Provider Publications

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Personal Care Provider Publications

Personal Care Agency Provider Publications

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Update Number	Update Topic and Release Date
2018
2018-43	Changes to Certain Durable Medical Equipment Maximum Allowable Fees, 12/4/18
2018-32	New Coverage and Clarified Prior Authorization Policy for Mobility Devices, 9/13/18
2018-28	Reimbursement Rate Increase for Private Duty Nursing and Pediatric Community Care Services, 9/4/18
2018-18	New Electronic Visit Verification Requirement, 5/14/18 *May 16, 2018: This Update* has been revised since its original publication.** The link for the ForwardHealth electronic visit verification dedicated webpage has been revised. The change is indicated in red text.
2018-16	Clarified Prior Authorization Policy for Home Health and Personal Care Services, 5/1/18
2018-10	New Face-to-Face Visit Requirement and Changes to Policy for Home Health Services, Durable Medical Equipment, and Disposable Medical Supplies, 3/5/18
2018-01	Rate Increase for Personal Care Services, 1/4/18
2017
2017-24	Cancellation of the Personal Care Independent Assessment Program, 7/31/17
2017-11	New Personal Care Independent Assessment and Prior Authorization Policy, 4/6/17 July 31, 2017: The independent assessment and prior authorization policy outlined in this ForwardHealth Update is obsolete as of August 1, 2017. Please refer to the July 2017 Update (2017-24), titled "Cancellation of the Personal Care Independent Assessment Program," for more information or to the ForwardHealth Online Handbook for current personal care policy.
2017-08	Regional Provider Trainings for New Personal Care Independent Assessments and Prior Authorization Process, 3/20/17 March 22, 2017: This Update has been revised since its original publication. Home Health Agencies was added to the "To" provider list.
2017-02	New Coverage Policy for Home Ventilator Rental, 1/26/17
2016
2016-16	Changes to Coverage Policy for Testing for Drugs of Abuse, 4/18/16
2016-13	Reminder of Correct Billing Process for Long-Term Care Services, 4/1/16
2014
2014-25	Change to Type of Bill Code for Home Health Claims, 4/8/14
2014-14	Personal Care Providers Can Now Upload Personal Care Screening Tool Reports Using the ForwardHealth Portal, 3/10/14
2014-04	Reminder Regarding Home Health and Personal Care Agency Personnel Reporting Requirements and Revalidation Information, 2/3/14
2013
2013-64	Revisions to Companion Guide for the 837 Health Care Claim: Institutional Transaction, 11/25/13
2012
2012-37	New Requirements for Home Health and Personal Care Agencies to Report Personnel Information to ForwardHealth, 8/3/12
2011
2011-72	Implementation of the HIPAA Accredited Standards Committee X12 Version 5010 Electronic 278 Health Care Services Review — Request for Review and Response Transaction, 11/7/11
2011-53	Revisions to UB-04 Claim Form Instructions Resulting from HIPAA ASC X12 Version 5010 Implementation, 9/14/11
2011-52	Revisions to 1500 Health Insurance Claim Form Instructions Resulting from HIPAA ASC X12 Version 5010 Implementation, 9/14/11
2011-42	Change to ForwardHealth Update 2011-32 Regarding Claims for Home Health, Personal Care, and Private Duty Nursing Services, 8/10/11
2011-37	National Provider Identifier Policy Clarification for Durable Medical Equipment Providers, 7/8/11
2011-32	Reminder: Claims for Home Health, Personal Care, and Private Duty Nursing Services Must Be Submitted as Institutional Claims, 6/29/11
2011-25	Changes to Personal Care Agency Certification Rules and Clarification of Registered Nurse Supervisor Duties, 4/29/11
2011-02	Changes to the Personal Care Screening Tool and Related Policy Clarifications, 1/1/11
2011-01	Discretionary Variances for Registered Nurse Supervisory Visits and Discretionary Waivers of Qualifications for Registered Nurse Supervisors Discontinued, 1/1/11
2010
2010-97	Clarification for Extraordinary Claims Submission for Professional Services, 11/1/10
2010-92	New Prior Authorization Requirements for Advanced Imaging Services, 10/1/10
2010-90	Reimbursement Reduction for Most Paper Claims Submitted to ForwardHealth, 10/1/10
2010-82	Prior Authorization Is Required for Certain Durable Medical Equipment Under the BadgerCare Plus Core Plan and the BadgerCare Plus Basic Plan, 9/1/10
