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Alerts
  • Ascension Password Change: On May 8, 2024, a cyber security event disrupted clinical operations of the Ascension Healthcare Network. To ensure the security of protected health information on the ForwardHealth Portal, ForwardHealth will prompt all providers owned by Ascension to change their password. Providers not owned by Ascension will not be prompted to change their password.

    For instructions on changing your Portal password, refer to the ForwardHealth Provider Portal Account User Guide.

  • Multi-factor authentication (MFA) is now required for the secure ForwardHealth Portal. Providers are encouraged to refer to the ForwardHealth Multi-Factor Authorization Instruction Sheet for help setting up MFA preferences.
    Providers may contact their Portal account administrator or call the ForwardHealth Portal Help Desk at 866-908-1363. Note: This is a project-specific announcement and is not related to the Change Healthcare disruption.
FQHC Provider Publications

Federally Qualified Health Center Provider Publications

These publications are available only as PDFs. You will need Adobe Reader® to view these files.

Update
Number		Update Topics and Release Date
2019
2019-12 Clarification of Telehealth Policy for Telestroke, 4/9/19
2019-11 SeniorCare Waiver Given Temporary Extension, 4/3/19
2019-10 Pharmacy Policy Changes for Adderall XR Effective May 1, 2019, 3/13/19
2019-09 Expanded Practice Settings for Dental Hygienist Services, 3/1/19
2019-06 Coverage Policy for Silver Diamine Fluoride, 2/19/19
2019-04 SeniorCare Waiver Given Temporary Extension for 60 Days, 1/31/19
2019-03 Brand Name Metadate CD No Longer Available, 1/28/19
2018
2018-48 Policy Changes for Alpha Hydroxyprogesterone Caproate (17P) Compound and Makena Injections, 12/18/18
2018-47 January 2019 Preferred Drug List Review and Other Pharmacy Policy Changes, 12/14/18
2018-45 SeniorCare Waiver Given Temporary Extension to January 31, 2019, 12/7/18
2018-44 Changes to Prior Authorization for Migraine Agents, CGRP Antagonists, 12/7/18
2018-42 ForwardHealth Interim Coverage of Select Drugs, Including High Cost Drugs, Orphan Drugs, and Drugs Approved Under an FDA Accelerated Approval Pathway, 12/3/18
2018-34 Pharmacy Policy Changes Effective September 21, 2018, 9/21/18
2018-25 New Outpatient Mental Health Policy Adding Coverage of Mental Health Clinical Consultations for Students, 7/2/18

July 19, 2018: This Update has been revised since its original publication. Information under Covered Services has been changed for the definition of mental health clinical consultation.
2018-24 Information for Eligible Professionals Regarding Program Year 2018 of the Wisconsin Medicaid EHR Incentive Program, 6/25/18
2018-22 July 2018 Preferred Drug List Review and Other Pharmacy Policy Changes, 6/15/18
2018-20 Certification and Service Provision for Opioid Treatment Programs, 6/6/18
2018-19 Drug Coverage Limitations for SeniorCare Members, 6/4/18
2018-12 Clarification of New Reimbursement Methodology for Community Health Centers, 4/2/18
2018-08 New Reimbursement Methodology for Community Health Centers, 2/28/18
2017
2017-42 January 2018 Preferred Drug List Review and Other Pharmacy Policy Changes, 12/15/17
2017-34 New and Clarified Pharmacy Policy and Claims Submission Requirements, 10/26/17
2017-32 Prior Authorization Required for Mavyret™ and Vosevi™, 10/6/17
2017-27 New Prior Authorization Policy for Outpatient Behavioral Health Services, 9/5/17
2017-26 New Policy and Procedure Codes for Certain Dental Services and Appliances 8/25/17
2017-25 New and Clarified Telehealth Policy, 8/18/17
2017-19 Information for Eligible Professionals Regarding Program Year 2017 of the Wisconsin Medicaid Electronic Health Record Incentive Program, 6/19/17

October 2, 2017: Information under the "Clinical Quality Measure Reporting Periods" heading has been revised in response to the Hospital Inpatient Prospective Payment System final rule. The change is indicated in red text.
2017-17 July 2017 Preferred Drug List Review and Other Pharmacy Policy Changes, 6/16/17

June 21, 2017: This Update has been revised with additional information since its original publication. Information under Olysio® as Combined with Sovaldi® has been added in red text on page 17 of the Update.
2017-16 Prior Authorization Required for Spinraza™, 5/24/17
2017-07 Changes to Billing and Reimbursement Policy for Covered Outpatient Drugs, 3/15/17
2016
2016-54 January 2017 Preferred Drug List Review and Other Pharmacy Policy Changes, 12/16/16

March 6, 2017: This Update has been revised since its original publication. Information under the Clinical Criteria for Cytokine and CAM Antagonist Drugs for Crohn's Disease section has been added in red text on page 9 of the Update.
2016-48 ForwardHealth Coverage and Prior Authorization Policy for Personal Continuous Glucose Monitoring Devices and Accessories, 10/27/16
2016-41 Information for Eligible Professionals Regarding Program Year 2016 of the Wisconsin Medicaid Electronic Health Record Incentive Program, 10/5/16

January 4, 2017: Information under the "Electronic Health Record Reporting Periods" heading has been revised in response to the CMS Hospital Outpatient Prospective Payment System final rule. The change is indicated in red text.
May 16, 2017: Federally Qualified Health Centers and Rural Health Clinics were added to the "To" list of providers.
2016-38 Targeted Reimbursement Rate Increase for Certain Dental Services Provided in Four Counties, 9/16/16

October 7, 2016: This Update has been revised since its original publication. The list of procedure codes in the Attachment on page 5 have been revised. Procedure codes D3221 and D7140 have been added and procedure codes D3220 and D7111 have been removed. The changes are indicated in red text
2016-32 Revised Prior Authorization Forms and Changes to Pharmacy Policies for Hepatitis C Agents Effective August 1, 2016, 7/29/16
2016-30 Pharmacy Policy Changes Effective August 1, 2016, 7/18/16
2016-28 Prior Authorization No Longer Required for Cochlear Implant and Bone-Anchored Hearing Device Implant Surgeries, 7/13/16
2016-25 Information for Eligible Professionals Regarding Program Year 2016 of the Wisconsin Medicaid Electronic Health Record Incentive Program, 6/24/16
2016-23 Reporting Other Health Insurance Information on Dental Claims, 6/24/16
2016-22 July 2016 Preferred Drug List Review and Other Pharmacy Policy Changes, 6/17/16
2016-21 Prior Authorization Will No Longer Be Required for Crinone® 8% When Used for Certain Indications, 6/7/16
2016-20 Prior Authorization Will No Longer Be Required for OnabotulinumtoxinA (Botox®) When Used to Treat Chronic Migraines, 5/27/16
2016-19 Prior Authorization Required for Rosuvastatin Tablets, 5/24/16
2016-18 Date of Service Defined and Documentation Requirements Clarified for Durable Medical Equipment and Disposable Medical Supplies, 5/16/16
2016-16 Changes to Coverage Policy for Testing for Drugs of Abuse, 4/18/16
2016-15 Information for Eligible Professionals Regarding Changes to the Wisconsin Medicaid Electronic Health Record Incentive Program for Program Year 2015, 4/28/16

