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Tag · billing / coding / payment

Items in the last 60 days tagged "billing / coding / payment" with substantive content available.

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MassHealth · Oct 1, 2026
Score 91
Nursing Facility Bulletin 204: Updated Eligibility Criteria for Substance Use Disorder (SUD) Add-on and New Medications for Opioid Use Disorder (MOUD) Add-on, Open PDF file, 456.29 KB
PrimaryAuthoritative depthState Medicaid 42 CFR Pt 2 MA State Medicaid Billing, coding and payment
New York Medicaid Fraud Control Unit · Oct 5, 2026
Score 89
Attorney General James Announces Arrest of Queens Dentist Who Stole Over $300,000 from Medicaid
PrimaryAuthoritative depthState MFCU MFCU NY State AG enforcement Fraud waste abuse Billing, coding and payment
OIG Enforcement Actions: Provider Self-Disclosure and CIA Event Settlements · Oct 7, 2026
Score 88
Baptist Health Brookwood Hospital Agreed to Pay $105,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims that Failed to Meet Coverage Criteria
PrimaryAuthoritative depthHHS OIG OIG enforcement Billing, coding and payment Civil monetary penalty Fraud waste abuse
South Carolina DHHS Medicaid · Oct 7, 2026
Score 88
Updates to Clinic Services Manual
PrimaryAuthoritative depthState Medicaid AKS SC Anti-Kickback Statute Billing, coding and payment State Medicaid
South Carolina DHHS Medicaid · Oct 6, 2026
Score 88
Updates to the Durable Medical Equipment Services Manual
PrimaryAuthoritative depthState Medicaid AKS SC Anti-Kickback Statute Billing, coding and payment Fraud waste abuse State Medicaid
OIG Reports (Audits + Evaluations) · Sep 17, 2026
Score 88
OIG Report (Audit): Methodist Hospital Received at Least $12.4 Million in Medicare Overpayments
PrimaryHHS OIG OIG enforcement Fraud waste abuse Billing, coding and payment
Oregon Medicaid Fraud Control Unit · Oct 3, 2026
Score 87
Attorney General Rayfield: Advantage Dental to Pay $4.5 Million for Improperly Billing Phone Calls to the Oregon Health Plan
PrimaryAuthoritative depthState MFCU MFCU OR State Medicaid Fraud waste abuse Billing, coding and payment
Michigan Medicaid · Sep 15, 2026
Score 86
MMP 26-30
PrimaryAuthoritative depthState Medicaid MI State Medicaid Billing, coding and payment
Kansas Medical Assistance Program · Oct 14, 2026
Score 85
UPDATED 22252, General
PrimaryAuthoritative depthState Medicaid KS Billing, coding and payment Managed care State Medicaid
Michigan Medicaid · Oct 10, 2026
Score 85
MMP 26-24
PrimaryAuthoritative depthState Medicaid MI Billing, coding and payment State Medicaid
Texas Office of Inspector General (HHSC) · Sep 17, 2026
Score 85
Dental anesthesia billing
PrimaryAuthoritative depthState OIG TX State Medicaid Managed care Billing, coding and payment
Washington HCA Apple Health provider alerts (billing guides, hospital payment, prior authorization) · Oct 3, 2026
Score 84
Community Behavioral Health Support Services Billing Guide updates effective 9/1/2026
PrimaryAuthoritative depthState Medicaid WA Billing, coding and payment State Medicaid
Louisiana Medicaid · Oct 24, 2026
Score 80
Informational Bulletin 26-18
PrimaryAuthoritative depthState Medicaid LA Billing, coding and payment State Medicaid
South Carolina DHHS Medicaid · Sep 24, 2026
Score 78
Physician-administered Drugs (PAD) Billing Guidance
PrimaryAuthoritative depthState Medicaid SC State Medicaid Billing, coding and payment
Washington HCA Apple Health provider alerts (billing guides, hospital payment, prior authorization) · Oct 3, 2026
Score 77
Reminder: Hospital trauma services enhanced professional payments
PrimaryState Medicaid WA Billing, coding and payment Emergency services Hospital or health system State Medicaid
Indiana FSSA Medicaid · Oct 24, 2026
Score 76
BT2026174
PrimaryState Medicaid IN Billing, coding and payment State Medicaid
Michigan Medicaid · Sep 13, 2026
Score 75
MMP 24-50
PrimaryAuthoritative depthState Medicaid MI State Medicaid Billing, coding and payment
Indiana FSSA Medicaid · Oct 24, 2026
Score 70
BT2026173
PrimaryState Medicaid IN Billing, coding and payment State Medicaid
