24-09-01
25-09-01
31-09-01Ch. 1101
Ch. 1150
Ch. 1241Pentacel® (DTaP-IPV/Hib), Kinrix®
(DTaP-IPV) and Rotarix® (Rotavirus)
Vaccines02/09/09 01-09-01
08-09-01
09-09-01
31-09-02
33-09-01— Special Pharmaceutical Benefits Program (SPBP)—2009 Federal Poverty Guidelines for SP1 Card Holders 02/13/09 01-09-03
24-09-03
08-09-03
28-09-02
09-09-03
31-09-04
21-09-02Ch. 1101
Ch. 1150
Ch. 12412009 Recommended Childhood and
Adolescent Immunization Schedules02/20/09 01-09-04
08-09-04
09-09-04
31-09-05
33-09-02— Clarifying Medical Assistance (MA) Policy related to Medicare Cost Sharing under Part D for Dual Eligible Recipients in the MA Program 03/10/09 99-09-02 — Clarification of Procedures for Responding to Requests for Copies of Medical Assistance (MA) Recipients' Bills 03/20/09 99-09-03 Ch. 1121 Prior Authorization of Hypoglycemics, Incretin Mimetics—Enhancers 03/20/09 02-09-01
11-09-01
30-09-01
03-09-01
14-09-01
31-09-06
08-09-05
24-09-04
32-09-01
09-09-05
27-09-01Ch. 1150 Medical Assistance Program Fee Schedule Procedure Code End-dating of Keratomileusis 03/27/09 99-09-04 Ch. 1149 Implementation of the Pediatric Dental Periodicity Schedule 04/24/09 27-09-02 Ch. 1121 Medical Necessity Guidelines for Cymbalta for Treatment of Fibromyalgia 05/22/09 01-09-05
02-09-02
03-09-02
08-09-06
09-09-06
11-09-02
14-09-02
24-09-05
27-09-03
30-09-02
31-09-07
32-09-02Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update 06/05/09 01-09-06
09-09-07
27-09-04
02-09-03
11-09-03
30-09-03
03-09-03
14-09-08
31-09-08
08-09-07
24-09-06
32-09-03Ch. 1150 Revisions to Medical Assistance Program Fee Schedule Rates for Select Services 06/15/09 99-09-05 Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—Cytokine and CAM Antagonists Updated Handbook Pages 06/19/09 01-09-09
02-09-06
03-09-06
08-09-10
09-09-10
11-09-06
14-09-06
24-09-09
27-09-07
30-09-06
31-09-11
332-09-06Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—Hypoglycemics, Insulins Updated Handbook Pages 06/19/09 01-09-07
02-09-04
03-09-04
08-09-08
09-09-08
11-09-04
14-09-04
24-09-07
27-09-05
30-09-04
31-09-09
32-09-04Ch. 1121 Automated Prior Authorization of Pharmacy Services—Stimulants and Related Agents Updated Handbook Pages 06/29/09 01-09-11
08-09-12
14-09-08
30-09-08
02-09-08
09-09-12
24-09-11
31-09-13
03-09-08
11-09-08
27-09-08
32-09-08Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—
Antibiotics, GI Updated Handbook Pages06/29/09 01-09-26
02-09-23
03-09-23
08-09-27
09-09-27
11-09-23
14-09-23
24-09-26
27-09-23
30-09-23
31-09-28
32-09-23Ch. 1121 Automated Prior Authorization of Pharmacy Services—
Bronchodilators, Beta Agonist Updated Handbook Pages06/29/09 01-09-25
02-09-22
03-09-22
08-09-26
09-09-26
11-09-22
14-09-22
24-09-25
27-09-22
30-09-22
31-09-27
32-09-22Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—
Inhaled Glucocorticoids Updated Handbook Pages06/29/09 01-09-17
02-09-14
03-09-14
08-09-18
09-09-18
11-09-14
14-09-14
24-09-17
27-09-14
30-09-14
31-09-19
32-09-14Ch. 1121 Automated Prior Authorization of Pharmacy Services—
Sedative Hypnotics Updated Handbook Pages06/29/09 01-09-12
08-09-13
14-09-09
30-09-09
02-09-09
09-09-13
24-09-12
31-09-14
03-09-09
11-09-09
27-09-09
32-09-09Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—
Oral Antifungals Updated Handbook Pages06/29/09 01-09-16
02-09-13
03-09-13
08-09-17
09-09-17
11-09-13
14-09-13
24-09-16
27-09-13
30-09-13
31-09-18
32-09-13Ch. 1121 Automated Prior Authorization of Pharmacy Services—
Minimally Sedating Antihistamines Updated Handbook Pages06/29/09 01-09-23
02-09-20
03-09-20
08-09-24
09-09-24
11-09-20
14-09-20
24-09-23
27-09-20
30-09-20
31-09-25
32-09-20Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—
Pulmonary Arterial Hypertension (PAH) Agents Handbook Pages06/29/09 01-09-13
08-09-14
14-09-10
30-09-10
02-09-10
09-09-14
24-09-13
31-09-15
03-09-10
11-09-10
27-09-10
32-09-10Ch. 1121 Automated Prior Authorization of Pharmacy Services—
Ophthalmic Immunomodulators Updated Handbook Pages06/29/09 01-09-14
08-09-15
14-09-11
30-09-11
02-09-11
09-09-15
24-09-14
31-09-16
03-09-11
11-09-11
27-09-11
32-09-11Ch. 1121 Automated Prior Authorization of Pharmacy Services—
Antidepressants, SSRIs Updated Handbook Pages06/29/09 01-09-22
02-09-19
03-09-19
08-09-23
09-09-23
11-09-19
14-09-19
24-09-22
27-09-19
30-09-19
31-09-24
32-09-19Ch. 1121 Automated Prior Authorization of Pharmacy Services—
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)06/29/09 01-09-24
02-09-21 03-09-21
08-09-25
09-09-25
11-09-21
14-09-21
24-09-24
27-09-21
30-09-21
31-09-26
32-09-21Ch. 1121 Pharmacy Update—Oral Fluoroquinolones Updated Handbook Pages 06/29/09 01-09-20
02-09-17
03-09-17
08-09-21
09-09-21
11-09-17
14-09-17
24-09-20
27-09-17
30-09-17
31-09-22
32-09-17Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—Intranasal Rhinitis Agents Updated Handbook Pages 06/29/09 01-09-18
02-09-15
03-09-15
08-09-19
09-09-19
11-09-15
14-09-15
24-09-18
27-09-15
30-09-15
31-09-20
32-09-15Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—Growth Hormones Updated Handbook Pages 06/29/09 01-09-19
02-09-16
03-09-16
08-09-20
09-09-20
11-09-16
14-09-16
24-09-19
27-09-16
30-09-16
31-09-21
32-09-16Ch. 1121 Automated Prior Authorization of Pharmacy Services—Bronchodilators, Anticholinergic Updated Handbook Pages 06/29/09 01-09-21
02-09-18
03-09-18
08-09-22
09-09-22
11-09-18
14-09-18
24-09-21
27-09-18
30-09-18
31-09-23
32-09-18Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—Acne Agents, Oral Updated Handbook Pages 06/29/09 01-09-10
08-09-11
14-09-07
30-09-07
02-09-07
09-09-11
24-09-10
31-09-12
03-09-07
11-09-07
27-09-08
32-09-07Ch. 1121 Automated Prior Authorization of Pharmacy Services—Lipotropics, Statins Updated Handbook Pages 06/29/09 01-09-15
02-09-12
03-09-12
08-09-16
09-09-16
11-09-12
14-09-12
24-09-15
27-09-12
30-09-12
31-09-17
32-09-12Ch. 1150 2008 HCPCS Updates and Other Procedure Code and Procedure Code/Modifier Combination Changes 07/06/09 99-09-06 Ch. 1121 Prior Authorization of Benzodiazepines—Pharmacy Services 07/27/09 01-09-31
02-09-28
03-09-28
08-09-32
09-09-32
11-09-28
14-09-28
24-09-31
27-09-29
30-09-28
31-09-33
