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Resources: 2021 Annual Update to the Therapy Code List, Prior Authorization and More

Posted by Admin Posted on Jan 15 2021

2021 Annual Update to the Therapy Code List

This MLN Matters Article is for physicians, therapists, providers, and suppliers billing Medicare Administrative Contractors (MACs) for therapy services provided to Medicare beneficiaries.

This article informs you of updates to the list of codes that sometimes or always describe therapy services. The additions, changes, and deletions to the therapy code list reflect those made in the Calendar Year (CY) 2021 CPT and Level II HCPCS. Make sure your billing staffs are aware of these updates.  

Click here for details.​


Prior Authorization

Department for Medicaid Services mailed a provider letter dated January 7 regarding changes to the Ancillary Authorization Process.

Click here to view the provider letter.​

Click here to view the provider form.​

ATTENTION ALL PROVIDERS: Effective with dates of service beginning 11/17/20, prior authorizations will be suspended for all provider types except for the following: EPSDT, Nursing Facility must continue to submit LOC via KLOCS and call Carewise Health at 1-800-807-8842 for ancillary services. Additionally, the 1915 c. Waivers - ABI, ABI LTC, Model II, SCL, HCB and Michelle P will require a prior authorization.  


Quality Incentive Payments

If you have questions relative to the QIP payments, you should contact the following:

1. If you have issues with data submitted to the National Healthcare Safety Network, contact:

2. If your data appears complete and you believe you have erroneously not received payment, you should contact:  


HHS Increases and Begins Distributing Phase 3 Provider Relief Funding

HHS Increases and Begins Distributing Over $24 Billion in Phase 3 COVID-19 Provider Relief Funding.  

Click here for details.

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