Oregon Health Authority: Tools for OHP Health Plans (coordinated care organization announcements) · Oct 3, 2026
Score 70
Changes to teledentistry codes D9995 and D9996 effective Jan. 1, 2027
PrimaryState Medicaid OR Billing, coding and payment Dental State Medicaid Telehealth
Michigan Medicaid · Sep 15, 2026
Score 68
MMP 26-31
PrimaryState Medicaid MI State Medicaid Billing, coding and payment
Kansas Medical Assistance Program · Oct 3, 2026
Score 65
KanCare 3.0 Open Claims Resolution Log
PrimaryAuthoritative depthState Medicaid KS State Medicaid Billing, coding and payment
Kansas Medical Assistance Program · Sep 13, 2026
Score 65
KanCare 3.0 Open Claims Resolution Log
PrimaryState Medicaid KS Billing, coding and payment Managed care State Medicaid
Kansas Medical Assistance Program · Sep 13, 2026
Score 65
KanCare 3.0 Open Claims Resolution Log
PrimaryState Medicaid KS Billing, coding and payment Managed care State Medicaid
Indiana FSSA Medicaid · Oct 24, 2026
Score 63
BT2026172
PrimaryState Medicaid IN Billing, coding and payment State Medicaid
Alabama Medicaid Agency · Oct 23, 2026
Score 63
New Justice-Involved Youth (JIY) Travel Payment for EPSDT Provider’s Travel to Carceral Facilities
PrimaryAuthoritative depthState Medicaid HIPAA AL Billing, coding and payment State Medicaid
Kansas Medical Assistance Program · Sep 13, 2026
Score 63
KanCare 3.0 Closed Claims Resolution Log
PrimaryState Medicaid KS Billing, coding and payment Managed care State Medicaid
Kansas Medical Assistance Program · Sep 13, 2026
Score 62
26136, General
PrimaryState Medicaid KS Billing, coding and payment State Medicaid
Michigan Medicaid · Sep 15, 2026
Score 61
MMP 26-27
PrimaryState Medicaid MI State Medicaid Billing, coding and payment
Kansas Medical Assistance Program · Sep 13, 2026
Score 61
KanCare 3.0 Open Claims Resolution Log
PrimaryState Medicaid KS Billing, coding and payment Fraud waste abuse Managed care State Medicaid
Kansas Medical Assistance Program · Sep 13, 2026
Score 61
KanCare 3.0 Closed Claims Resolution Log
PrimaryState Medicaid KS Billing, coding and payment Long-term care Managed care State Medicaid
Louisiana Medicaid · Oct 24, 2026
Score 60
Informational Bulletin 26-15
PrimaryAuthoritative depthState Medicaid LA Billing, coding and payment State Medicaid
Virginia DMAS (Medicaid) · Oct 23, 2026
Score 60
Updates to Emergency Medicaid Supplement and Chapters 1 and 3 of the Provider Manuals
PrimaryAuthoritative depthState Medicaid VA Billing, coding and payment State Medicaid
South Carolina DHHS Medicaid · Oct 3, 2026
Score 60
Prescriber Certification of Incontinence Form Update
PrimaryAuthoritative depthState Medicaid SC State Medicaid Billing, coding and payment
MaineCare Services · Sep 3, 2026
Score 60
Section 90, Physician Services: Retroactive Rate Update Effective January 1, 2026, CR#142205, 142218
PrimaryState Medicaid ME Billing, coding and payment State Medicaid
Kansas Medical Assistance Program · Oct 23, 2026
Score 58
KanCare 3.0 Open Claims Resolution Log
PrimaryAuthoritative depthState Medicaid KS Billing, coding and payment Managed care State Medicaid
MaineCare Services · Oct 13, 2026
Score 58
The MaineCare Third Party Liability (TPL) Exemption Request and Attestation Form is Now Available
PrimaryAuthoritative depthState Medicaid ME Billing, coding and payment State Medicaid
Oregon Medicaid · Oct 3, 2026
Score 58
Fee-for-Service Hospice Rates Effective Oct. 1, 2026
PrimaryAuthoritative depthState Medicaid OR State Medicaid Billing, coding and payment
Kansas Medical Assistance Program · Sep 13, 2026
Score 58
26133, General
PrimaryState Medicaid KS Billing, coding and payment State Medicaid
Kansas Medical Assistance Program · Oct 16, 2026
Score 56
KanCare 3.0 Open Claims Resolution Log
PrimaryState Medicaid KS Billing, coding and payment Managed care State Medicaid
Oregon Health Authority: Oregon Health Plan Permanent Rule Filings (OAR chapter 410) · Oct 3, 2026
Score 56
050-0861-08202026.pdf: OAR 410-050-0861 amended to update the outpatient and inpatient DRG hospital assessment rates. No public comment was recieved.