32-09-28Ch. 1121 Prior Authorization of Buprenorphine Agents (Suboxone and Subutex)—Pharmacy Services 07/27/09 01-09-30
02-09-27
03-09-27
08-09-31
09-09-31
11-09-27
14-09-27
24-09-30
27-09-28
30-09-27
31-09-32
32-09-27Ch. 1121 Prior Authorization of Topical Acne Agents—Pharmacy Services 07/27/09 01-09-28
02-09-25
03-09-25
08-09-29
09-09-29
11-09-25
14-09-25
24-09-28
27-09-26
30-09-29
31-09-30
32-09-25Ch. 1121 State Maximum Allowable Cost (MAC) List (Including the Federal Upper Limit)—Pharmacy Services 07/27/09 01-09-32
02-09-29
03-09-29
08-09-33
09-09-33
11-09-29
14-09-29
24-09-32
27-09-30
30-09-29
31-09-34
32-09-29Ch. 1121 Prior Authorization of Cough and Cold Medications for Children Under Six (6) years of Age—Pharmacy Services 07/27/09 01-09-27
02-09-24
03-09-24
08-09-28
09-09-28
11-09-24
14-09-24
24-09-27
27-09-25
30-09-04
31-09-29
32-09-24— 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. 1150 Revised Medical Assessment Form
(PA 635)08/10/09 31-09-38
19-09-01
09-09-34Ch. 1121 Prior Authorization of Skeletal Muscle Relaxants—
Pharmacy Services08/10/09 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 Vaccines08/13/09 01-09-38
08-09-39
09-09-40
31-09-41
33-09-03Ch. 1101
1150
1141
1221Select Plan 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 Services09/01/09 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
1221Select Plan 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
1241Structured Screening for Developmental
Delays and Autism Spectrum Disorders09/08/09 99-09-07 Ch. 1121 Prior Authorization of Neulasta—Pharmacy Services 09/17/09 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 10/09/09 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 1145 Recipient 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 02/05/10 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
1144Application of Topical Fluoride
Varnish by Physicians and CRNPs03/15/10
09-10-08
31-10-08Ch. 1121 Prior Authorization of Neulasta—Pharmacy Services 04/01/10 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
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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. 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
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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 Policy07/17/10 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
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24-10-18
32-10-17Ch. 1101 Select Plan 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—
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09-10-28
27-10-21
02-10-20
11-10-20
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32-10-20Ch. 1121 Prior Authorization of Analgesics, Narcotic Short Acting—
Pharmacy Services08/27/10 01-10-25
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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
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30-10-18
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14-10-19
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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
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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
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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
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27-10-34
02-10-33
11-10-33
30-10-33
03-10-35
14-10-34
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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
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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
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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
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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
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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
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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
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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
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30-10-41
03-10-44
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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
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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
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14-10-46
31-10-57
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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
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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
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33-11-03Ch. 1150 Health Care Benefit Package 12 Updated Employability Assessment Procedure Code List 04/13/11 01-11-02
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33-11-03Ch. 1101
1150Medical Assistance Electronic Health Record (EHR) Incentive Program Application Process for Eligible Professionals (EP) 05/13/11 08-11-07
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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
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32-11-01Ch. 1121 Prior Authorization of Angiotensin Modulators—Pharmacy Services 05/26/11 01-11-10
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30-11-05
03-11-06
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32-11-05Ch. 1121 Prior Authorization of Antidepressants, SSRIs—Pharmacy Services 05/26/11 01-11-08
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30-11-03
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32-11-03Ch. 1121 Prior Authorization of Atypical Antipsychotics—Pharmacy Services 05/26/11 01-11-09
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03-11-05
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32-11-04Ch. 1121 Prior Authorization of Proton Pump Inhibitors (PPIs)—Pharmacy Services 05/26/11 01-11-07