May 16, 2017: This Update has been revised since its original publication. Federally Qualified Health Centers and Rural Health Clinics were added to the "To" list of providers.
2016-14 Changes to Pharmacy Policies for Hepatitis C Agents, 4/13/16
2016-11 2016 Procedure Code Changes for Dental Services, 3/9/16
2016-09 Prior Authorization Criteria and Coverage Policy for Prophylactic Mastectomies, 3/3/16
2016-08 Prior Authorization Criteria and Coverage Policy for Gynecomastia Surgery, 3/3/16
2016-07 Revised Prior Authorization Criteria and Coverage Policy for Cochlear Implant Surgery, 2/23/16
2016-06 Prior Authorization Required for Generic Imatinib Tablets, 2/1/16
2015
2015-63 SeniorCare Waiver Extended to December 31, 2018, 12/21/15
2015-61 January 2016 Preferred Drug List Review and Other Pharmacy Policy Changes, 12/18/15
2015-59 Prior Authorization Requirements and Coverage Policy for Restorative Plastic Surgeries and Procedures, 11/25/15
2015-57 Prior Authorization Required for Paliperidone Tablets, 11/02/15
2015-51 Clarification of the Completion Instructions for the Consent for Sterilization Form, 10/13/15
2015-50 Pharmacy Policy Changes Effective October 15, 2015, 10/5/15
2015-43 New Prior Authorization Guidelines for Pectus Carinatum Surgery, 9/9/15
2015-42 Revised Prior Authorization Criteria and Documentation Requirements for Periodontal Scaling and Root Planing, 9/16/15
2015-41 New Policy Regarding Coverage and Prior Authorization Criteria for Hyperbaric Oxygen Therapy, 9/1/15
2015-34 Revised Prior Authorization Drug Attachment for Hepatitis C Agents Effective August 1, 2015, 7/22/15
2015-30 New Prior Authorization Approval Criteria for Reduction Mammoplasty, 7/2/15
2015-29 Drug-Related Supplies Reimbursed Fee-for-Service for Outpatient Pharmacies, 6/29/15
2015-27 July 2015 Preferred Drug List Review and Other Pharmacy Policy Changes, 6/17/15

February 23, 2016: This Update has been revised since its original publication. Information under the Clinical Criteria for Pediatric-Covered Indications for Growth Hormone Drugs section has been added in red text on page 10 of the Update.
2015-24 Information for Eligible Professionals Regarding Program Year 2015 of the Wisconsin Medicaid Electronic Health Record Incentive Program, 6/8/15

January 27, 2016: The deadline for all Eligible Professionals to apply for Program Year 2015 Electronic Health Record incentive payments has been extended from March 31, 2016, to July 31, 2016.
2015-23 Coverage Policy for Sleep Medicine Testing, 6/4/15
2015-21 Additional Cellular/Tissue-Based Product Covered by ForwardHealth, 5/27/15
2015-19 Prior Authorization Changes for a Bone-Anchored Hearing Device Implant Surgery and Non-implant Bone-Anchored Hearing Device, 5/14/15
2015-13 Changes to Pharmacy Policies for Hepatitis C Agents Effective April 1, 2015, 3/18/15
2015-09 Clarification Regarding Comprehensive Medication Review and Assessment Services for Members Recently Discharged from a Hospital or Long Term Care Setting, 3/6/15
2015-04 Coverage Policy for Continuous Glucose Monitoring, 1/12/15
2014
2014-79 Changes to Provider-Administered Drugs Carve-Out Policy, 12/16/14
2014-78 January 2015 Preferred Drug List Review and Other Pharmacy Policy Changes, 12/18/14
2014-77 Change to Requirement Regarding Electronic Submission of Medication Therapy Management Documentation, 12/11/14
2014-75 Procedure Code Changes for Influenza Vaccinations, 12/4/14
2014-74 Changes to Pharmacy Policies for Hepatitis C Agents Effective December 1, 2014, 11/19/14
2014-71 Changes for Program Year 2014 of the Wisconsin Medicaid Electronic Health Record Incentive Program for Eligible Professionals, 10/30/14
2014-62Changes to the 1500 Health Insurance Claim Form and Completion Instructions, 10/14/14
2014-63 Coverage Policy for Cellular/Tissue-Based Products, 10/10/14
2014-55 Changes to Pharmacy Policies Effective October 1, 2014, 9/17/14
2014-53 Revised Prior Authorization Guidelines for Synagis®, 9/15/14

September 16, 2014: This Update has been revised since its original publication. Information under the Chronic Lung Disease of Prematurity section has been changed to clarify the gestational age at delivery is younger than 32 weeks. Revisions are indicated in red.
2014-45Medication Therapy Management New Electronic Submission of Documentation Requirement, 8/18/14
2014-40Claim Submission Changes for Travel Time and Professional Services for the Outpatient Mental Health and Substance Abuse Services in the Home or Community for Adults Benefit, 6/24/14
2014-39July 2014 Preferred Drug List Review and Other Pharmacy Policy Changes, 6/20/14
2014-302014 Procedure Code Changes for Durable Medical Equipment, 4/30/14
2014-242014 Procedure Code Changes for Disposable Medical Supplies, 3/31/14
2014-22Revision to Durable Medical Equipment Coverage, Policies, and Limitations, 4/30/14
2014-20Policy Changes for Alpha Hydroxyprogesterone Caproate (17P) Compound Injections and Makena Injections, 3/31/14
2014-13Prior Authorization Required for Sovaldi™, 3/3/14
2014-08Changes to Pharmacy Policies Effective March 1, 2014, 2/17/14
2013
2013-69Certain Mental Health Services for Children Are Now Covered Under the Outpatient Mental Health Benefit When Provided in the Home, 12/17/13
2013-67January 2014 Preferred Drug List Review and Other Pharmacy Policy Changes, 12/13/13
2013-64Revisions to Companion Guide for the 837 Health Care Claim: Institutional Transaction, 11/25/13
2013-56ForwardHealth Encourages Providers to Include Specific Explanation of Medicare Benefits Information with Medicare Advantage Crossover Claims for Diabetic Supplies, 10/24/13
2013-53Revisions to Payer Sheet for All ForwardHealth Programs as a Result of Changes to Claims Submission Requirements for Wisconsin AIDS Drug Assistance Program, 10/9/13
2013-52Information for Eligible Professionals Regarding Program Year 2014 of the Wisconsin Medicaid Electronic Health Record Incentive Program, 10/7/13
2013-482013 Procedure Code Changes for Outpatient Mental Health and Substance Abuse Services in the Home or Community for Adults, 9/27/13
2013-47Additional Information and Clarifications Regarding Professional Claims for Compound and Noncompound Drugs, 9/26/13
2013-46Changes to Pharmacy Policies Effective Fall 2013, 9/18/13

