Important updated provider information

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WEBINAR: Telehealth & COVID-19

Addressing billing and claims questions associated with meeting the demand for enhanced telemedicine needs during the Covid-19 emergency

RECORDED: April 20, 2020 

PRESENTED BY: Louisiana Healthcare Connections Director of Claims and Contract Support Services Jennifer Pinkins on behalf of the Louisiana Managed Medicaid Association 


  • Telehealth Resources
  • Telehealth Billing & Procedure Codes
  • Telehealth Guidance & Requirements 

Click here to view.

Behavioral Health - Rendering Provider NPI

Medicaid Dental Program Changes

January 2021 Check Run Notice

Hospital Inpatient Per Diem Rate Updates

CPT E/M Office Revisions Level of Medical Decision Making (MDM)

Revision to COVID-19 Testing Payments - Lab Services Memo

HHS Provider Relief Fund Distribution Phase 3

2020 IPAT Survey Letter

COVID-19 Vaccine FAQs

ABHLA System Information Notifications

Pharmacy Prior Authorization Peer to Peer Requests 

Update: Reporting of COVID-19/SARS-CoV-2 Results

Assistant Surgeon Payment Reduction

Multiple Procedure Payment Reduction

Maximum Units

Discontinuation of Eviti for Oncology Support - 11/23/2020

Evaluation and Management (E/M) Changes

Continued Alignment with LDH Medicaid Services Manuals

Value-Based Payment Covid-19 Response

Holiday Check Run Schedule - December 2020 and January 2021

Holiday Check Run Schedule - November 2020

HHS Expands Relief Fund Eligibility and Updates Reporting Requirements

Duplicate Claims Submission

Claims Submission - Frequency Codes

Outpatient Services Before and After Inpatient Services

DaVita National Ancillary Agreement

Footbaths and Soaks Notification

PA Number Format Change

Third General Distribution of Provider Relief Fund - October 2, 2020

Online Prior Authorization Search Tool (ProPAT)

Eviti Provider Training Notice 09/14/2020

MEMO - Providers Should Confirm Medicaid Eligibility Using MEVS

Behavioral Health - Act 370

EVV for EPSDT Personal Care Services (PCS)

Claims Submission - Portable X-Ray

Federally Qualified Health Centers - Billing Guidelines

Behavioral Health - Inpatient Services - September16, 2020

Post Payment Review Changes

Louisiana Census Day - September 9th

NEW - NEMT Rates Update

Louisiana Department of Health - Peer Support Services - Request for Information

NEW - Pain Management Program Changes

Labor Day Holiday Check Run (Revised August 28, 2020)

LDH Notification - Storm Ready 2020

ATLAS Shatterproof Addiction Treatment Notification

NEW - Free CE Opportunity on Treatment Planning

Medicaid Provider Relief Fund Update 08032020

Medicaid Provider Distribution of the Provider Relief Fund FAQs

NEW - Alignment with LDH Medicaid Services Manual

UPDATED DEADLINE: Medicaid Provider Relief Funding Application Due 8/3/2020

Altered Check Run Schedule 07.13.2020

CARES Act Provider Relief Fund Information

NEW - LA Children's Coordinated System of Care (CSoC)