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32-11-02Ch. 1150 Revisions to the Medical Assistance Program Fee Schedule Rates for Select Services 05/30/11 99-11-02 Ch. 1121 Prior Authorization of Multiple Sclerosis Agents—Pharmacy Services 06/08/11 01-11-17 Ch. 1121 Prior Authorization of Antihyperuricemics—Pharmacy Services 06/08/11 01-11-16
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32-11-11Ch. 1121 Prior Authorization of Anticoagulants—Pharmacy Services 06/08/11 01-11-18
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30-11-13
03-11-14
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32-11-13Ch. 1121 Prior Authorization of Cymbalta Handbook Pages—
Pharmacy Services06/08/11 01-11-18
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30-11-13
03-11-14
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32-11-13Ch. 1121 Prior Authorization of Tysabri—Pharmacy Services 06/08/11 01-11-13
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32-11-08Ch. 1121 Prior Authorization of Xolair—Pharmacy Services 06/08/11 01-11-15
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32-11-10Ch. 1121 Compounded Hydroxyprogesterone Caproate (17-P)—
Pharmacy Services06/08/11 01-11-19
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32-11-14Ch. 1121 Prior Authorization of Duplicate Therapy—Pharmacy Services 06/08/11 01-11-20
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32-11-06Ch. 1121 Prior Authorization of Nuedexta—Pharmacy Services 06/21/11 01-11-12
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02-11-07
11-11-07
30-11-07
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32-11-07Ch. 1121 Anticoagulants Handbook Pages—Pharmacy Services 07/14/11 01-11-40
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11-11-35
30-11-35
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32-11-35Ch. 1121 Angiotensin Modulators Handbook Pages—Pharmacy Services 07/14/11 01-11-39
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30-11-34
03-11-35
14-11-35
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32-11-34Ch. 1121 Opiate Dependence Treatments (Formerly Oral Buprenorphine Agents) Handbook Pages—Pharmacy Services 07/14/11 01-11-34
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24-11-33
32-11-29Ch. 1121 Bladder Relaxant Preparations Handbook Pages—
Pharmacy Services07/14/11 01-11-14
09-11-25
27-11-22
02-11-19
11-11-19
30-11-19
03-11-20
14-11-20
31-11-25
08-11-26
24-11-23
32-11-19Ch. 1121 Platelet Aggregation Inhibitors Handbook Pages—
Pharmacy Services07/14/11 01-11-38
09-11-39
27-11-36
02-11-33
11-11-33
30-11-33
03-11-34
14-11-34
31-11-39
08-11-40
24-11-37
32-11-33Ch. 1121 Cephalosporins and Related Agents Handbook Pages—
Pharmacy Services07/14/11 01-11-26
09-11-27
27-11-24
02-11-21
11-11-21
30-11-21
03-11-22
14-11-22
31-11-27
08-11-28
24-11-25
32-11-21Ch. 1121 Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Handbook Pages—Pharmacy Services 07/14/11 01-11-29
09-11-30
27-11-27
02-11-24
11-11-24
30-11-24
03-11-25
14-11-25
31-11-30
08-11-31
24-11-28
32-11-24Ch. 1121 Pulmonary Arterial Hypertension Agents, Oral and Inhaled Handbook Pages—Pharmacy Services 07/14/11 01-11-30
09-11-31
27-11-28
02-11-25
11-11-25
30-11-25
03-11-26
14-11-26
31-11-31
08-11-32
24-11-29
32-11-25Ch. 1121 Prior Authorization of Growth Hormones—
Pharmacy Services07/14/11 01-11-42
09-11-43
27-11-40
02-11-37
11-11-37
30-11-37
03-11-38
14-11-38
31-11-43
08-11-44
24-11-41
32-11-25Ch. 1121 Bone Resorption Suppression and Related Agents Handbook Pages—Pharmacy Services 07/14/11 01-11-32
09-11-33
27-11-30
02-11-27
11-11-27
30-11-27
03-11-28
14-11-28
31-11-33
08-11-34
24-11-31
32-11-27Ch. 1121 Multiple Sclerosis Agents Handbook Pages—
Pharmacy Services07/14/11 01-11-41
09-11-42
27-11-39
02-11-36
11-11-36
30-11-36
03-11-37
14-11-37
31-11-42
08-11-43
24-11-40
32-11-36Ch. 1121 Preferred Drug List (PDL) Update August 2011—
Pharmacy Services07/14/11 01-11-37
09-11-38
27-11-35
02-11-32
11-11-32
30-11-32
03-11-33
14-11-33
31-11-38
08-11-39
24-11-36
32-11-32Ch. 1121 Preferred Drug List (PDL) Update August 2011—
Pharmacy Services07/14/11 01-11-35
09-11-36
27-11-33
02-11-30
11-11-30
30-11-30
03-11-31
14-11-31
31-11-36
08-11-37
24-11-34
32-11-32Ch. 1121 Phosphate Binders Handbook Pages—Pharmacy Services 07/14/11 01-11-35
09-11-36
27-11-33
02-11-30
11-11-30
30-11-30
03-11-31
14-11-31
31-11-36
08-11-37
24-11-36
32-11-30Ch. 1121 Analgesics, Narcotics Short Acting Handbook Pages—
Pharmacy Services07/14/11 01-11-23
09-11-24
27-11-21
02-11-18
11-11-18
30-11-18
03-11-19
14-11-19
31-11-24
08-11-25
24-11-22
32-11-18Ch. 1121 Angiotensin Modulator Combinations Handbook Pages—
Pharmacy Services07/14/11 01-11-31
09-11-32
27-11-29
02-11-26
11-11-26
30-11-26
03-11-27
14-11-27
31-11-32
08-11-33
24-11-30
32-11-26Ch. 1121 HIV/AIDS Medications Handbook Pages—
Pharmacy Services07/14/11 01-11-22
09-11-23
27-11-20
02-11-17
11-11-17
30-11-17
03-11-18
14-11-18
31-11-23
08-11-24
24-11-21
32-11-17Ch. 1121 Antifungals, Topical Handbook Pages—Pharmacy Services 07/14/11 01-11-25
09-11-26
27-11-23
02-11-20
11-11-20
30-11-20
03-11-21
14-11-21
31-11-26
08-11-27
24-11-24
32-11-17Ch. 1121 Incretin Memetic/Enhancer Hypoglycemics Handbook Pages—Pharmacy Services 07/14/11 01-11-33
09-11-34
27-11-31
02-11-28
11-11-28
30-11-28
03-11-29
14-11-29
31-11-34
08-11-35
24-11-32
32-11-28Ch. 1121 Oral Contraceptives Handbook Pages—Pharmacy Services 07/14/11 01-11-28
09-11-29
27-11-26
02-11-23
11-11-23
30-11-23
03-11-24
14-11-24
31-11-29
08-11-30
24-11-27
32-11-23Ch. 1121 Prenatal Vitamins Handbook Pages—Pharmacy Services 07/14/11 01-11-36
09-11-37
27-11-34
02-11-31
11-11-31
30-11-31
03-11-32
14-11-32
31-11-87
08-11-38
24-11-35
32-11-31Ch. 1121 Colony Stimulating Factors Handbook Pages—
Pharmacy Services07/14/11 01-11-27
09-11-28
27-11-25
02-11-22
11-11-22
30-11-22
03-11-23
14-11-23
31-11-28
08-11-29
24-11-26
32-11-22Ch. 1121 Antiemetics (Promethazine)—Pharmacy Services 07/19/11 01-11-21
09-11-22
27-11-19
02-11-16
11-11-16
30-11-16
03-11-17
14-11-17
31-11-22
08-11-23
24-11-20
32-11-16Ch. 1121 Correction to Preferred Drug List (PDL) Update August 2011—Pharmacy Services 08/08/11 01-11-45
02-11-39
03-11-40
08-11-46