September 19, 2013: This Update has been revised since its original publication. Information on page 4 regarding PA requests for Anti-obesity drugs and information on pages 6 through 8 regarding a prescriber's handwritten signature on the PA/DGA form have been revised. Revisions are indicated in red.
2013-42Policy Clarifications for OnabotulinumtoxinA (Botox®) and Other Botulinum Toxins, 9/5/13
2013-41Clarification for the Revised Prior Authorization/ Preferred Drug List (PA/PDL) Exemption Request Form and Completion Instructions, 8/20/13
2013-39Pharmacy Providers May Contract with a ForwardHealth-Approved Medication Therapy Management Case Management Software Vendor, 8/1/13
2013-35July 2013 Preferred Drug List Review and Other Pharmacy Policy Changes, 6/20/13
2013-31Requesting Exemption from Prior Authorization Requirements for Advanced Imaging Services, 6/3/13

6/4/2013: This Update has been revised since its original publication. Information under the "Updating the List of Eligible Providers" heading has changed to reflect Portal solution changes.
2013-21Information for Program Year 2013 of the Wisconsin Medicaid Electronic Health Record Incentive Program for Eligible Professionals, 4/1/13
2013-20Information and Policy Clarifications for the Medication Therapy Management Benefit, 3/26/13
2013-152013 Procedure Code Changes for Dental Services, 3/12/13
2013-14Policy for Onabotulinumtoxin A (Botox®), 2/21/13
2013-132013 Procedure Code Changes for the Outpatient Mental Health Benefit, 2/19/13
2013-062013 Procedure Code Changes for Disposable Medical Supplies, 1/24/13
2013-05Procedure Code Changes for Family Planning Only Services, 1/24/13
2013-032013 Procedure Code Changes for Durable Medical Equipment, 1/31/13
2013-02New Modifier for Family Planning Only Services, 1/14/13
2012
2012-72SeniorCare Extended to December 31, 2015, 12/27/12
2012-71January 2013 Preferred Drug List Review and Other Pharmacy Policy Changes, 12/21/12

2/22/2013: This Update has been revised since its original publication. On page 8, the name of the preferred drug in the Cytokine and CAM antagonist drug class used to treat ulcerative colitis has been changed to Humira®.
2012-67Information for Eligible Professionals Regarding the Wisconsin Medicaid Electronic Health Record Incentive Program, 12/17/12
2012-64Policy Changes for Services Rendered by Qualified Treatment Trainees, 11/28/12
2012-46Changes to Prospective Drug Utilization Review Alerts, 9/11/12
2012-42Disposable Medical Supplies Procedure Code Clarification, 8/24/12
2012-39Medication Therapy Management Benefit, 8/23/12
2012-35New Prior Authorization Criteria for Vagus Nerve Stimulator Implant Surgeries, 7/25/12
2012-34New Prior Authorization Criteria for Restorative Plastic Surgery and Procedures, 7/25/12
2012-29Introducing the Medication Therapy Management Benefit, 6/29/12
2012-25Summer 2012 Preferred Drug List Review and Other Pharmacy Policy Changes, 6/19/12
2012-19Policy Changes for Bone-anchored Hearing Aids, 5/14/12
2012-18Eligible Professionals Reporting Meaningful Use for the Wisconsin Medicaid Electronic Health Record Incentive Program and Other Program Information, 5/14/12

This Update has been revised since its original publication. The Web page address on page 4 for core and menu set objectives has been revised.
2012-08Procedure Code Changes for Family Planning Only Services, 3/21/12
2012-07Spring 2012 Pharmacy Policy Changes, 3/9/12
2012-06Wisconsin Medicaid Electronic Health Record Incentive Program Standard Deduction Information for Eligible Professionals, 2/20/12
2012-042012 Procedure Code Changes for Durable Medical Equipment, 2/17/12
2012-03Procedure Code Changes for Disposable Medical Supplies, 2/17/12
2012-01New Prior Authorization Policy for Antipsychotic Drugs for Children 6 Years of Age and Younger, 1/26/12

This Update has been revised since its original publication. The end date for the Attestation to Prescribe More Than One Antipsychotic Drug for a Member 16 Years of Age or Younger is for dates of process on and after February 15, 2012, not for dates of service on and after February 14, 2011.
2011
2011-84January 2012 Preferred Drug List Review and Other Pharmacy Policy Changes, 12/20/11
2011-78Clarification of Provider Responsibilities for Requesting and Amending Prior Authorizations for Synagis®, 11/22/11
2011-72Implementation of the HIPAA Accredited Standards Committee X12 Version 5010 Electronic 278 Health Care Services Review — Request for Review and Response Transaction, 11/7/11
2011-68Additional Information and Clarifications Regarding the Wisconsin Medicaid Electronic Health Record Incentive Program, 10/31/11

This Update has been revised since its original publication. The November and December dates for an Eligible Hospital's fiscal year in Attachment 2 have changed since original publication. For more information, refer to page 7 of this Update or to the Determining the Payment Year for Eligible Hospitals topic (topic #12517) in the EHR Incentive Program section, Financial Information chapter of the Online Handbook.
2011-57Changes to Claims for Drugs and Diabetic Supplies Resulting from Implementation of the National Council for Prescription Drug Programs Telecommunication Standard Version D.0, 9/23/11
2011-56Changes to Pharmacy Policies Effective in October 2011, 9/21/11
2011-54New Reimbursement Methodologies for Drugs and Diabetic Supplies, 9/20/11
2011-53Revisions to UB-04 Claim Form Instructions Resulting from HIPAA ASC X12 Version 5010 Implementation, 9/14/11
2011-52Revisions to 1500 Health Insurance Claim Form Instructions Resulting from HIPAA ASC X12 Version 5010 Implementation, 9/14/11
2011-50Clarification of Sterilization Policy Regarding Retroactive Eligibility, 8/29/11
2011-49Changes to Prior Authorization for Drugs and Diabetic Supplies Resulting from Implementation of the National Council for Prescription Drug Programs Telecommunication Standard, 8/31/11
2011-48Additional Power Sources Not Covered and Changes to Coverage for Ventilator Equipment, 8/24/11
2011-40The Wisconsin Medicaid Electronic Health Record Incentive Program for Eligible Professionals, 7/25/11
2011-38Wisconsin Chronic Disease Program Training Available, 7/25/11
2011-37National Provider Identifier Policy Clarification for Durable Medical Equipment Providers, 7/8/11
2011-36Summer 2011 Preferred Drug List Review, 7/11/11

August 8, 2011: A clarification has been made on page 9 to the clinical criteria for non-preferred orally disintegrating PPI tablets.
July 15, 2011: An additional revision has been made on pages 6 and 7 as a result of the retroactive policy change.
July 11, 2011: Retroactive for dates of service on and after July 1, 2011, simvastatin 80mg will remain a preferred drug. Page 7 of this Update has been revised to reflect the change in policy. The Preferred Drug List Quick Reference pharmacy data table was revised and posted to the ForwardHealth Portal on July 7, 2011, to reflect the change in policy. In addition, a change to the clinical criteria for proton pump inhibitor drugs was made on page 9.
2011-29Policy Clarification for Cochlear Implants, 5/11/11
2011-282011 Procedure Code Updates for Durable Medical Equipment, 5/11/11
2011-27Policy Changes and Reminders for Gradient Compression Garments and Compression Burn Garments, 4/26/11
2011-26Changes to Newborn Reporting, 4/26/11

