MVP: update home health prior auth

Are you a provider that accepts MVP Medicare Plan members that receive home health services? Then this blog post is for you!

As per MVP for any DOS starting on 4/1/26 and there after the following home health services will NOT require a prior authorization:

  • Registered Nurse (RN)
  • Licensed Practical Nurse (LPN)
  • Home Health Aide services
  • Speech Therapy
  • Physical Therapy
  • Occupational therapy

This update applies to Participating Providers ONLY!


Medicare Medical Necessity Requirenment:

  • Important the services still need to be properly ordered and documented
  • Need to meet the CMS Medical Necessity requirenments
  • Are subject to retrospective review (audit)

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