2010-48	Durable Medical Equipment Covered Under the BadgerCare Plus Basic Plan, 6/1/10
2010-47	Disposable Medical Supplies Covered Under the BadgerCare Plus Basic Plan, 6/1/10
2010-24	Changes to Personal Care Certification, 3/1/10
2009
2009-83	BadgerCare Plus Core Plan to Cover Home Health Services Following an Inpatient Hospital Stay, 12/1/09
2009-08	Personal Care Activity Time Allocation Table Revised, 3/1/09
2008
2008-212	Disposable Medical Supplies Covered Under the BadgerCare Plus Core Plan for Childless Adults, 12/1/08
2008-211	Durable Medical Equipment Covered Under the BadgerCare Plus Core Plan for Childless Adults, 12/1/08
2008-197	Enddating a Prior Authorization Request, 11/1/08
2008-187	Correction to Prior Authorization Status Table, 10/1/08
2008-160	1.5 Percent Reimbursement Rate Increase for Home Care Services, 8/1/08
2008-150	Planned Effective Dates for Prior Authorization Changes for ForwardHealth interChange Implementation, 8/1/08
2008-146	Changes to Coverage of Disposable Medical Supplies Under the BadgerCare Plus Benchmark Plan, Effective with the Implementation of ForwardHealth interchange, 8/1/08
2008-118	Changes to Prior Authorization for Personal Care Services, 7/1/08
2008-113	Changes to Prior Authorization for Home Health Services, Including Private Duty Nursing and Private Duty Nursing to Ventilator-Dependent Members, 7/1/08
2008-101	Reminder: Physician Orders Required for Nursing Acts Delegated to Personal Care Workers, 7/1/08
2008-100	Reminders of Policy Regarding Personal Care Workers Accompanying Members for Medical Diagnosis and Treatment and Requesting Pro Re Nata Time, 7/1/08
2008-99	Documenting Personal Care Worker Services,
2008-92	ForwardHealth Announces Changes to Paper and Electronic Claims Submission for Personal Care Services, 6/1/08
2008-78	ForwardHealth Announces Changes to Paper and Electronic Claims Submission for Home Health Services, Including Private Duty Nursing and Private Duty Nursing to Ventilator-Dependent Members, 6/1/08
2008-72	Changes to Prior Authorization for Disposable Medical Supplies, 6/1/08
2008-71	ForwardHealth Announces Changes to Paper and Electronic Claims Submission for Disposable Medical Supplies, 6/1/08
2008-35	Changes to Coverage of Disposable Medical Supplies Under the BadgerCare Plus Benchmark Plan, 5/1/08
2008-09	Procedure Code Updates for Disposable Medical Supplies, 2/1/08
2007
2007-103	Durable Medical Equipment Under BadgerCare Plus, 12/1/07
2007-94	Personal Care Services Under BadgerCare Plus, 11/1/07
2007-89	Disposable Medical Supplies Under BadgerCare Plus, 11/1/07
2007-56	Discontinued Procedure Code for Power-Operated Vehicles (Scooters), 8/1/07
2007-49	Change to the UB-04 Paper Claim Form Instructions, 7/1/07
2007-37	Significant Changes to the Personal Care Screening Tool, 5/1/07
2007-17	New UB-04 (CMS 1450) Claim Instructions for Personal Care Services, 2/1/07
2007-04	Wisconsin Medicaid Postpones Mandatory Implementation Date of the Personal Care Screening Tool, 1/01/07
2006
2006-98	Procedure Code Updates for Disposable Medical Supplies, 12/1/06
2006-71	Wisconsin Medicaid Announces Release of Personal Care Screening Tool, 8/1/06
2006-19	Modifier "CR" Accepted for Catastrophe/Disaster-Related Crossover Claims, 3/1/06
2006-14	Procedure Code Updates for Disposable Medical Supplies, 2/1/06
2005
2005-67	Maximum Allowable Fee Changes for Prosthetic Devices and Stockings, 11/1/05
2005-41	Maximum Allowable Fee Changes, Modifier Changes, and Documentation Requirements for Power-Operated Vehicles (Scooters), 8/1/05
2005-11	Wisconsin Medicaid Accepts Physicians� Stamped Signatures from Home Care and Hospice Providers, 2/1/05
2005-09	Additional Option for Submitting Prior Authorization Requests Via the Web, 1/1/05
2005-08	Wisconsin Medicaid Accepting Prior Authorization Requests Via the Web for Additional Service Areas, 1/1/05
2005-03	Procedure Code Updates for Disposable Medical Supplies, 1/1/05
2004
2004-89	Wisconsin Medicaid Accepting Prior Authorization Requests Via the Medicaid Web Site for Additional Service Areas; Training Sessions in January and February 2005, 12/1/04
2004-69	The Wisconsin Medicaid Cost Reporting (WIMCR) Initiative, 8/1/04
2004-65	Training for New and Current Users of Provider Electronic Solutions (PES) Software Offered in September and October, 8/1/04
2004-59	Procedure Code Updates for Incontinence Supplies, 7/1/04