On June 16, 2011, the Newborn Report (F-1165) has been revised since it was originally published in this ForwardHealth Update. The revised form dated 06/11 is in the Attachment of this Update.
2011-23Electronic Health Record Incentive Program Information Sessions Offered for Providers, Hospitals, and Staff, 4/11/11

The list of affected providers has been revised as of April 19, 2011. Advanced Practice Nurse Prescribers with Psychiatric Specialty, Dental Groups and Rural Health Clinics are eligible health care providers for this program and have been added to the Update. Optometrists were incorrectly listed as being eligible health care providers. All changes to the Update are indicated in red.
2011-22Photographs Mailed to ForwardHealth as Additional Supporting Clinical Documentation for Prior Authorization Requests Will No Longer Be Returned to Providers, 4/11/11
2011-21Changes to the Coverage of Active Pharmaceutical Ingredients and Excipients for Compound Drugs, 3/1/11
2011-20Changes to Pharmacy Policies Effective in April 2011, 3/1/11
2011-13Important Information About the National Correct Coding Initiative, 3/1/11
2011-10New Laboratory Procedure Code Reimbursable for Tuberculosis-Related Services-Only Benefit, 2/1/11
2011-09Introducing Two New Reports for Compound and Noncompound Drug Claims, 2/1/11
2011-07Explanation of Benefits Code for Generic Drug Reimbursement, 1/1/11
2011-06Three-Month Supply Drug Policy Changes, 1/1/11
2011-05Changes to Newborn Reporting, 1/1/11
2011-04Changes to the Pharmacy Services Lock-In Program, 1/1/11
2010
2011-05Changes to Newborn Reporting, 1/1/11
2010-121Members 20 and Under May Elect Hospice and Continue with Active Treatment, 12/1/10
2010-120New Procedure Code for Directly Observed Therapy for Tuberculosis Treatment, 12/1/10
2010-119How to Correctly Indicate Modifiers on Claims for Repeat or Separately Identifiable Procedures, 12/1/10
2010-118Real Time and Provider Electronic Solutions Claim Response Enhancement, 12/1/10
2010-117Over-the-Counter Drug Policy, 12/1/10
2010-116Advanced Practice Nurse Prescribers with Psychiatric Specialty May Now Be Certified by Wisconsin Medicaid on the ForwardHealth Portal, 12/1/10
2010-112Opioid Monthly Prescription Fill Limit, 12/1/10
2010-108Diabetic Supply Policy Changes, 12/1/10
2010-103Changes to Pharmacy Policies Occurring in December 2010, 11/1/10
2010-99Coverage of Certain Asthma Supplies Under the BadgerCare Plus Benchmark Plan, the BadgerCare Plus Core Plan, and the BadgerCare Plus Basic Plan, 11/1/10
2010-92New Prior Authorization Requirements for Advanced Imaging Services, 10/1/10
2010-90Reimbursement Reduction for Most Paper Claims Submitted to ForwardHealth, 10/1/10
2010-86Prior Authorization Is Required for Avandia, Avandamet, and Avandaryl, 9/1/10
2010-85Reimbursement Rate Increase for Pharmacy Providers for Therapeutic Interchange and Influenza Vaccine, 9/1/10
2010-84Fall 2010 Preferred Drug List Changes, 9/1/10
2010-82Prior Authorization Is Required for Certain Durable Medical Equipment Under the BadgerCare Plus Core Plan and the BadgerCare Plus Basic Plan, 9/1/10
2010-74Reminder of Deficit Reduction Act Policy for Prescribers, 8/1/10

This Update has been revised since its original publication. Information about Provider Electronic Solutions software has been corrected. Refer to page 2 of the Update for more information.
2010-72ClaimCheck Clarification, 8/1/10
2010-69All HealthCheck Services Are Now Covered Under the BadgerCare Plus Benchmark Plan, 8/1/10
2010-67Hearing Instruments and Services Now Covered Under the BadgerCare Plus Benchmark Plan, 7/1/10
2010-63Compound and Noncompound Drug Claim Submissions Using the ForwardHealth Portal, 8/1/10
2010-57July 2010 Preferred Drug List Review and Other Pharmacy Policy Changes, 6/1/10
2010-56Changes to Two Provider-Administered Drug Categories Related to Reproductive Health for Females, 6/1/10
2010-55Clarification of Policy and Coverage for Incontinence and Urological Supplies Included in the J&B Medical Supply Contract, 6/1/10
2010-52Pharmacy Services Covered Under the BadgerCare Plus Basic Plan, 6/1/10

This Update has been revised since its original publication. The Explanation of Benefits code on page 5 has been revised.
2010-43Coverage of Certain Medical Services Under the BadgerCare Plus Basic Plan, 6/1/10
2010-39Coverage of Cervarix® and Changes to the Coverage of Gardasil®, 5/1/10
2010-36Some Males Now Eligible for the Family Planning Waiver, 5/1/10

This Update has been revised since its original publication. The URL to ACCESS has been corrected. See the correct URL indicated in red at the bottom of page 1.
2010-30Changes for Diabetic Supplies, 4/1/10
2010-26Procedure Code Updates for Durable Medical Equipment, 3/1/10
2010-25New Reimbursement Policies for Immunizations Given to BadgerCare Plus and Medicaid Members, 5/1/10
2010-23Spring 2010 Preferred Drug List Review, 3/1/10
2010-21Additional Comprehensive Examination Codes for BadgerCare Plus Core Plan, 3/1/10
2010-19Change in Billing and Reimbursement for a Sterilization Procedure, 3/1/10
2010-14New Policies and Clarification of Certain Pharmacy Policies, 2/1/10

This Update has been revised since its original publication. Revisions were made on page 2 of this ForwardHealth Update and are indicated in red.
2010-13Clarification and New Policies for Drugs for Prescribers, 2/1/10

This Update has been revised since its original publication. Revisions were made on page 2 of this ForwardHealth Update and are indicated in red.
2010-11New Implementation Date and Clarification of Incontinence and Urological Supply Coverage for the J&B Medical Supply Contract, 2/1/10
2010-04Quantity Limits for Certain Drugs, 2/1/10
2010-01Preferred Drug List Changes, 1/1/10
2009
2009-98Changes to the Three-Month Supply of Drugs Policy, 12/1/09
2009-95Changes to Early Refill Prospective Drug Utilization Review, 12/1/09
2009-94Procedure Code Updates for Disposable Medical Supplies, 12/1/09
2009-92Additional Reimbursement for Reporting Body Mass Index for Children, 12/1/09
2009-89Changes to Pharmacy Policies Occurring in January 2010, 12/1/09
2009-88Pharmacy Coordination of Benefits Changes, 12/1/09

