New Payment Policies (Effective May 1, 2021)

Date: 04/08/21

MHS Health Wisconsin continually reviews and updates our payment and utilization policies to ensure that they are designed to comply with industry standards while delivering the best patient experience to our members.

The following new payment policies will take effect on May 1, 2021. 

New Payment Policies, Effective May 1, 2021

CC.PP.061	Non-OB & OB Transabdominal and Transvaginal Ultrasounds	Medicaid; Medicare
CC.PP.065	Multiple Diagnostic Cardiovascular Procedure Payment Reduction	Medicaid; Medicare
CC.PP.068	Multiple Procedure Payment Reduction for Therapeutic Services	Medicaid; Medicare
CC.PP.069	Multiple Procedure Reduction: Ophthalmology	Medicaid; Medicare
CC.PP.070	340B Drug Payment Reduction	Medicare
Prepay Edit	WCG Integration Value Capture – Correct Coding Batch 2 (Cotiviti 8, WCIVC B2)	Medicaid; Medicare

Thank you for your continued partnership. If you have any questions related to this change or any of our policies, please contact MHS Health Provider Services at 1-800-222-9831.