09-11-45
11-11-39
14-11-40
24-11-46
27-11-42
30-11-39
31-11-44
32-11-39
33-11-07Ch. 1121 Procedures to Submit Requests for Prior Authorization of Selected Medications by Facsimile (Fax)—Pharmacy Services 08/08/11 01-11-46
02-11-40
11-11-40
30-11-40
09-11-46
27-11-43
03-11-41
14-11-41
31-11-45
08-11-47
24-11-47
32-11-40
33-11-08Ch. 1150 2011 HCPCS Updates and Other Procedure Code Changes 08/08/11 00-11-04 Ch. 1101 Provider Screening of Employees and Contractors for Exclusion from Participation in Federal Health Care Programs and the Effect of Exclusion on Participation 08/15/11 99-11-05 Ch. 1121 Prior Authorization of Synagis—Pharmacy Services 08/15/11 01-11-47
09-11-47
27-11-44
02-11-41
11-11-41
30-11-41
03-11-42
14-11-42
31-11-46
08-11-48
24-11-48
32-11-41
33-11-09Ch. 1121 Early Refills—Pharmacy Services 08/15/11 01-11-47
09-11-47
27-11-44
02-11-41
11-11-41
30-11-41
03-11-42
14-11-42
31-11-46
08-11-48
24-11-48
32-11-41
03-11-09— Specialty Pharmacy Drug Program
—Updated List of Covered Drugs
—Pharmacy Services09/09/11 99-11-60 Ch. 1149 Medical Assistance Dental Benefit Changes 09/26/11 27-11-47
08-11-51Ch. 1163 Revised Payment Policy for Hospital Readmissions 10/03/11 01-11-44 — Discontinued Mailing of Medical Assistance Bulletins 09/26/11 99-11-08 Ch. 1150 Prudent Payment of Claims 09/30/11 99-11-07 Ch. 1163 Revised Payment Policy for Hospital Readmission 09/30/11 01-11-44 Ch. 1121 Prior Authorization of Stimulants and Related Agents—Pharmacy Services 10/17/11 01-11-48
09-11-48
27-11-45
02-11-42
11-11-42
30-11-42
03-11-43
14-11-43
31-11-47
08-11-49
24-11-49
32-11-42
33-11-10Ch. 1121 Prior Authorization of Xyrem—Pharmacy Services 10/17/11 01-11-49
09-11-49
27-11-46
02-11-43
11-11-43
30-11-43
03-11-44
14-11-44
31-11-48
08-11-50
24-11-50
32-11-43
33-11-11— 5010/D.0 Instructions to be Ready for Electronic Transaction Upgrades 10/27/11 99-11-09 Ch. 1121 Prior Authorization of Benzodiazepines—Pharmacy Services 10/28/11 01-11-50 Ch. 1121 Prior Authorization of Skeletal Muscle Relaxants—
Pharmacy Services10/28/11 01-11-50
09-11-50
27-11-48
02-11-44
11-11-44
30-11-44
03-11-45
14-11-45
31-11-49
08-11-52
24-11-51
32-11-44
33-11-12Ch. 1121 Prior Authorization of Early Refills Exemptions and Automated Approvals—Pharmacy Services 11/02/11 01-11-53
09-11-53
27-11-51
02-11-47
11-11-48
30-11-47
03-11-48
14-11-48
31-11-52
08-11-55
24-11-54
32-11-47
33-11-15Ch. 1150 Announcing the Federally Mandated Implementation of the National Correct Coding Initiative (NCCI) in the Pennsylvania Department of Public Welfare's Medical Assistance Program 11/10/11 99-11-10 Ch. 1150 ClaimCheck® Claims Criteria—Update 11/23/11 99-11-11 Ch. 1101
1150Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2 for Eligible Professionals (EP) 12/02/11 08-11-56
09-11-54
27-11-52
31-11-53
33-11-16Ch. 1101
1150Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2 for Eligible Hospitals (EH) 12/02/11 01-11-54 Ch. 1121 Prior Authorization of Anticoagulants—Pharmacy Services 12/03/11 01-11-57
09-11-57
27-11-55
33-11-19
02-11-50
11-11-51
30-11-50
03-11-51
14-11-51
31-11-56
08-11-59
24-11-57
32-11-50Ch. 1121 Prior Authorization of Erythropoiesis Stimulating Agents—Pharmacy Services 12/03/11 01-11-56
09-11-56
27-11-54
33-11-18
02-11-49
11-11-50
30-11-49
03-11-50
14-11-50
31-11-55
08-11-58
24-11-56
32-11-49Ch. 1121 Prior Authorization of Antipsychotics—Pharmacy Services 12/09/11 01-11-52
09-11-52
27-11-50
02-11-46
11-11-46
30-11-46
03-11-47
14-11-47
31-11-51
08-11-54
24-11-53
32-11-46
33-11-14Ch. 1121 Prior Authorization of Hepatitis C Agents—
Pharmacy Services12/10/11 01-11-55
09-11-55
27-11-53
33-11-17
02-11-48
11-11-49
30-11-48
03-11-49
14-11-49
31-11-54
08-11-57
24-11-55
32-11-48Ch. 1121 Medical Assistance Pharmacy Benefit Package Change 12/30/11 99-11-58
14-11-52
18-11-03
24-11-58
27-11-56
31-11-57
33-11-202012 Ch. 1121 Prior Authorization of Antidepressants, Other—
Pharmacy Services01/26/12 01-12-02
09-12-02
27-12-02
33-12-02
02-12-02
11-12-02
30-12-02
03-12-02
14-12-02
31-12-02
08-12-02
24-12-02
32-12-02Ch. 1121 Prior Authorization of Antihypertensives, Sympatholytic—
Pharmacy Services01/26/12 01-12-04
08-12-04
14-12-04
30-12-04
33-12-04
02-12-04
09-12-04
24-12-04
31-12-04
03-12-04
11-12-04
27-12-04
32-12-04Ch. 1121 Prior Authorization of Antihistamines, Minimally Sedating—
Pharmacy Services01/26/12 01-12-03
09-12-03
27-12-03
33-12-03
02-12-03
11-12-03
30-12-03
03-12-03
14-12-03
31-12-03
08-12-03
24-12-03
32-12-03Ch. 1121 Preferred Drug List (PDL) Update February 2012—
Pharmacy Services01/26/12 01-12-01
09-12-01
27-12-01
33-12-01
02-12-01
11-12-01
30-12-01
03-12-01
14-12-01
31-12-01
08-12-01
24-12-01
32-12-01Ch. 1121 Prior Authorization of Cymbalta—Pharmacy Services 01/26/12 01-12-06
09-12-06
27-12-06
33-12-06
02-12-06
11-12-06
30-12-06
03-12-06
14-12-06
31-12-06
08-12-06
24-12-06
32-12-06Ch. 1121 Prior Authorization of Bronchodilators, Beta Agonists—
Pharmacy Services01/26/12 01-12-05
09-12-05
27-12-05
33-12-05
02-12-05
11-12-05
30-12-05
03-12-05
14-12-05
31-12-05
08-12-05
24-12-05
32-12-05Ch. 1121 Prior Authorization of Emollients—Pharmacy Services 01/30/12 01-12-08
09-12-08
27-12-08
33-12-08
02-12-08
11-12-08
30-12-08
03-12-08
14-12-08
31-12-08
08-12-08
24-12-08
32-12-08Ch. 1121 Prior Authorization of Antipsychotics—Pharmacy Services 01/30/12 01-12-07
09-12-07
27-12-07
33-12-07
02-12-07
11-12-07
30-12-07
03-12-07
14-12-07
31-12-07
08-12-07
24-12-07
32-12-07Ch. 1121 Prior Authorization of Intranasal Rhinitis Agents—
Pharmacy Services02/01/12 01-12-11
09-12-11
27-12-11
33-12-11
02-12-11
11-12-11
30-12-11
03-12-11
14-12-11
31-12-11
08-12-11
24-12-11
32-12-11Ch. 1121 Prior Authorization of Enzyme Replacements, Gauchers Disease—Pharmacy Services 02/01/12 01-12-09
08-12-09
14-12-09
30-12-09
33-12-09
02-12-09
09-12-09
24-12-09
31-12-09
03-12-09
11-12-09
27-12-09
32-12-09Ch. 1121 Prior Authorization of Immunomodulators, Atopic Dermatitis—Pharmacy Services 02/01/12 01-12-10
08-12-10
14-12-10
30-12-10
33-12-10
02-12-10
09-12-10
24-12-10
31-12-10
03-12-10
11-12-10
27-12-10
32-12-10Ch. 1121 Prior Authorization of Iron, Parenteral—Pharmacy Services 02/01/12 01-12-12