This Update has been revised since its original publication. Revisions were made on page 1 of this ForwardHealth Update and are indicated in red.
2009-85New Covered Health Education Benefit for Core Plan Members Diagnosed with Certain Chronic Conditions, 12/1/09
2009-82New Policy for the Outpatient Mental Health Benefit and Corrections to Previously Published Information, 12/1/09
2009-78SeniorCare Extended to December 31, 2012, 11/1/09
2009-77Fall 2009 Preferred Drug List Review Phase II Changes, 11/1/09
2009-73Overview of ForwardHealth Coverage of 2009 H1N1 and Seasonal Influenza Services, 10/1/09
2009-71Revised Prior Authorization Drug Attachment for Synagis® Form and Completion Instructions, 10/1/09
2009-69New Contract for Incontinence and Selected Urological Supplies for Certain BadgerCare Plus and Medicaid Members, 10/1/09

This Update has been revised since its original publication to correct the telephone numbers for J&B Medical Supply. Providers should not distribute copies of the previously-published ForwardHealth Member Update because it contains incorrect telephone numbers for J&B Medical Supply.
2009-63Fall 2009 Preferred Drug List Review, 9/1/09
2009-60Changes to the Outpatient Mental Health Benefit as a Result of DHS 35 and Changes to DHS 105 and 107, 10/1/09
2009-58New Reimbursement Rates for Certain Professional Services Effective October 1, 2009, 10/1/09

This Update has been revised since its original publication. Information for procedure code 27158 has been corrected. See page 5 of the Attachment for more information.
2009-53Prior Authorization Procedures for Anti-Obesity Drugs, 9/1/09
2009-52New Prior Authorization Criteria for Lovaza, 9/1/09
2009-49Introducing the Drug Authorization and Policy Override Center and Prior Authorization Requirements for Synagis®, 9/1/09
2009-46Claims Submitted with Dispense As Written Code "6", 8/1/09
2009-45Prospective Drug Utilization Review Alerts, 8/1/09
2009-44New Location for Submitting the Wisconsin Well Woman Medicaid Determination Form and Form Revisions, 8/1/09

