| Administrative |
admin-023 |
Administrative Denials |
May 29, 2024 |
May 29, 2024 |
May 29, 2025 |
| Administrative |
ADMIN-004 |
Behavioral Health Residential Treatment Centers |
September 04, 2024 |
September 04, 2024 |
September 04, 2025 |
| Administrative |
admin-002 |
Behavioral Health Services Level of Care Determination |
September 25, 2024 |
September 25, 2024 |
September 25, 2025 |
| Administrative |
admin-015 |
Category III CPT Codes |
January 01, 2025 |
January 01, 2025 |
January 01, 2026 |
| Administrative |
admin-001 |
Clinical Criteria for Review Determinations |
December 04, 2024 |
December 04, 2024 |
December 04, 2025 |
| Administrative |
admin-008 |
Custodial/Respite Care |
March 23, 2025 |
March 23, 2025 |
March 23, 2026 |
| Administrative |
admin-021 |
Dismissal: Failure to Follow Filing Procedures |
May 29, 2024 |
May 29, 2024 |
May 29, 2025 |
| Administrative |
admin-016 |
Hospice Eligibility Determination Policy |
January 22, 2025 |
January 22, 2025 |
January 22, 2026 |
| Administrative |
admin-003 |
Medical Services Level of Care Determination |
December 04, 2024 |
December 04, 2024 |
December 04, 2025 |
| Administrative |
admin-020 |
Noncovered Behavioral Health-Related Services |
February 26, 2025 |
February 26, 2025 |
February 26, 2026 |
| Administrative |
ADMIN-018 |
Personal Care Services |
December 04, 2024 |
December 04, 2024 |
December 04, 2025 |
| Administrative |
admin-022 |
Retrospective Service Reviews |
November 25, 2024 |
September 25, 2024 |
September 25, 2025 |
| Administrative |
admin-017 |
Temporary COVID-19 Telemedicine Policy |
May 29, 2024 |
May 29, 2024 |
May 29, 2025 |
| Administrative |
admin-006 |
Women’s Health and Cancer Rights Act Clarification |
July 31, 2024 |
July 31, 2024 |
July 31, 2025 |
| Administrative |
admin-014 |
Hospital Acquired Conditions and Never Events |
October 23, 2024 |
October 23, 2024 |
October 23, 2025 |
| Administrative |
ADMIN-005 |
Reopening of Organizational Determinations for Medical Review |
October 28, 2024 |
August 28, 2024 |
August 28, 2025 |
| Administrative |
ADMIN-009 |
Behavioral Health Intensive Outpatient and Partial Hospitalization Programs |
December 23, 2024 |
October 23, 2024 |
October 23, 2025 |
| Administrative |
ADMIN-012 |
Experimental/Investigational Services |
March 22, 2025 |
January 22, 2025 |
January 22, 2026 |