08-12-12
14-12-12
30-12-12
33-12-12
02-12-12
09-12-12
24-12-12
31-12-12
03-12-12
11-12-12
27-12-12
32-12-12Ch. 1121 Prior Authorization of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)—Pharmacy Services 02/03/12 01-12-15
09-12-15
27-12-15
33-12-15
02-12-15
11-12-15
30-12-15
03-12-15
14-12-15
31-12-15
08-12-15
24-12-15
32-12-15Ch. 1121 Prior Authorization of Myalgia and Neuropathy Agents—
Pharmacy Services02/03/12 01-12-14
08-12-14
14-12-14
30-12-14
33-12-14
02-12-14
09-12-14
24-12-14
31-12-14
03-12-14
11-12-14
27-12-14
32-12-14Ch. 1121 Prior Authorization of Sedative Hypnotics—Pharmacy Services 02/06/12 01-12-19
09-12-19
27-12-19
33-12-19
02-12-19
11-12-19
30-12-19
03-12-19
14-12-19
31-12-19
08-12-19
24-12-19
32-12-19Ch. 1121 Prior Authorization of Botulinum Toxins—Pharmacy Services 02/06/12 01-12-13
09-12-13
27-12-13
33-12-13
02-12-13
11-12-13
30-12-13
03-12-13
14-12-13
31-12-13
08-12-13
24-12-13
32-12-13Ch. 1121 Prior Authorization of Stimulants and Related Agents—Pharmacy Services 02/06/12 01-12-21
09-12-21
27-12-21
33-12-21
02-12-21
11-12-21
30-12-21
03-12-21
14-12-21
31-12-21
08-12-21
24-12-21
32-12-21Ch. 1121 Prior Authorization of Otic Anti-Infectives and Anesthetics—Pharmacy Services 02/13/12 01-12-18
08-12-18
14-12-18
30-12-18
33-12-18
02-12-18
09-12-18
24-12-18
31-12-18
03-12-18
11-12-18
27-12-18
32-12-18Ch. 1121 Prior Authorization of Ophthalmic Antibiotic-Steroid Combinations—Pharmacy Services 02/13/12 01-12-17
08-12-17
14-12-17
30-12-17
33-12-17
02-12-17
09-12-17
24-12-17
31-12-17
03-12-17
11-12-17
27-12-17
02-12-17Ch. 1121 Prior Authorization of Smoking Cessation Products—Pharmacy Services 02/14/12 01-12-20
09-12-20
27-12-20
03-12-20
02-12-20
11-12-20
30-12-20
03-12-20
14-12-20
31-12-20
08-12-20
24-12-20
32-12-20Ch. 1128 Processing of Medicare Renal Dialysis Services Crossover Claims for Procedure Code 90999 02/21/12 30-12-22 Ch. 1101
1150Correction to Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2 for Eligible Professionals (EP) 03/08/12 08-12-22
09-12-24
27-12-22
31-12-22
33-12-22Ch. 1121 Prior Authorization of Myalgia and Neuropathy Agents—Pharmacy Services 03/18/12 01-12-22
09-12-23
27-12-23
33-12-23
02-12-22
11-12-22
30-12-23
03-12-22
14-12-22
31-12-23
08-12-23
24-12-22
32-12-22Ch. 1121 Prior Authorization of Antibiotics, Topical—Pharmacy Services 03/18/12 01-12-24
09-12-25
27-12-24
33-12-25
02-12-23
11-12-23
30-12-24
03-12-23
14-12-23
31-12-25
08-12-25
24-12-23
32-12-23Ch. 1123 Removal of NU Pricing Modifier from Procedure Codes for Oxygen Contents 03/20/12 24-12-24
25-12-01Ch. 1121 Prior Authorization of Oncology Agents, Oral—Pharmacy Services 04/02/12 01-12-16
09-12-16
27-12-16
33-12-16
02-12-16
11-12-16
30-12-16
03-12-16
14-12-16
31-12-16
08-12-16
24-12-16
32-12-16— Provider Electronic Solutions (PES) Software v3.59 replaces v3.58 04/06/12 99-12-01 Ch. 1101
Ch. 1150
Ch. 1241Updates to the Medical Assistance Program Fee Schedule for the Administration of Prevnar 13® Vaccine 04/06/12 01-12-25
08-12-26
09-12-26
31-12-26
33-12-26Ch. 1101 Updates to Medical Assistance Copayment Policy 04/16/12 99-12-03 Ch. 1121 Changes to the Drug Cost Component of Payment for Brand Name and Generic Drugs—Pharmacy Services 05/01/12 01-12-28
09-12-29
27-12-26
33-12-28
02-12-25
11-12-25
30-12-26
03-12-25
14-12-25
31-12-29
08-12-28
24-12-26
32-12-25Ch. 1121 Changes to the Dispensing Fee Component of Payment for Brand Name and Generic Drugs—Pharmacy Services 05/01/12 01-12-27
09-12-28
27-12-25
33-12-27
02-12-24
11-12-24
30-12-25
03-12-24
14-12-24
31-12-24
08-12-27
24-12-25
32-12-24Ch. 1149 Revision of Online Training Module for the Application of Topical Fluoride Varnish 05/01/12 09-12-27
31-12-27Ch. 1163 Newborn Payment Policy for Acute Care General Hospitals 05/04/12 01-12-26 — Specialty Pharmacy Drug Program—Updated List of Covered Drugs—Pharmacy Services 05/11/12 99-12-04 — Electronic Forms 05/11/12 99-12-02 Ch. 1121 Prior Authorization of Makena—Pharmacy Services 05/11/12 01-12-29
02-12-26
03-12-26
08-12-29
09-12-30
11-12-26
14-12-26
24-12-27
27-12-27
30-12-27
31-12-30
32-12-26
33-12-29Ch. 1150 Consultations Performed Using Telemedicine 05/23/12 09-12-31
31-12-31
33-12-30Ch. 1229 HealthChoices Physical Health Managed Care Expansion 05/25/12 99-12-05 — Provider Preventable Conditions 06/15/12 01-12-30
03-12-27
09-12-32
18-12-01
31-12-32
33-12-31
02-12-27
08-12-30
14-12-27
27-12-28
32-12-27
47-12-01— FQHC Change in Scope of Service 06/20/12 08-12-31 Ch. 1150 2012 HCPCS Updates and Other Procedure Code Changes 06/25/12 99-12-06 Ch. 1121 Prior Authorization of Incretin Mimetic/Enhancers Hypoglycemics—Pharmacy Services 07/11/12 01-12-32
09-12-34
27-12-30
33-12-33
02-12-29
11-12-28
30-12-29
03-12-29
14-12-29
31-12-34
08-12-33
24-12-29
32-12-29Ch. 1121 Preferred Drug List (PDL) Update August 2012—Pharmacy Services 07/12/12 01-12-33
09-12-35
27-12-31
33-12-34
02-12-30
11-12-29
30-12-37
03-12-30
14-12-30
31-12-35
08-12-34
24-12-30
32-12-30Ch. 1121 Prior Authorization of Opiate Dependence Treatments—Pharmacy Services 07/13/12 01-12-36
08-12-36
14-12-31
30-12-31
33-12-35
02-12-31
09-12-37
24-12-32
31-12-37
03-12-31
11-12-30
27-12-33
32-12-31Ch. 1121 Prior Authorization of Platelet Aggregation Inhibitors—Pharmacy Services 08/03/12 01-12-45
09-12-43
27-12-39
33-12-41
02-12-37
11-12-36
30-12-37
03-12-37
14-12-37
31-12-43
08-12-42
24-12-38
32-12-37Ch. 1121 Prior Authorization of Pituitary Suppressive Agents, LHRH—Pharmacy Services 08/03/12 01-12-44
09-12-42
27-12-38
33-12-40
02-12-36
11-12-35
30-12-36
03-12-36
14-12-36
31-12-42
08-12-41
24-12-37
32-12-36Ch. 1121 Prior Authorization of Benign Prostatic Hyperplasia (BPH) Treatments—Pharmacy Services 08/03/12 01-12-41
09-12-40
27-12-36
33-12-38
02-12-34
11-12-33
30-12-34
03-12-34
14-12-34
31-12-40
08-12-39
24-12-35
32-12-34Ch. 1121 Prior Authorization of Erythropoiesis Stimulating Proteins—Pharmacy Services 08/03/12 01-12-42
09-12-41
27-12-37
33-12-39
02-12-35
11-12-34
30-12-35
03-12-35
14-12-35
31-12-41
08-12-40
24-12-36
32-12-35Ch. 1121 Prior Authorization of Antibiotics, GI—Pharmacy Services 08/03/12 01-12-39
09-12-38
27-12-34
33-12-36