This Update has been revised since its original publication to include the full name of the Wisconsin Well Woman Medicaid Determination form, F-10075 (07/09), and to update the e-mail address for submitting the form.
2009-43Revised Process for Family Planning Waiver Enrollment Applications, 8/1/09
2009-36Reimbursement Change for SeniorCare, 6/1/09
2009-34BadgerCare Plus Core Plan for Adults with No Dependent Children-Covered Pharmacy Services, 6/1/09
2009-32Ostomy Supplies Are Covered by BadgerCare Plus Benchmark Plan, 6/1/09
2009-31New Frames Available Through the Medicaid State Purchase Eyeglass Contract, 6/1/09
2009-30Pharmacy Coordination of Benefits Clarification for Other Coverage Code 4, 5/1/09
2009-27Procedure Code Updates for Disposable Medical Supplies, 5/1/09
2009-25Clarification of Policy and Reimbursement for Provider-Administered Drugs, 5/1/09
2009-20Changes to the Newborn Report Form, 5/1/09
2009-19Swine Flu Antiviral Drugs Are Temporarily Covered by the BadgerCare Plus Benchmark Plan and the BadgerCare Plus Core Plan, 5/1/09
2009-18ForwardHealth Will Require '01' in the Prescriber ID Qualifier Field on Point-of-Sale Real-Time Pharmacy Claims, 4/1/09
2009-15Revised Cost Report Forms for Federally Qualified Health Centers, 4/1/09
2009-10Spring 2009 Preferred Drug List Review, 3/1/09
2009-072009 CPT and HCPCS Procedure Code Changes for Physicians and Related Providers, 3/1/09
2009-04Pharmacy Coordination of Benefits Clarifications, 2/1/09
2008
2008-216Provider-Administered Drugs for Members Enrolled in Managed Care Organizations Now Reimbursed by Fee-for-Service, 12/1/08
2008-210Cost Reporting for Federally Qualified Health Centers and Rural Health Clinics Services Covered Under the BadgerCare Plus Core Plan for Childless Adults, 12/1/08
2008-209Family Planning-Related Services Covered Under the BadgerCare Plus Core Plan for Childless Adults, 12/1/08
2008-202Coverage of Certain Medical Services Under the BadgerCare Plus Core Plan for Childless Adults, 12/1/08
2008-198BadgerCare Plus Core Plan for Childless Adults Training Available for Providers Who Serve Milwaukee General Assistance Medical Program Members, 11/1/08
2008-197Enddating a Prior Authorization Request, 11/1/08
2008-196New, Separate Dental Periodicity Table for HealthCheck, 11/1/08
2008-191Coverage of Capillary Blood Draw, 11/1/08
2008-188Risperdal Requires Brand Medically Necessary Prior Authorization, 10/1/08
2008-187Correction to Prior Authorization Status Table, 10/1/08
2008-180Fall 2008 Preferred Drug List Review, 9/1/08
2008-179BadgerCare Plus Benchmark Plan Covers Dental Surgical Extractions
2008-173Changes to the Newborn Report Form, 9/1/08
2008-166Changes to Reimbursement for Claims Submitted with the Health Professional Shortage Area-Enhanced Reimbursement Modifier, 9/1/08
2008-1591 Percent Reimbursement Rate Increase for Non-Institutional Services, 8/1/08
2008-150 Planned Effective Dates for Prior Authorization Changes for ForwardHealth interChange Implementation, 8/1/08
2008-143Reminder: Tamper-Resistant Prescription Pad Requirement for Drug Prescriptions Effective October 1, 2008, 9/1/08
2008-141Expanded Review by ClaimCheck, 8/1/08
2008-126National Drug Codes Required on Claims for Physician-Administered Drugs, 7/1/08
2008-123Submitting Paper Attachments with Electronic Claims, 7/1/08
2008-122HealthCheck Information Available Through the ForwardHealth Portal, 7/1/08
2008-111ForwardHealth Announces Changes to Paper and Electronic Claims Submission for HealthCheck Providers, 7/1/08
2008-105ForwardHealth Announces Changes to Paper and Electronic Claims Submission for Pharmacy Services, 7/1/08
2008-76Changes to Prior Authorization for Vision Services, 6/1/08
2008-75ForwardHealth Announces Changes to Paper and Electronic Claims Submission for Vision Services, 6/1/08
2008-70Changes to Prior Authorization for Durable Medical Equipment, 6/1/08
2008-69ForwardHealth Announces Changes to Paper and Electronic Claims Submission for Durable Medical Equipment, 6/1/08
2008-65Changes to Prior Authorization for Physician Services, 6/1/08
2008-64ForwardHealth Announces Changes to Paper and Electronic Claims Submission for Physician Services, 6/1/08
2008-57Changes to Prior Authorization for Pharmacy Services, 6/1/08
2008-54Changes to Prior Authorization for the Outpatient Mental Health Benefit, 6/1/08
2008-53ForwardHealth Announces Changes to Paper and Electronic Claims Submission for Outpatient Mental Health Services, 6/1/08
2008-49Changes to Prior Authorization for HealthCheck Services, 6/1/08
2008-40Brand Medically Necessary Prior Authorization Requirements, 6/1/08
2008-372003 Wisconsin Act 272 Requirements for Billing, 5/1/08
2008-34Clarification of Coverage and Copayments for Hearing Services and Hearing Instruments, Including Cochlear Implants and Bone-Anchored Hearing Devices, Under the BadgerCare Plus Benchmark Plan, May 1, 2008
2008-31Information on Plans of Care and the Coverage of Evaluations for Physical Therapy, Occupational Therapy, and Speech and Language Pathology Services, 4/1/2008
2008-29Drug Coverage for Members Enrolled in the BadgerCare Plus Benchmark Plan, 4/1/08
2008-26Continuity of Care Transition Period for Pharmacy Services Ending for Managed Care Members, 3/1/08
2008-25Spring 2008 Preferred Drug List Review, 3/1/08
2008-22Reminder: Tamper-Resistant Prescription Pad Requirement Effective April 1, 2008, 3/1/08
2008-18Limited Supply of Free Tamper-Resistant Prescription Pads Now Available, 2/1/08
2008-13Additional Dental and Dental Hygienist Services May Be Billed by HealthCheck Agencies, 2/1/08
2008-11Procedure Code Changes for Physicians and Related Providers, 2/1/08
2008-10Procedure Code Updates for Durable Medical Equipment, 2/1/08
2008-08Temporary Claim Submission Procedures Ending February 4, 2008, for Medicare Part D Dual Eligibles, 1/1/08
2008-07Pharmacy Consolidation for Wisconsin Medicaid and BadgerCare Plus Managed Care Members, 1/1/08
2007
2007-108Pharmacy Services Under BadgerCare Plus, 12/1/07
2007-104Vision Services Under BadgerCare Plus, 12/1/07
2007-99Coverage of Certain Medical Services Under BadgerCare Plus, 12/1/07
2007-90Chiropractic Services Under BadgerCare Plus, 11/1/07
2007-88Cost Reporting for Rural Health Clinics and Federally Qualified Health Centers Services Under BadgerCare Plus, 11/1/07
2007-83Family Planning Services Under BadgerCare Plus, 11/1/07
2007-77Winter 2007 Preferred Drug List Review, 11/1/07
2007-74New Place of Service Code, 11/1/07
2007-73Clarification of Policy Regarding Consultations, 11/1/07
2007-70Telemedicine Can Be Considered an Encounter in a Cost Settlement Report for Rural Health Clinics and Federally Qualified Health Centers, 10/1/07
2007-67Tamper-Resistant Prescription Pad Requirement Delayed, 10/1/07
2007-66Fall 2007 Preferred Drug List Review, 9/1/07
2007-65Tamper-Resistant Prescription Pad Requirement, 9/1/07
2007-64Diagnosis Code Restrictions and Quantity Limits for Altabax™, Bactroban®, and Mupirocin, 9/1/07
2007-61Prior Authorization Requirements and Procedure Code Changes for Cochlear Implants and Bone-Anchored Hearing Devices, 9/1/07
2007-59Temporary Claim Submission Procedures Extended to December 31, 2007 for Medicare Part D Dual Eligibles, 9/1/07
2007-57Site of Service Revenue Codes for Rural Health Clinic and Federally Qualified Health Center Cost Reports, 8/1/07
2007-56Discontinued Procedure Code for Power-Operated Vehicles (Scooters), 8/1/07
2007-55Reporting Dental Hygienist Encounters on Federally Qualified Health Center Cost Reports, 8/1/07
2007-44Modification of Temporary Claim Submission Procedures for Medicare Part D Dual Eligibles, 6/1/07
2007-43Revised Prior Authorization / Preferred Drug List for Hypoglycemics for Adjunct Therapy Form, 6/1/07
2007-42Temporary Claim Submission Procedures Extended to June 30 for Medicare Part D Dual Eligibles, 5/1/07
2007-41Guidelines for Certain Reproductive Health Services, 6/1/07
