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)
Find this type of information useful? Follow my blog for more!
- NYS Medicaid Telehealth updates
- MA Common Wealth Alliance: new prior auth req BH services
- Healthfirst: prior auth for codes 10/1/26
- Aetna: CA HMO provider disputes submission changes
- NY UHC Community Plan- no payment for 97161-97168 codes
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