02-12-32
11-12-31
30-12-32
03-12-32
14-12-32
31-12-38
08-12-37
24-12-33
32-12-32Ch. 1121 Prior Authorization of Anticoagulants—Pharmacy Services 08/03/12 01-12-40
09-12-39
27-12-35
33-12-37
02-12-33
11-12-32
30-12-33
03-12-33
14-12-33
31-12-39
08-12-38
24-12-34
32-12-33Ch. 1121 Prior Authorization of Lipotropics, Statins—Pharmacy Services 08/03/12 01-12-46
09-12-44
27-12-40
33-12-42
02-12-38
11-12-37
30-12-38
03-12-38
14-12-37
31-12-44
08-12-43
24-12-39
32-12-38Ch. 1121 Prior Authorization of Growth Factors—Pharmacy Services 08/07/12 01-12-31
08-12-32
14-12-28
30-12-28
33-12-32
02-12-28
09-12-33
24-12-28
31-12-33
03-12-28
11-12-27
27-12-29
32-12-28Ch. 1229 HealthChoices Physical Health Managed Care New West Zone Expansion 08/08/12 99-12-08 Ch. 1101
Ch. 1150Medical Assistance Program Fee Schedule Revisions 08/31/12 99-12-10 Ch. 1150 Information Regarding Peritoneal Dialysis Treatment 09/13/12 01-12-50
30-12-43
31-12-49Ch. 1101
Ch. 1150Medical Assistance Program Fee Schedule Changes for Renal Dialysis Services 09/13/12 30-12-39
13-12-45Ch. 1121 Prior Authorization of Hepatitis C Agents—Pharmacy Services 09/13/12 01-12-49
09-12-47
27-12-43
33-12-45
02-12-41
11-12-40
30-12-42
03-12-41
14-12-41
31-12-48
08-12-46
24-12-42
32-12-41Ch. 1121 Prior Authorization of Cytokine and CAM Antagonists—Pharmacy Services 09/13/12 01-12-48
09-12-46
27-12-42
33-12-44
02-12-40
11-12-39
30-12-41
03-12-40
14-12-40
31-12-47
08-12-45
24-12-41
32-12-40Ch. 1121 Prior Authorization of Bronchodilators, Anticholinergic—Pharmacy Services 09/13/12 01-12-47
09-12-45
27-12-41
33-12-43
02-12-39
11-12-38
30-12-40
03-12-39
14-12-39
31-12-46
08-12-44
24-12-40
32-12-39Ch. 1150 New Procedure Codes for Tobacco Cessation Counseling Services 10/03/12 99-12-09 Ch. 1101 Delaying Alternative Cost Sharing for Families of Children with Disabilities with Incomes Over 200% of the Federal Poverty Income Guidelines 10/15/12 99-12-15 Ch. 1121 Prior Authorization of Botulinum Toxins—Pharmacy Services 10/22/12 01-12-53
09-12-50
27-12-46
33-12-48
02-12-44
11-12-43
30-12-46
03-12-44
14-12-44
31-12-52
08-12-49
24-12-45
32-12-44Ch. 1121 Prior Authorization of Angiotensin Modulator Combinations—Pharmacy Services 10/22/012 01-12-52
02-12-43
03-12-43
08-12-48
09-12-49
11-12-42
14-12-43
24-12-44
27-12-45
30-12-45
31-12-51
32-12-43
33-12-47Ch. 1150 Federally Mandated Implementation: Updates to National Correct Coding Initiative (NCCI) 10/26/12 99-12-12 Ch. 1121 Prior Authorization of Angiotensin Modulators—Pharmacy Services 10/30/12 01-12-54
08-12-50
14-12-45
30-12-47
33-12-49
02-12-45
09-12-51
24-12-46
31-12-53
03-12-45
11-12-44
27-12-47
32-12-45Ch. 1121 Prior Authorization of Multiple Sclerosis Agents—Pharmacy Services 10/30/12 01-12-56
08-12-52
14-12-47
30-12-49
33-12-51
02-12-47
09-12-53
24-12-48
31-12-55
03-12-47
11-12-46
27-12-49
32-12-47Ch. 1121 Prior Authorization of Tysabri—Pharmacy Services 10/30/12 01-12-57
08-12-53
14-12-48
30-12-50
33-12-52
02-12-48
09-12-54
24-12-49
31-12-56
03-12-48
11-12-47
27-12-50
32-12-48Ch. 1121 Prior Authorization of Incretin Mimetic/Enhancer Hypoglycemics—Pharmacy Services 10/30/12 01-12-55
08-12-51
14-12-46
30-12-48
33-12-50
02-12-46
09-12-52
24-12-47
31-12-54
03-12-46
11-12-45
27-12-48
32-12-46Ch.1123 Prior Authorization Requirements for the Rental of Medical Appliances and Durable Medical Equipment 12/10/12 24-12-55
25-12-02Ch. 1101
Ch. 1150Medical Assistance Program Fee Schedule Revisions 12/10/12 99-12-13 Ch. 1101
Ch. 1150
Ch. 1149Addition to the Medical Assistance Program Fee Schedule for Administration of Flu Vaccine for Intradermal Use: Fluzone Intradermal® 12/13/12 01-12-64
08-12-59
09-12-60
31-12-62
33-12-58Ch. 1150 NPI Requirements on All Claim Submission Media 12/19/12 99-12-14 Ch. 1121 Anticoagulants—New Quantity Limit for Low Molecular Weight Heparins and Arixtra (Fondaparinux)—Pharmacy Services 12/21/12 01-12-63
09-12-59
27-12-55
33-12-57
02-12-53
11-12-52
30-12-55
03-12-53
14-12-53
31-12-61
08-12-58
24-12-54
32-12-53Ch. 1121 Prior Authorization of Kalydeco—Pharmacy 12/21/12 01-12-60
09-12-56
27-12-52
33-12-54
02-12-50
11-12-49
30-12-52
03-12-50
14-12-50
31-12-58
08-12-55
24-12-51
32-12-50Ch. 1121 Prior Authorization of Hypoglycemics, TZDs—Pharmacy Services 12/21/12 01-12-61
09-12-57
27-12-53
33-12-55
02-12-51
11-12-50
30-12-53
03-12-51
14-12-51
31-12-59
08-12-56
24-12-52
32-12-51Ch. 1121 Prior Authorization of Antipsychotics—Pharmacy Services 12/21/12 01-12-62
09-12-58
27-12-54
33-12-56
02-12-52
11-12-51
30-12-54
03-12-52
14-12-52
31-12-60
08-12-57
24-12-53
32-12-52Ch. 1121 Prior Authorization of Korlym—Pharmacy Services 12/21/12 01-12-59
09-12-55
27-12-51
33-12-53
02-12-49
11-12-48
30-12-51
03-12-49
14-12-49
31-12-57
08-12-54
24-12-50
32-12-49Ch. 1150 Clinical Laboratory Improvement Amendments Requirements 12/28/12 01-12-67
08-12-62
09-12-63
28-12-01
31-13-65
33-13-612013 Ch. 1121 Prior Authorization of Antipsoriatics Topical—Pharmacy Services 01/07/13 01-13-01
09-13-01
27-13-01
33-13-01
02-13-01
11-13-01
30-13-01
03-13-01
14-13-01
31-13-01
08-13-01
24-13-01
32-13-01Ch. 1121 Prior Authorization of Antipsychotics—Pharmacy Services 01/07/13 01-13-02
09-13-02
27-13-02
33-13-02
02-13-02
11-13-02
30-13-02
03-13-02
14-13-02
31-13-02
08-13-02
24-13-02
32-13-02Ch. 1121 Prior Authorization of Diabetic Strips—Pharmacy Services 01/07/13 01-13-03
09-13-03
27-13-03
33-13-03
02-13-03
11-13-03
30-13-03
03-13-03
14-13-03
31-13-03
08-13-03
24-13-03
32-13-03Ch. 1121 Prior Authorization of Glucocorticoids Oral—Pharmacy Services 01/07/13 01-13-04
09-13-04
27-13-04
33-13-04
02-13-04
11-13-04
30-13-04
03-13-04
14-13-04
31-13-04
08-13-04
24-13-04
32-13-04Ch. 1121 Prior Authorization of Leukotriene Modifiers—Pharmacy Services 01/07/13 01-13-05
09-13-05
27-13-05
33-13-05
02-13-05
11-13-05
30-13-05
03-13-05
14-13-05
31-13-05
08-13-05
24-13-05
32-13-05Ch. 1121 Prior Authorization of Neuropathic Pain Agents (Formerly Myalgia and Neuropathy Agents)—Pharmacy Services 01/07/13 01-13-06
09-13-06
27-13-06
33-13-06
02-13-06
11-13-06
30-13-06
03-13-06
14-13-06
31-13-06
08-13-06
24-13-06
32-13-06Ch. 1121 Prior Authorization of Oncology Agents Breast Cancer—Pharmacy Services 01/07/13 01-13-07