2007-34Temporary Claim Submission Procedures Extended to May 31 for Medicare Part D Dual Eligibles, 4/1/07
2007-32Temporary Claim Submission Procedures Extended to April 30 for Medicare Part D Dual Eligibles, 3/1/07
2007-31Wisconsin Medicaid Expands 100-Day Supply Drug List, 3/1/07
2007-29New Medicaid State Purchase Eyeglass Contract Awarded, 3/1/07
2007-28Spring 2007 Preferred Drug List Review, 3/1/07
2007-26Medicare Part D Payment Recoupment. 3/1/07
2007-25Temporary Claim Submission Procedures Extended to March 31 for Medicare Part D Dual Eligibles, 2/1/07
2007-24Changes to Immunization CPT Procedure Codes for the Vaccines for Children Program, 2/1/07
2007-22Purchase of Chest Wall Oscillation Systems, 2/1/07
2007-14Emergency Medication Dispensing, 2/1/07
2007-11Temporary Claim Submission Procedures Extended to February 28 for Medicare Part D Dual Eligibles, 1/1/07
2007-09Outpatient Mental Health Benefit, 1/1/07
2007-07Explanation of Benefits Codes Associated with Drug Claims Available on the Medicaid Web Site, 1/1/07
2007-06Medical Necessity and Claims Submission Requirements for Compression Garments, 1/1/07
2007-01Covered Services and Drugs for the Family Planning Waiver, 1/1/07
2006
2006-101Temporary Claim Submission Procedures Extended to January 31, 2007, for Medicare Part D Dual Eligibles, 12/1/06
2006-100Revised Criteria and Forms for the Prior Authorization / Preferred Drug List, 12/1/06
2006-99Procedure Code Updates for Durable Medical Equipment, 12/1/06
2006-97Medicare Part D True Out-of-Pocket Information for Wisconsin SeniorCare, 12/1/06
2006-95New 1500 Health Insurance Claim Form and Supplemental Instructions, 12/1/06
2006-89Correction to Health Professional Shortage Areas and ZIP Codes, 11/1/06
2006-87Temporary Claim Submission Procedures Extended to December 31 for Medicare Part D Dual Eligibles, 11/1/06
2006-86Fall 2006 Preferred Drug List Revision, 10/1/06
2006-85100-Day Supply Drug Policy and Drug Utilization Review Alert, 10/1/06
2006-80Temporomandibular Joint Evaluation Requirement Discontinued, 10/1/06
2006-77Temporary Claim Submission Procedures Extended to November 15 for Medicare Part D Dual Eligibles, 10/1/06
2006-76Fall 2006 Preferred Drug List Review, 9/1/06
2006-75Temporary Claim Submission Procedures Extended to October 15 for Medicare Part D Dual Eligibles, 9/1/06
2006-72Wisconsin Medicaid Allows Dose Consolidation and Tablet Splitting, 8/1/06
2006-70Wisconsin Medicaid Adopting Documentation Guidelines for Evaluation and Management Visits, 8/1/06
2006-69Primary Care Treatment and Follow-up Care for Mental Health and Substance Abuse, 8/1/06
2006-68Facility Reimbursement for Sterilizations Provided to Family Planning Waiver Program Recipients, 8/1/06
2006-67Temporary Claim Submission Procedures Extended to September 15 for Medicare Part D Dual Eligibles, 8/1/06
2006-64Temporary Claim Submission Procedures Extended to August 15 for Medicare Part D Dual Eligibles, 7/1/06
2006-59Health Professional Shortage Area Zip Code Changes, 6/1/06
2006-58Wisconsin Medicaid Reimburses Selected Services Provided Through Telemedicine, 6/1/06
2006-53Quantity Limits Apply to Triptans and Pharmaceutical Care Code Expansion, 6/1/06
2006-50Atypical Antipsychotic Drug Class Added to Preferred Drug List and Prior Authorization/Preferred Drug List Forms Revised, 6/1/06
2006-49Temporary Claim Submission Procedures Extended to July 15 for Medicare Part D Dual Eligibles, 6/1/06
2006-47Repayment Process Billing Deadline, 6/1/06
2006-45Temporary Claim Submission Procedures Extended to June 15 for Medicare Part D Dual Eligibles, 5/1/06
2006-38Temporary Claim Submission Procedures Extended to May 15 for Medicare Part D Dual Eligibles, 4/1/06
2006-36Federally Qualified Health Center Cost Report Forms Revised, 4/1/06
2006-35"A Guide to Obtaining Augmentative Communication Devices and Accessories Through Wisconsin Medicaid" Revised, 4/1/06
2006-33Revised Preferred Drug List Information, 3/1/06
2006-32Spring 2006 Preferred Drug List Review, 3/1/06
2006-31Temporary Claim Submission Procedures Extended to April 15 for Medicare Part D Dual Eligibles, 3/1/06
2006-21Separate Reimbursement Allowed for Emergency Evaluation and Management Services Performed with Surgery Services or Consultations, 3/1/06
2006-19Modifier "CR" Accepted for Catastrophe/Disaster-Related Crossover Claims 3/1/06
2006-18Wisconsin Medicaid Extends Temporary Claims Submission Procedures for Medicare Part D Dual Eligibles, 2/1/06
2006-16Procedure Code Updates for Durable Medical Equipment, 2/1/06
2006-12Coverage Changes and Copayment Reminders for Vision Providers, 2/1/06
2006-05Coordination of Benefits for SeniorCare Participants Enrolled in Medicare Part D, 1/1/06
2006-04Coordination of Benefits for Medicare Part D Dual Eligibles, 1/1/06
2006-03Temporary Procedures for Submitting Claims for Dual Eligibles, 1/1/06
2005
2005-67Maximum Allowable Fee Changes for Prosthetic Devices and Stockings, 11/1/05
2005-66Physician Services Handbook Revised, 11/1/05
2005-64Medicare Drug Coverage for Dual Eligibles, 10/1/05
2005-62New Health Professional Shortage Area Modifier, 10/1/05
2005-60Wisconsin Medicaid Enters Multi-State Preferred Drug List and Supplemental Rebate Program, 9/1/05
2005-59Wisconsin Medicaid Coverage for Postoperative Management for Cataract Surgery, 9/1/05
2005-58"Medicaid Therapy Services for Children" Brochure Revised, 9/1/05
2005-54Reimbursement Changes for Provider-Administered Drug Codes, 9/1/05
2005-53New Claim Submission Requirements for Synagis® (palivizumab), 9/1/05
2005-52Life Expectancy and Quantity Limit Changes for Durable Medical Equipment, 9/1/05
2005-49Adaptive Equipment Covered by Wisconsin Medicaid, 9/1/05
2005-46Wisconsin Medicaid No Longer Reimbursing for Procedure Code 97010, 9/1/05
2005-44Information About a New Class Added to the Preferred Drug List, 8/1/05
2005-42Changes to Immunization CPT Procedure Codes, 8/1/05
2005-41Maximum Allowable Fee Changes, Modifier Changes, and Documentation Requirements for Power-Operated Vehicles (Scooters), 8/1/05
2005-32Expanded Preferred Drug List Information for Prescribers, 6/1/05
2005-31Expanded Preferred Drug List Information for Pharmacy Providers, 6/1/05
2005-28Point-of-Sale Enhancement and Claims Submission Requirement for Recipients with Commercial Health Insurance, 5/1/05
2005-24Expanded Brand Medically Necessary Prior Authorization Criteria, 4/1/05
2005-23Federally Qualified Health Center Provider Number Required on Claims, 4/1/05
2005-20Wisconsin Medicaid Coverage of Cochlear and Bone-Anchored Hearing Devices, 3/1/05
2005-19Wisconsin Medicaid Coverage of Vagus Nerve Stimulators, 3/1/05
2005-18New Preferred Drug List Information for Prescribers, 3/1/05
2005-17New Preferred Drug List Information for Dispensing Providers, 3/1/05
2005-15Vaccines for Children Program Resumes Coverage of Tetanus Vaccine, 3/1/05
2005-09Additional Option for Submitting Prior Authorization Requests Via the Web, 1/1/05
2005-08Wisconsin Medicaid Accepting Prior Authorization Requests Via the Web for Additional Service Areas, 1/1/05
2005-07Procedure Code Updates, 1/1/05
2005-05Wisconsin Medicaid Now Reimburses for Laboratory Procedure Code 0010T for Tuberculosis Blood Test, 1/1/05
2005-04Procedure Code Updates for Durable Medical Equipment, 1/1/05
2004
2004-93Preferred Drug List Information for Dispensing Providers, 12/1/04
2004-92Preferred Drug List Information for Prescribers, 12/1/04
2004-89Wisconsin Medicaid Accepting Prior Authorization Requests Via the Medicaid Web Site for Additional Service Areas; Training Sessions in January and February 2005, 12/1/04
2004-81Department of Health and Family Services Issues Emergency Order Regarding Influenza Vaccine for the 2004-2005 Season, 10/1/04
2004-78Drug Utilization Review and Pharmaceutical Care Services May Be Submitted in the Same Transaction, 9/1/04
2004-77Prescriber Information on the Wisconsin Medicaid Preferred Drug List, 9/1/04