2004-53	Submitting Prior Authorization Requests Via the Web for Selected Services, 6/1/04
2004-45	Wisconsin Medicaid Provides Form to Request Discretionary Waiver of Qualifications for Registered Nurses Supervising Personal Care Workers, 6/1/04
2004-40	Training Sessions in July on Submitting Prior Authorization Requests Via the Web, 5/1/04
2004-35	Prior Authorization Request Submission Available Soon on the Web, 4/1/04
2004-32	Procedure Code Updates for Disposable Medical Supplies, 4/1/04
2004-04	Procedure code updates for disposable medical supplies, 2/1/04
2003
2003-164	Copayment for disposable medical supplies, 12/1/03
2003-155	Procedure code updates for durable medical equipment, 10/1/03
2003-125	Effective dates for claims submission and prior authorization changes as a result of HIPAA for disposable medical supplies, 8/1/03
2003-117	Effective dates for claims submission and prior authorization changes as a result of HIPAA for personal care services, 8/1/03
2003-69	Changes to local codes, paper claims, and prior authorization for personal care services as a result of HIPAA , 7/1/03
2003-51	Changes to local codes, paper claims, and prior authorization for disposable medical supplies as a result of HIPAA , 7/1/03
2003-16	Interactive Durable Medical Equipment Index now available, 3/1/03
2002
2002-59	Disposable medical supplies covered in the home care rate, 11/1/02
2002-43	Changes to the Disposable Medical Supplies Index/Maximum Allowable Fee Schedule, 7/1/02
2002-31	1.095% reimbursement rate increase for non-institutional services, 6/1/02
2002-12	Searchable Disposable Medical Supplies Index now available online, 3/1/02
2002-05	1.065% reimbursement rate increase for non-institutional services, 3/1/02
2001
2001-45	Change in requirements for personal care registered nurse supervisory visits, 12/1/01
2001-40	Durable Medical Equipment Index/Maximum Allowable Fee Schedule changes, 12/1/01
2001-23	Changes to the Disposable Medical Supplies Index, 7/1/01
2001-22	Changes to the Durable Medical Equipment Index/Maximum Allowable Fee Schedule, 7/1/01
2000
2000-54	Documentation of personal care worker time, 11/1/00
2000-53	Revisions to personal care policies, 11/1/00
2000-51	Billing personal care for hospice recipients, 11/1/00
2000-49	Revised Disposable Medical Supplies Index, 10/1/00
2000-42	Changes to the Durable Medical Equipment Index/Maximum Allowable Fee Schedule, 10/1/00
2000-33	Home care coverage determination software for Windows, 9/1/00
2000-25	View electronic versions of Personal Care Handbook on Medicaid Web site, 7/31/00
2000-22	Rate increase for personal care agencies, 6/1/00
2000-20	One percent reimbursement increase for noninstitutional services Effective July 1, 2000, 7/1/00
2000-01	Home care coverage determination software revised, 2/24/00
1999
99-51	Rate increase for personal care agencies, 12/1/99
99-25	Revised Disposable Medical Supplies Index, 7/1/99
99-22	Changes to the DME Index/Maximum Allowable Fee Schedule, 7/1/99
99-03	Revised DMS Index, 1/1/99
99-01	DME Index/Maximum Allowable Fee schedule changes, 1/1/99
1998
98-31	DMS codes change to HCPCS codes, 11/1/98
98-24	Home care rate increase adjustments, 07/14/98
98-17	Two percent reimbursement increase for noninstitutional services, 5/28/98
98-15	Prior authorization request changes for home health and personal care agencies, 05/20/98
98-10	Revised DMS Index, 3/9/98
98-08	Wisconsin Medicaid and SSI children, Medicaid HMO information, Medical fiscal agent (EDS) professional relations representatives list, 2/12/98
1997
97-40	Biennial Budget Increases Reimbursement for Noninstitutional Services — Effective July 1, 1997, 12/3/97
97-27	DME Index changes — Effective October 1, 1997, 9/2/97
97-23	Revised DMS Index, 8/14/97
97-15	Home Health Coverage Determination Software Required Only for Dually Eligible Recipients, 4/28/97
97-11	Revised DMS Index, 3/18/97
97-03	DMS quantity limits, 1/23/97
1996
96-41	Revised DMS Index, 11/18/96
96-28	Community services deficit reduction benefit expansion, 7/31/96
96-21	Revised DMS Index, 6/13/96
96-03	New tuberculosis (TB) benefit, 3/12/96
1995
95-2	New HCFA 485/486 forms, 1/9/95
1993
MAPB-093-055-H	Claim submission limit on drug claims, 12/20/93
MAPB-093-024-L	Claim submission limit for disposable medical supplies, 11/1/93

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