08-13-07
14-13-07
32-13-07
02-13-07
09-13-07
24-13-07
30-13-07
03-13-07
11-13-07
27-13-07
31-13-07
33-13-07Ch. 1121 Prior Authorization of Smoking Cessation Products—Pharmacy Services 01/07/13 01-13-08
09-13-08
27-13-08
33-13-08
02-13-08
11-13-08
30-13-08
03-13-08
14-13-08
31-13-08
08-13-08
24-13-08
32-13-08Ch. 1121 Prior Authorization of Diabetic Meters—Pharmacy Services 01/07/13 01-13-09
09-13-09
27-13-09
33-13-09
02-13-09
11-13-09
30-13-09
03-13-09
14-13-09
31-13-09
08-13-09
24-13-09
32-13-09Ch. 1229 HealthChoices Physical Health Managed Care New East Zone Expansion 01/18/13 99-13-02 Ch. 1121 Preferred Drug List (PDL) Update January 15, 2013—Pharmacy Services 01/22/13 01-13-11
09-13-11
27-13-11
33-13-11
02-13-10
11-13-10
30-13-10
03-13-10
14-13-10
31-13-12
08-13-11
24-13-11
32-13-10Ch. 1150 Medical Assistance Program Fee Increase for Select Primary Care Services and Physician Attestation Form 01/22/13 31-13-11 Ch. 1121 Prior Authorization of Cytokine and CAM Antagonists—Pharmacy Services 01/25/13 01-13-12
08-13-12
14-13-11
30-13-11
33-13-12
02-13-11
09-13-12
24-13-12
31-13-13
03-13-11
11-13-11
27-13-12
32-13-11Ch. 1150 Medical Assistance Program Fee Increase for Select Primary Care Services and Physician Attestation Form 01/22/13 31-13-11 Ch. 1101
Ch. 1150Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2013 for Eligible Professionals (EP) 02/01/13 08-13-10
09-13-10
27-13-10
31-13-10
33-13-10Ch. 1101
Ch. 1150Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2013 for Eligible Hospitals (EH) 02/01/13 01-13-10 Ch. 1101 Updated Procedures for Submitting the Deficit Reduction Act of 2005 Attestation Form 02/14/13 99-13-04 Ch. 1229 Continued Existence of the Fee-For-Service Delivery System in HealthChoices Zones and Enrollment of Breast and Cervical Cancer Prevention and Treatment (BCCPT) Recipients in HealthChoices 02/22/13 99-13-05 Ch. 1121 Prior Authorization of Analgesics Narcotic Short Acting—Pharmacy Services 03/29/13 01-13-16
08-13-16
14-13-15
30-13-15
33-13-17
02-13-15
09-13-17
24-13-16
31-13-18
03-13-15
11-13-15
27-13-16
32-13-15Ch. 1121 Prior Authorization of Bladder Relaxant Preparations—
Pharmacy Services03/29/13 01-13-14
09-13-15
27-13-14
33-13-15
02-13-13
11-13-13
30-13-13
03-13-13
14-13-13
31-13-16
08-13-14
24-13-14
32-13-13Ch. 1121 Prior Authorization of Bronchodilators Beta Agonists Short Acting Agents—Pharmacy Services 03/29/13 01-13-17
08-13-17
14-13-16
30-13-16
33-13-18
02-13-16
09-13-18
24-13-17
31-13-19
03-13-16
11-13-16
27-13-17
32-13-16Ch. 1121 Prior Authorization of Antipsychotics—Pharmacy Services 03/29/13 01-13-13
08-13-13
14-13-12
30-13-12
33-13-14
02-13-12
09-13-14
24-13-13
31-13-15
03-13-12
11-13-12
27-13-13
32-13-12Ch. 1121 Prior Authorization of Chronic Obstructive Pulmonary Disease (COPD) Agents—Pharmacy Services 03/29/13 01-13-15
09-13-16
27-13-15
33-13-16
02-13-14
11-13-14
30-13-14
03-13-14
14-13-14
31-13-17
08-13-15
24-13-15
32-13-14Ch. 1101
Ch. 1150Medical Assistance Program Fee Schedule Revisions for Procedure Code K0606 04/01/13 24-13-10
25-13-01Ch. 1101
Ch. 1150Medical Assistance Program Fee Schedule Revisions 04/15/13 99-13-03 Ch. 1121 Medical Assistance Pharmacy Benefit Package Update 04/22/13 99-13-20
14-13-17
18-13-01
24-13-18
17-13-18
31-13-21
33-13-20Ch. 1121 Prior Authorization of Anticoagulants—Pharmacy Services 5/3/13 01-13-19
09-13-21
27-13-19
33-13-21
02-13-17
11-13-17
30-13-17
03-13-17
14-13-18
31-13-22
08-13-19
24-13-19
32-13-17Ch. 1101 Revised Physician Attestation Form for Primary Care Services 05/03/13 31-13-32 Ch. 1121 Prior Authorization of Pulmonary Arterial Hypertension (PAH) Agents Oral and Inhaled—Pharmacy Services 05/03/13 01-13-23
09-13-25
27-13-23
33-13-25
02-13-21
11-13-21
30-13-21
03-13-21
14-13-22
31-13-26
08-13-23
24-13-23
32-13-21Ch. 1121 Prior Authorization of Lyrica (pregabalin) Neuropathic Pain Agents and Oral Anticonvulsants—Pharmacy Services 05/03/13 01-13-25
09-13-27
27-13-25
33-13-27
02-13-23
11-13-23
30-13-23
03-13-23
14-13-24
31-13-28
08-13-25
24-13-25
32-13-23Ch. 1121 Prior Authorization of Multiple Sclerosis Agents—
Pharmacy Services05/03/13 01-13-20
09-13-22
27-13-20
33-13-22
02-13-18
11-13-18
30-13-18
03-13-18
14-13-19
31-13-23
08-13-20
24-13-20
32-13-18Ch. 1121 Prior Authorization of Botulinum Toxins (Type A and Type B)—Pharmacy Services 05/03/13 01-13-21
09-13-23
27-13-21
33-13-23
02-13-19
11-13-19
30-13-19
03-13-19
14-13-20
31-13-24
08-13-21
24-13-21
32-13-19Ch. 1121 Prior Authorization of Benzodiazepines; Analgesics Narcotic Long Acting; and Analgesics Narcotic Short Acting—Pharmacy Services 05/03/13 01-13-26
09-13-28
27-13-26
33-13-28
02-13-24
11-13-24
30-13-24
03-13-24
14-13-25
31-13-29
08-13-26
24-13-26
32-13-24Ch. 1121 Medicare Part D Coverage of Barbiturates and Benzodiazepines—Pharmacy Services 05/03/13 01-13-28
08-13-28
14-13-27
30-13-26
33-13-30
02-13-26
09-13-30
24-13-28
31-13-31
03-13-26
11-13-26
27-13-28
32-13-26Ch. 1121 Prior Authorization of Cytokine and CAM Antagonists—Pharmacy Services 05/03/13 01-13-27
09-13-29
27-13-27
33-13-29
02-13-25
11-13-25
30-13-25
03-13-25
14-13-26
31-13-30
08-13-27
24-13-27
32-13-25Ch. 1121 340B Drug Pricing Program Provider Requirements and Billing Instructions—Pharmacy Services 05/16/13 99-13-08 Ch. 1101 Application of InvestiClaimTM Analytics to Select Claims 05/17/13 99-13-09 Ch. 1150 Implementation of the Medical Assistance Program's Physician Fee Increases for Select Primary Care Services 05/23/13 31-13-34 Ch. 1150 Addition to the Medical Assistance Program Fee Schedule for Administration of Flu Vaccine Derived from Cell Cultures: Flucelvax 05/25/13 01-13-18
08-13-18
09-13-19
31-13-20
33-13-19Ch. 1121 Prior Authorization of Androgenic Agents—Pharmacy Services 05/31/13 01-13-22
02-13-20
03-13-20
08-13-22
09-13-24
11-13-20
14-13-21
24-13-22
27-13-22
30-13-20
31-13-25
32-13-20
33-13-24Ch. 1121 Prior Authorization of H.P. Acthar Gel—Pharmacy Services 05/31/13 01-13-24
02-13-22
03-13-22
08-13-24
09-13-26
11-13-22
14-13-23
24-13-24
27-13-24
30-13-22
31-13-27
32-13-22