NEW - Medical Transportation - Pickup Origin

NEW - Medical Transportation - Out of State Fee Schedule

NEW - Medical Transportation - Same Day Pickups

NEW - Medical Transportation - Hospital-Based Ambulances

NEW - Provider Taxonomy Code Claims Requirement

NEW - Home Health - Billing REV and CPT Codes

NEW - Home Health - Billing DME Supplies

Medicaid Provider Portal Webinars Memo

Holiday Check Run Notice - July 3, 2020

BH Notification 06152020

NEMT Update 06182020

New LA Medicaid Website LDH Bulletin

ABHLA Webinar Series Schedule May 2020

Memorial Day Check Run Notice 05062020

COVID-19 Prohibited PPE Billing Memo

FQHC/RHC Encounter Code Notice 043020

Memo to Psych Hospitals and Residential Facilities Regarding COVID-19

Provider Telemedicine Visit Instructions

Medical Monitoring Station at New Orleans Convention Center

Personal Housing Units at the New Orleans Convention Center

LDH Informational Bulletin Registration

2020 HCPCS and Physician-Administered Drug Reimbursement Update

ABHLA Secure Web Portal Claim Status Education Notice

All MCO Provider Education Notification

NCQA Credentialing/Accreditation Requirements during COVID-19

MHR Provider Update - COVID19 Response

MSA 20-09 Bulletin Error Notification

Patient Testing Instructions

COVID-19 Provider Update 03172020

COVID-19 Provider Update Revised 03122020

COVID-19 NEMT Provider Update 03142020

COVID-19 Provider Update 03142020

COVID-19 Medicaid Provider Update

Implementation of Prior Authorization for Multi-Systemic Therapy

Implementation of Authorization for Crisis Intervention

Changes to Out of State Hospital Reimbursement

LA Policy Out of State Outpatient CCR

Shatterproof Provider Update 01-2020

Recoupment Notification 01092020

ABHLA Focused IPAT Survey 12202019

ABHLA 2020 Provider Workshops

Peer Support Specialist Training

Holiday Check Run Notification 11182019

SCID Notification 11152019

Member Coverage Ending Notification 10/17/2019

Shatterproof Provider Update 10-2019

BH SE Modifier Rescind Notification 09182019

NDBH 60th Annual Conference Press Release 2019

Updated Pediatric Day Health Care Prior Authorization Checklist

ABHLA Urgent Care Flyer

BH SE Modifier Denials Notification 08022019 - Updated

CLIA Rejection Notification 08082019

Updated Hospital Provider Rates effective 07.01.2019

Network Notification Duplicate Remits 07.29.19

Multi Specialty Same Day Notification 07162019

Peer Support Specialist (PSS) Training Letter

Peer Support Specialists (PSS) Application

Member Assignment and Attribution Policy

Member Attribution Notification 07162019

MCNA LA Pain Medications Flyer

MCNA LA Vaccines Flyer

MCNA LA Measles Flyer

Hep C provider notice

Provider Bulletin - June Edition

BH Billing Notification 06042019

BH SE Modifier Denials Notification 05312019

Provider Bulletin

SCA Network Notification

DME MP Rebase Letter Updated

TAP Training for Physicians

SBIRT Provider Flyer

MAT Training for Physicians

Member Assignment & Attribution Policy 2019

DME Date Span Billing Clarification

Credentialing Documentation Request EBP Claims

ImCal Request for Letter of Interest 2019

Admission Criteria by ASAM Level

New Requirements for ASAM Level Triage Assessment

Electric Breast Pump Request Form

DME MP Rebase Letter

HCPCS Fee Schedule

Tracking Evidence-Based Practices

Flu Vaccinations Coverage 2018-2019

Update and Clarification – 2019 ABA CPT Codes

Act 582 BHS PM Update Blast 1-11-19

Newly Posted Sterilization Form Blast 1-11-19

ACT 582 18-14 11-15-18

Revised Provider Notification for Draft Policies 09.27.2018

Act 582 Legislation Summary 9-12-18

EM Up Coding and Down Coding 9-5-18

Member Choice Fax Blast

Pay For Quality - Aetna Better Health of Louisiana April 2018

Implementation of Member Choice Form. 4/24/18

Healthy Louisiana Mental Health Rehabilitation Member Choice Form. 4/24/18

Please submit all delivery claims. 4/16/18

LDH BH Provider Manual and SBHS Requirements 4/16/18

Policy Statements 2/9/18

Provider Policy Updates 1/1/18

Q1 2016 Fax blast

Q2 2016 Fax blast

Q3 2016 Fax blast

Q1 2017 Fax blast

11/20/17 Cotiviti Overpayment Letter

01/10/17 Clinical Documentation 
01/10/17 ABHLA Claims Reconsideration Form
01/10/17 LOCUS Training Q1 2017
12/19/16 Clinical Documentation
11/28/16 Provider Appeals Complaints
11/28/16 PA Retro Eligible
11/28/16 Retro Utilization Review
11/28/16  Credentialing Changes
11/28/16  HPA 16-32
11/28/16  CLAS Standard
11/28/16  Newborn Billing Guidelines 
09/22/16  ABHLA Emergency Acute Flaccid Notice
09/07/16  ABHLA Provider Newsletter Q2 2016
08/22/16  Provider notice TPL effective 20160901
08/19/16  Louisiana state of emergency fax blast
08/18/16  LDH flood DME fax blast
08/17/16  LDH flood call fax blast
07/01/16  PDHC Fax Blast
07/15/16  MCG BH Fax Blast
07/15/16  Notification of Pregnancy Fax Blast
07/15/16  Provider Referrals to CM Fax Blast
05/26/16  CareWebQI prior authorization issues
05/25/16  Instructions for processing voided NEAT claims
05/25/16  Provider quick guide New
05/24/16  HEDIS PCP tips, HEDIS pediatrician tips
05/24/16  Room and board
05/17/16  BiliTool
03/31/16  DHH rescinded bulletin 16-2: claims processing edits for provider taxonomy
03/31/16  ABHLA provider newsletter Q1 2016
03/11/16  Hospice code changes
02/20/16  Changes to ADHD drug prior authorization
02/17/16  Taxonomy needed for claims
01/08/16  New inpatient notification FAX number
12/11/15  New provider relations liason
12/11/15  Behavioral health provider training
11/02/15  Limitations on drug screening claim
11/24/15  LA website formulary tool not working
10/29/15  Genetic testing requires prior authorization
08/05/15  Hepatitis C pharmacy prior authorization
08/06/15  Authorization for standard deliveries



