REMINDER: STAR Kids and STAR+PLUS LTSS Billing Matrix Update

Date: 09/15/22

As a reminder, in 2019, The Centers for Medicaid and Medicare Services (CMS) directed Health and Human Services (HHS) to update the applicable billing code tables for compliance with the National Correct Coding Initiative. Effective December 1, 2022 the STAR Kids and STAR+PLUS Long-Term Services and Supports (LTSS) updated billing matrices will be published.

To review the current matrices, please visit HHS:

• STAR Kids LTSS Billing Matrix and Crosswalk
• STAR+PLUS LTSS Billing Matrix and Crosswalk

Superior HealthPlan will be required to issue updated prior authorizations for Superior Medicaid (STAR Kids and STAR+PLUS) LTSS services with new code and modifier combinations no later than October 17, 2022.  

Please Note: The LTSS billing matrix changes may not impact all LTSS authorizations, but they can potentially impact you at the time of billing for services rendered. For those billing matrix changes that do require changes to your authorizations (i.e. HCPC and modifier changes), Superior will issue updated authorizations no later than October 17, 2022. To help ensure that you are accurately billing for the services rendered, please utilize the product specific LTSS Billing Matrices linked above or visit the HHS Handbooks webpage.

For any questions, please contact your local Account Manager.

Please note: This article is an update from the previously posted article: IMPORTANT NOTICE: STAR Kids and STAR+PLUS LTSS Billing Matrix Update.