We publish billing policies to offer transparency and help you bill claims more accurately to reduce delays in processing claims, as well as avoid rebilling and additional requests for information.
The following billing policies were recently published to or updated in our Provider Manual’s Billing Policies page.
Note: If the effective date is listed as N/A, the policy represents our current system set up and/or expectations for transparency. There are either no changes for you as the policy is already in effect or was recently shared with the network and we’re implementing a clinical edit in alignment with the policy’s language.
| Billing policy | Description | Effective date |
|---|---|---|
| New policies | ||
| Drug pricing | This policy outlines existing billing criteria around 340B Drug Pricing. | N/A |
| Benign Prostatic Hyperplasia Treatments | This policy provides general coding guidance on documentation, modifiers and POS information | N/A |
| Tumor Treatment Field Therapy (TTFT) - policy article | This policy outlines documentation requirements | N/A |
| Updated policies | ||
| Care management | We've added information on codes G0556-G0558 and S0257 | N/A |
| General Coding | We've made the verbiage around the NDC language more generic | N/A |