33-13-26Ch. 1150 2013 HCPCS Updates and Other Procedure Code Changes 06/24/13 99-13-07 Ch. 1121 Prior Authorization of Anticoagulants—Pharmacy Services 07/02/13 01-13-38
02-13-34
03-13-34
08-13-36
09-13-38
11-13-34
14-13-35
24-13-36
27-13-36
30-13-34
31-13-42
32-13-34
33-13-38Ch. 1121 Prior Authorization of Antiparasitics Topical—Pharmacy Services 07/02/13 01-13-37
02-13-33
03-13-33
08-13-35
09-13-37
11-13-33
14-13-34
24-13-35
27-13-35
30-13-33
31-13-41
32-13-33
33-13-37Ch. 1121 Prior Authorization of Multiple Sclerosis Agents—
Pharmacy Services07/02/13 01-13-39
02-13-35
03-13-35
08-13-37
09-13-39
11-13-35
14-13-36
24-13-37
27-13-37
30-13-35
31-13-43
32-13-35
33-13-39Ch. 1150 Hospital Payment Arrangements 1 and 2 for Emergency Room Services 07/02/13 01-13-29
31-13-33Ch. 1121 Prior Authorization of Vasodilators Coronary—
Pharmacy Services07/02/13 01-13-36
02-13-32
03-13-32
08-13-34
09-13-36
11-13-32
14-13-33
24-13-34
27-13-34
30-13-32
31-13-40
32-13-32
33-13-36Ch. 1121 Prior Authorization of Incretin Mimetic/Enhancer Hypoglycemics—Pharmacy Services 07/02/13 01-13-34
02-13-30
03-13-30
08-13-32
09-13-34
11-13-30
14-13-31
24-13-32
27-13-32
30-13-30
31-13-38
32-13-30
33-13-34Ch. 1121 Prior Authorization of H. Pylori Treatments—
Pharmacy Services07/02/13 01-13-32
02-13-28
03-13-28
08-13-30
09-13-32
11-13-28
14-13-29
24-13-30
27-13-30
30-13-28
31-13-36
32-13-28
33-13-32Ch. 1121 Preferred Drug List (PDL) Update July 24, 2013—
Pharmacy Services07/07/13 01-13-31
09-13-31
27-13-29
33-13-31
02-13-27
11-13-27
30-13-27
03-13-27
14-13-28
31-13-35
08-13-29
24-13-29
32-13-27Ch. 1121 Prior Authorization of Colony Stimulating Factors—
Pharmacy Services07/13/13 01-13-33
09-13-33
27-13-31
33-13-33
02-13-29
11-13-29
30-13-29
03-13-29
14-13-30
31-13-37
08-13-31
24-13-31
32-13-29Ch. 1121 Prior Authorization of Irritable Bowel Syndrome Agents—
Pharmacy Services07/13/13 01-13-35
09-13-35
27-13-33
33-13-35
02-13-31
11-13-31
30-13-31
03-13-31
14-13-32
31-13-39
08-13-33
24-13-33
32-13-31Ch. 1121 Prior Authorization of Acne Agents Oral—Doxycycline—
Pharmacy Services07/22/13 01-13-40
08-13-38
14-13-37
30-13-36
33-13-40
02-13-36
09-13-40
24-13-38
31-13-44
03-13-36
11-13-36
27-13-38
32-13-36Ch. 1127
Ch. 1150Changes to the Payment Structure for Birth Center Services 08/29/13 09-13-13
31-13-14
33-13-13
47-13-01Ch. 1101 Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2014 for Eligible Hospitals (EH) 09/20/13 01-13-41 Ch. 1101 Implementation of ADA Claim Form—Version 2012 and Elimination of ADA Claim Form—Version 2006 09/20/13 17-13-01
19-13-01
20-13-01
27-13-39
31-13-45Ch. 1101
Ch. 1149
Ch. 1129Correction to the Procedures for Reporting of Other Provider Preventable Conditions (OPPCs) for Federally Qualified Health Centers Rural Health Clinics and Dentists 10/02/13 08-13-39
27-13-41Ch. 1101 Application of InvestiClaimTM Analytics to Select Claims—Update 10/04/13 99-13-12 Ch. 1121 Prior Authorization of Anticoagulants—Pharmacy Services 11/04/13 01-13-45
09-13-45
27-13-45
33-13-44
02-13-40
11-13-40
30-13-40
03-13-40
14-13-41
31-13-50
08-13-43
24-13-42
32-13-40Ch. 1121 Prior Authorization of Angiotensin Modulators—Pharmacy Services 11/04/13 01-13-44
09-13-44
27-13-44
33-13-43
02-13-39
11-13-39
30-13-39
03-13-39
14-13-40
31-13-49
08-13-42
24-13-41
32-13-39Ch. 1121 Prior Authorization of Benign Prostatic Hyperplasia (BPH) Treatment—Pharmacy Services 11/04/13 01-13-46
09-13-46
27-13-46
33-13-45
02-13-41
11-13-41
30-13-41
03-13-41
14-13-42
31-13-51
08-13-44
24-13-43
32-13-41Ch. 1121 Prior Authorization of HIV/AIDS Medications—Pharmacy Services 11/04/13 01-13-47
09-13-47
27-13-47
33-13-46
02-13-42
11-13-42
30-13-42
03-13-42
14-13-43
31-13-52
08-13-45
24-13-44
32-13-42Ch. 1121 Prior Authorization of Alzheimer's Agents—Pharmacy Services 11/04/13 01-13-42
09-13-42
27-13-42
33-13-41
02-13-37
11-13-37
30-13-37
03-13-37
14-13-38
31-13-47
08-13-40
24-13-39
32-13-37Ch. 1121 Prior Authorization of Leukotriene Modifiers—Pharmacy Services 11/04/13 01-13-48
09-13-48
27-13-48
33-13-47
02-13-43
11-13-43
30-13-43
03-13-43
14-13-44
31-13-53
08-13-46
24-13-45
32-13-43Ch. 1121 Prior Authorization of Angiotensin Modulator Combinations—Pharmacy Services 11/04/13 01-13-43
09-13-43
27-13-43
33-13-42
02-13-38
11-13-38
30-13-38
03-13-38
14-13-39
31-13-48
08-13-41
24-13-40
32-13-38Ch. 1121 Prior Authorization of Antipsychotics—Pharmacy Services 11/22/13 01-13-52
09-13-50
27-13-49
33-13-49
02-13-44
11-13-44
30-13-44
03-13-44
14-13-45
31-13-57
08-13-49
24-13-46
32-13-44Ch. 1121 Prior Authorization of Analgesics
Narcotic Long Acting
Analgesics
Narcotic Short Acting and Cough and Cold Medications—
Pharmacy Services11/22/13 01-13-55
09-13-53
27-13-52
33-13-52
02-13-47
11-13-47
30-13-47
03-13-47
14-13-48
31-13-60
08-13-52
24-13-49
32-13-47Ch. 1121 Prior Authorization of Vecamyl (mecamylamine)—Pharmacy Services 11/22/13 01-13-54
09-13-52
27-13-51
33-13-51
02-13-46
11-13-46
30-13-46
03-13-46
14-13-47
31-13-59
08-13-51
24-13-48
32-13-46Ch. 1121 Prior Authorization of Lipotropics Other—Pharmacy Services 11/22/13 01-13-53
09-13-51
27-13-50
33-13-50
02-13-45
11-13-45
30-13-45
03-13-45
14-13-46
31-13-58
08-13-50
24-13-47
32-13-45Ch. 1101 CAQH CORE Federal Mandate: Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) 11/22/13 99-13-14 Ch. 1101 Presumptive Eligibility as Determined by Hospitals 12/06/13 01-13-56 Ch. 1121 Preferred Drug List (PDL) Update January 22, 2014—Pharmacy Services 12/18/13 01-13-57
02-13-48
03-13-48
08-13-53
09-13-54
11-13-48
14-13-49
24-13-50
27-13-53
30-13-48
31-13-61
32-13-48
33-13-53Ch. 1150 Medical Assistance Program Fee Schedule Revisions 12/27/13 99-13-13 2014 Ch. 1150 Additions to the Medical Assistance Program Fee Schedule for Administration of Quadrivalent Flu Vaccine 08-14-02 01/07/14 01-14-03
09-14-01
31-14-02
33-14-01Ch. 1101 Changes to MA 112 Newborn Eligibility Form 01/10/14 01-14-02
47-14-01Ch. 1101 Implementation of the CMS-1500 Health Insurance Claim Form (version 02-12) 01/10/14 99-14-03 (Editor's Note: This document continues with the Governor's Office's Catalog of Nonregulatory Documents in Part IV at 52 Pa.B. 4761 (August 6, 2022).)
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