Effective April 1, 2022: New Payment Policy - Enhanced Code Editing
Date: 03/04/22
Superior HealthPlan presents a new payment policy that expands the existing edits in Code Editing Overview (TX.PP.011). As a result, the new policy has been added, posted on Superior’s Clinical, Payment and Pharmacy webpage for review, prior to its implementation:
POLICY | EFFECTIVE DATE | APPLICABLE PRODUCTS | NEW POLICY OVERVIEW OR UPDATED POLICY REVISIONS |
|---|---|---|---|
Enhanced Code Editing
(TX.PP.011-A) | 06/01/2022 | Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), CHIP, Health Insurance Marketplace (Ambetter from Superior HealthPlan), Wellcare By Allwell (Medicare)
| The purpose of this policy is to define coding and reimbursement guidelines for practitioners in the same group practice who are in the same specialty, providing services for the same member and condition. |
To review all payment policies, please visit Superior’s Clinical, Payment and Pharmacy Polices webpage.
For questions or additional information, please contact Superior Provider Services at:
- 1-877-391-5921 Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), CHIP, Wellcare By Allwell (Medicare)
- 1-877-687-1196 Health Insurance Marketplace (Ambetter from Superior HealthPlan)