Posted in MVP (NY/VT) Insurance Payer, NY Providers, Training, Updates

MVP NY Medicaid Plans: Medical Devices and Supplies coverage change

This policy applies to MVP NY Medicaid Plans and their coverage for Medical Devices and Supplies.

The following examples are not all inclusive, that apply to this policy:

  1. Foot Care products: insoles, massagers, arch supports
  2. Pill Splitters
  3. Body weight scales
  4. Pulse Oximeters
  5. Thermometer’s (only oral, rectal and basal are covered)
  6. Wheelchair products
  7. Medical fridges
  8. Commodes
  9. Transfer benches
  10. Safety rails (bed, wall, bath)
  11. Fetal dopplers
  12. Bath/shower/toilet sears
  13. Sharp’s containers
  14. Ear Plugs
  15. Nasal dilator strips
  16. Cushions
  17. Decompression belts
  18. Reaches
  19. Travel Coolers etc
Picture Via Cumberland ME

MVP is aligning with NY Medicaid Fee for Services DME coverage. Devices or supplies that are NOT COVERED under FFS Medicaid “Pharmacy Fee Schedule” will continue to not be covered. Applicable DME Products should be billed under the member’s DME Benefit.


For complete list of NY MEDICAID DME COVERED and NON-COVERED Products, please click here.


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Posted in MVP (NY/VT) Insurance Payer, NY Providers, Training, Updates

MVP (NY): ABA Services Coverage update DOS 10/01/21 and thereafter

This blog post applies to physicians that are providing ABA ( Applied Behavior Analysis) services to MVP Managed Medicaid Patients.

Earlier this year MVP sent a notice to patients and Physicians that ABA (Applied Behavior Analysis) services will be covered for patients under 21 years old that have the MVP Managed Medicaid Plan, effective 10/01/2021

However, NY DOH (NY Department of Health) changed that for DOS 10/01/2021 and thereafter.

As of now ABA services are NOT COVERED FOR MVP Managed Medicaid Plans (for patients 21 years old and younger).

NY DOH will continue to cover the ABA Services for only Medicaid fee-for-service members, 21 years old and younger.

MVP is monitoring NY DOH and will make timely updates available as applicable.


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Posted in MVP (NY/VT) Insurance Payer, Training, Updates

MVP (NY/VT): COVID-19 Treatment and Virtual Care, Cost-Share Update

Below policy will apply to MVP plans that are located in New York and Vermont.

New York Virtual Care Cost-Share: Telemedicine

For MVP Medicare Advantage Plans- MVP will continue to apply the cost sharing waver for audio/visual and audio only until the DOS (dates of service) Dec 31,2021.

For MVP Commercial Plans- Starting August 1,2021 and thereafter the patients will have to pay their “in-person visit” cost-share for audio/visual and audio only visits according to their plan details.


Vermont Virtual Care Cost-Share: Telemedicine

For MVP Medicare Advantage Plans- MVP will continue to apply the cost sharing waver for audio/visual and audio only until the DOS (dates of service) Dec 31,2021.

For MVP Commercial Plans- Starting August 1,2021 and thereafter the patients will have to pay their “in-person visit” cost-share for audio/visual and audio only visits according to their plan details.


New York Covid-19 Treatment member Cost-Share:

Effective August 1, 2021, MVP will no longer waive the cost-share for COVID-19 treatment.


***Vermont Covid-19 Treatment member Cost-Share: ***

MVP will continue to cover COVID-19 treatment in full until March 1, 2022 as is required by
Vermont Rules.



COVID-19 Testing Member Cost-Share: NY &VT

MVP will continue to cover COVID-19 testing in full in New York and Vermont


COVID -19 Testing Coding and Billing Corner:

As of January 1, 2021 claims billed with a diagnosis code Z03.818 in conjunction with a COVID19 testing procedure code will be denied

MVP will retain the expanded set of codes eligible for telehealth, consistent with CMS guidance, and will continue to monitor state and federal guidelines and regulations. In addition, MVP supports continued telehealth reimbursement and is currently reviewing coding guidance.


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