PrimaryAuthoritative depthState register OR Billing, coding and payment State Medicaid
Kansas Medical Assistance Program · Sep 13, 2026
Score 56
KanCare 3.0 Open Claims Resolution Log
PrimaryState Medicaid KS Billing, coding and payment State Medicaid
Kansas Medical Assistance Program · Sep 13, 2026
Score 56
KanCare 3.0 Open Claims Resolution Log
PrimaryState Medicaid KS State Medicaid Managed care Billing, coding and payment
MaineCare Services · Sep 3, 2026
Score 56
Section 90: Quarter 3, Physician Drug and Seasonal Flu Code Update: CR 142091, 142074
PrimaryState Medicaid ME Billing, coding and payment State Medicaid
Kansas Medical Assistance Program · Oct 3, 2026
Score 55
KanCare 3.0 Closed Claims Resolution Log
PrimaryAuthoritative depthState Medicaid KS State Medicaid Billing, coding and payment
CMS Transmittals (sub-regulatory guidance) · Sep 17, 2026
Score 55
R13948CP
PrimaryCMS CMS guidance Billing, coding and payment
CMS Transmittals (sub-regulatory guidance) · Sep 17, 2026
Score 55
R13946CP
PrimaryCMS CMS guidance Billing, coding and payment
Kansas Medical Assistance Program · Sep 13, 2026
Score 55
KanCare 3.0 Closed Claims Resolution Log
PrimaryState Medicaid KS Billing, coding and payment Managed care State Medicaid
MaineCare Services · Sep 3, 2026
Score 54
Fiscal Year 2027 (FY27) Rate Correction: Section 97, Appendix C, Residential Care Facilities
PrimaryState Medicaid ME Billing, coding and payment State Medicaid
Washington HCA Apple Health provider alerts (billing guides, hospital payment, prior authorization) · Oct 3, 2026
Score 53
Interpreter Services Billing Guide Updated With Sign Language Interpreter Services Information
PrimaryState Medicaid WA Billing, coding and payment State Medicaid
MassHealth · Oct 1, 2026
Score 53
Nursing Facility Bulletin 203: Updates to the Bariatric Add-on, Open PDF file, 352.59 KB
PrimaryAuthoritative depthState Medicaid MA State Medicaid Billing, coding and payment
Kansas Medical Assistance Program · Oct 23, 2026
Score 51
KanCare 3.0 Closed Claims Resolution Log
PrimaryAuthoritative depthState Medicaid KS Billing, coding and payment Managed care State Medicaid
MaineCare Services · Sep 9, 2026
Score 51
Attention Trading Partners: MIHMS Upgrade October Payment Cycle Changes and System Access Limitations
PrimaryState Medicaid ME State Medicaid Billing, coding and payment
MaineCare Services · Oct 13, 2026
Score 50
System Remittance Advice (RA) and 835 Limitations
PrimaryAuthoritative depthState Medicaid ME Billing, coding and payment State Medicaid
Kansas Medical Assistance Program · Sep 13, 2026
Score 50
KanCare 3.0 Closed Claims Resolution Log
PrimaryState Medicaid KS State Medicaid Managed care Billing, coding and payment
Louisiana Medicaid · Oct 24, 2026
Score 48
Informational Bulletin 26-8
PrimaryAuthoritative depthState Medicaid LA Billing, coding and payment State Medicaid
OIG Reports (Audits + Evaluations) · Sep 16, 2026
Score 48
OIG Report (Audit): Medicare Hospital Provider Compliance Audit: McLeod Regional Medical Center
PrimaryAuthoritative depthHHS OIG OIG enforcement Billing, coding and payment Hospital conditions of participation
Kansas Medical Assistance Program · Sep 13, 2026
Score 48
KMAP Open Claims Resolution Log
PrimaryState Medicaid KS Billing, coding and payment Fraud waste abuse State Medicaid
Kansas Medical Assistance Program · Sep 19, 2026
Score 47
KanCare 3.0 Open Claims Resolution Log
PrimaryState Medicaid KS State Medicaid Managed care Billing, coding and payment
Louisiana Medicaid · Oct 24, 2026
Score 46
Informational Bulletin 26-8
PrimaryAuthoritative depthState Medicaid LA Billing, coding and payment State Medicaid
Kansas Medical Assistance Program · Oct 8, 2026
Score 46
26178, General
PrimaryAuthoritative depthState Medicaid KS Billing, coding and payment State Medicaid