2004-76Dispensing Provider Information on the Wisconsin Medicaid Preferred Drug List, 9/1/04
2004-75Revised List of Noncovered Durable Medical Equipment and Services, 9/1/04
2004-74Prescribers Reminded of Policy for Drugs Dispensed in a 100-Day Supply, 9/1/04
2004-73Dispensing Providers Reminded of Policy for Drugs Dispensed in a 100-Day Supply, 9/1/04
2004-71Wisconsin Medicaid Reimbursement of Influenza Vaccine for the 2004-2005 Season, 9/1/04
2004-66Billing Requirements for Synagis® (palivizumab), 8/1/04
2004-65Training for New and Current Users of Provider Electronic Solutions (PES) Software Offered in September and October, 8/1/04
2004-64Code Changes for End Stage Renal Disease-Related Services, 8/1/04
2004-63Prescriber Information on Prior Authorization Requirements for Brand Medically Necessary Drugs, 8/1/04
2004-62Pharmacy Information on Prior Authorization Requirements for Brand Medically Necessary Drugs, 8/1/04
2004-55Procedure Code Updates for Durable Medical Equipment, 7/1/04
2004-53Submitting Prior Authorization Requests Via the Web for Selected Services, 6/1/04
2004-51Family Planning Waiver Recipients May Be Eligible for Wisconsin Well Woman Medicaid, 6/1/04
2004-41Wisconsin Medicaid Allows Modifier with Procedure Codes for Durable Medical Equipment Repair, 5/1/04
2004-40Training Sessions in July on Submitting Prior Authorization Requests Via the Web, 5/1/04
2004-36Modifier Required for Back-up/Secondary Durable Medical Equipment, 5/1/04
2004-35Prior Authorization Request Submission Available Soon on the Web, 4/1/04
2004-31Wisconsin Medicaid Covers Transportation and Set-up for Portable X-ray Providers, 4/1/04
2004-28Revised Certification of Emergency for Non-U.S. Citizens Form, 4/1/04
2004-27Submitting Claims for Anesthesia Services, 4/1/04
2004-26Breast Reconstruction Following Breast Cancer Surgery No Longer Requires Prior Authorization, 4/1/04
2004-25"A Guide to Obtaining Augmentative Communication Devices and Accessories Through Wisconsin Medicaid" Booklet Available, 4/1/04
2004-21Health Professional Shortage Area changes, 3/1/04
2004-20Family Planning Waiver program eligibility period and presumptive eligibility reminders, 3/1/04
2004-16Prior authorization required for brand name selective serotonin reuptake inhibitor drugs, 3/1/04
2004-14Wisconsin Medicaid coverage of topical application of fluoride for children, 2/1/04
2004-05HCPCS Procedure code update for durable medical equipment, 2/1/04
2004-03Procedure code updates, 2/1/04
2003
2003-162Immunization CPT procedure code changes, 12/1/03
2003-156New policies and clarifications for hearing instruments and related services, 11/1/03
2003-142Wisconsin Medicaid, BadgerCare, and SeniorCare changes for retail pharmacies dispensing drug services, 8/1/03
2003-122Effective dates for claims submission and prior authorization changes as a result of HIPAA for retail pharmacies dispensing drugs and biologics, 8/1/03
2003-119Effective dates for claims submission and prior authorization changes as a result of HIPAA for physician services, 8/1/03
2003-102Changes to STAT-PA for orthopedic shoes as a result of HIPAA, 8/1/03
2003-98Effective dates for code changes as a result of HIPAA for tuberculosis-related services, 8/1/03
2003-97Effective dates for claims submission changes as a result of HIPAA for podiatry services, 8/1/03
2003-95Effective dates for claims submission changes as a result of HIPAA for nurse midwife services, 8/1/03
2003-92Effective dates for claims submission changes as a result of HIPAA for HealthCheck and HealthCheck outreach and case management services, 8/1/03
2003-88Effective dates for claims submission and prior authorization changes as a result of HIPAA for chiropractic services, 8/1/03
2003-84Changes to claims and prior authorization for retail pharmacies dispensing drugs and biologics as a result of HIPAA, 8/1/03
2003-68Family Planning Waiver Program policy additions and clarifications, 7/1/03
2003-62Changes to local codes and paper claims for podiatry services as a result of HIPAA, 7/1/03
2003-61Changes to local codes, paper claims, and prior authorization for physician services as a result of HIPAA, 7/1/03
2003-57Changes to local codes and paper claims for nurse midwife services as a result of HIPAA, 7/1/03
2003-55Changes to local codes and paper claims for HealthCheck and HealthCheck outreach and case management services as a result of HIPAA, 7/1/03
2003-47Changes to local codes, paper claims, and prior authorization for chiropractic services as a result of HIPAA, 7/1/03
2003-34Changes to local codes for tuberculosis-related services as a result of HIPAA, 6/1/03
2003-19Introducing the Guide to Determining Presumptive Eligibility for Pregnant Women, 3/1/03
2003-15Revised form for specialized medical vehicle transportation services, 3/1/03
2003-10Wisconsin Medicaid revises Newborn Report form, 2/1/03
2003-08Wisconsin Medicaid introduces Guide to the Tuberculosis-Related Services Only Benefit, 2/1/03
2003-07Wisconsin Medicaid revises selected forms for physician services, 1/1/03
2003-06Hearing instruments and related services code changes, 1/1/03
2003-02Wisconsin Medicaid revises Provider Certification of Emergency for Undocumented Aliens form, 1/1/03
2002
2002-68Introducing the Medicaid Family Planning Waiver benefit, 12/1/02
2002-65Wisconsin SeniorCare Coordination of Benefits, 12/1/02
2002-58Wisconsin Medicaid provides options for providers submitting claims for obstetric services, 10/1/02
2002-56Procedure code updates, 10/1/02
2002-55Revised policy requirements and procedure codes for breast pumps, 9/1/02
2002-53Wisconsin Medicaid covers procedure code for Lunelle™, 9/1/02
2002-47Coverage revised for critical care and prolonged services, 8/1/02
2002-45SeniorCare information for pharmacies, 8/1/02
2002-44Coverage of Botox® and Myobloc®, 8/1/02
2002-41Maximum allowable fee increase for podiatry services, 7/1/02
2002-40Maximum allowable fee increases for physician services, 7/1/02
2002-311.095% reimbursement rate increase for non-institutional services, 6/1/02
2002-28Maximum allowable fees increase for chiropractic services, 6/1/02
2002-19Procedure codes eligible to receive the Health Personnel Shortage Area-enhanced reimbursement rates, 5/1/02
2002-17Coverage of anti-emetic drugs, 5/1/02
2002-14Maximum allowable fees increase for speech-language pathology services, 3/1/02
2002-13Maximum allowable fee and coverage changes for physician services, 3/1/02
2002-11Maximum allowable fees increase for chiropractic services, 3/1/02
2002-06Maximum allowable fees increase for podiatry services, 3/1/02
2002-051.065% reimbursement rate increase for non-institutional services, 3/1/02
2002-01Medicaid reimbursement for required newborn screening, 1/1/02
2001
2001-11"Medicaid Therapy Services for Children" brochure available, 5/1/01
2001-02Revision of breast pump coverage, 1/1/01
2000
2000-46Immunization CPT code changes, 10/1/00
2000-38Vaccine Order Form revised, 9/1/00
2000-35Change in type and place of service for radiation therapy procedure codes, 9/1/00
2000-21View electronic versions of Physician Services Handbook on Medicaid Web site, 7/31/00
2000-20One percent reimbursement increase for noninstitutional services — Effective July 1, 2000, 6/1/00
2000-17Wheelchairs and durable medical equipment: Changes in maximum allowable fees and life expectancies, 7/1/00
2000-14Prior authorization no longer required for selected injection procedure codes, 5/1/00
1999
99-38Coverage of an additional type of breast pump and revised clinical guidelines, 8/6/99
99-17Newborns: new Medicaid eligibility procedures and reporting requirements for hospitals, 4/1/99
99-13Wisconsin Medicaid revises private duty nursing prior authorization guideline, 4/1/99
1998
98-38Wisconsin Medicaid changes health insurance billing requirements, 12/1/98
1995
95-47IUDs: reimbursement policy and rate changes, 11/29/95
 
 
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