Adverse incident reporting form
Adverse incident reporting form instructions


Date Published  Status System Issue
1/04/2021 Active

Denials for DME Groups

1/04/2021 Active BH Providers with Multiple Education Levels
12/01/20 Active  PSR Denials for Individual Providers Rendering Service
12/01/20 Active  CLIA System Information Notification
12/02/20 Active  ABA Services
12/04/20 Active  TPN Services
12/09/20 Active  Speech Therapy
12/10/20 Active  ASC Provider Type and Specialty
12/11/20 Active  COVID POS 11


HPA 20-25: EPSDT Periodicity Schedule

HPA 20-24 MCO Preparation - 2021 Healthcare Common Procedure Coding System Update 

HPA 20-23 ESRD Facilities and Independent Laboratory - Non-Routine Laboratory Service (Revised November 20, 2020)

HPA 20-22 Inpatient Concurrent Care

HPA 20-21 Obstetric Ultrasounds by Maternal Fetal Medicine Specialists

HPA 20-20 Dental Benefit Program Manager Update 

HPA 20-19 Changes to Durable Medical Equipment, Pediatric Day Health Care, Home Health, Rehabilitation and Personal Care Services due to Hurricane Delta

HPA 20-18 Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Personal Care Services (PCS) Update for Hurricane Laura

HPA 20-17 Changes to Durable Medical Equipment, Pediatric Day Health Care, Home Health, Rehabilitation and Personal Care Services due to Hurricane Laura

HPA 20-16 Class Action Lawsuit AJ v. LDH

HPA 20-15 Long-Term Electroencephalography (EEG) Setup and Monitoring

HPA 20-13 COVID-19 Update for PDHC Facilities

HPA 20-12 Telehealth Marketing and Member Education

HPA 20-11 Revised 96-A Hysterectomy Acknowledgement Form

HPA 20-10 EPSDT Personal Care Services

HPA 20-9 COVID-19 - SUD Telemedicine/Telehealth (Revised July 28, 2020)

HPA 20-8 COVID-19 LMHP Telemedicine/Telehealth (Revised July 28, 2020)

HPA 20-7 COVID-19 - MHR Telemedicine/Telehealth (Revised July 28, 2020)

HPA 20-6 Response to COVID-19 Revised 092320

HPA 20-5 PASRR Level II Evaluations: COVID-19

HPA 20-4 HCPCS and Physician-Administered Drug Reimbursement Updates

HPA 20-3 Reimbursement for Opioid Use Disorder Treatment in Opioid Treatment Programs

HPA 20-2 Telemedicine and Telehealth Billing Changes for RHCs and FQHCs

HPA 20-1 LSU Enhanced Professional Service Fees to be Paid Effective 1/1/2020

HPA 19-18 2020 Healthcare Common Procedure Coding System (HCPCS) Update

HPA 19-17 LPC and LMFT Reimbursement in FQHCs and RHCs

HPA 19-16: Hospice Fee Schedule Federal Fiscal Year 2020

HPA 19-15 Electronic Visit Verification for EPSDT Personal Care Services

HPA 19-14 Severe Combined Immunodeficiency (SCID) Testing

HPA 19-13 EPSDT PCS Rate Change

HPA 19-12 Changes to DME, Home Health, Rehabilitation and Personal Care Services and Pharmacy Due to Tropical Storm Barry (Revised July 13, 2019)

HPA 19-10 Revised 7.19.19

HPA 19-9 CLIA Number Information (Revised July 1, 2019)

HPA 19-7 ABHLA Methodology

HPA 19-7 Behavioral Health Alternate Payment Methodology in FQHCs and RHCs

HPA 19-5 Member Reassignment Policy Core Elements

HPA 19-4 Breast Pump Coverage - Attestation and Equipment Requirements

The Aetna Better Health of Louisiana system was updated to reflect the updated HCPC changes 03/15/2019.  Any new claims received will be paid against the updated fee schedule rate.  All impacted claims began to be reprocessed on 3/18/19.  Claims are expected to be recycled no later than 15 days preceding the update.  If you have any questions regarding your claims or the system update please contact your provider relations representative.