NYRx Formulary Update: Nucynta and Xtampza No Longer Covered Click to Enlarge Effective January 1, 2025, Collegium Pharmaceutical, the manufacturer of Nucynta®, Nucynta ER®, and Xtampza® is no longer participating in the Medicaid Drug Rebate Program and therefore these drugs will no longer be covered by NYRx.
NYRx Medicaid Pharmacy Prior Authorization Programs Update Click to Enlarge On October 25, 2024, the New York State Medicaid Drug Utilization Review Board (DURB) recommended changes to NYRx, the Medicaid pharmacy prior authorization (PA) program. The Commissioner of Health has reviewed the recommendations of the Board and has
NGS Addresses Claim Denials Related to HCPCS Code G2211 Click to Enlarge National Government Services (NGS) has reported an issue impacting Part B providers in Jurisdictions JK and J6 regarding claim denials for the HCPCS G2211 add-on code. The problem stems from a coding update on December 5,
CPT Codes for Prior Authorization: Reporting Prior Authorization–Related Activities Within E/M Services (99203, 99204, 99205, 99213, 99214, 99215, 99358, 99452, 99080) Click to Enlarge Prior authorization (PA) is an administrative process that requires physicians or other qualified health care professionals (QHPs) to obtain approval from
Get Your 2025 Medicare Fee Schedule Now Click to Enlarge The January 2025 Medicare Fee Schedule is now available. Stay up to date on essential payment details for your practice. Email Heather Lopez in the Physician Payment and Practice division at [email protected] to request your copy today!
NYRx Diabetic Supply Program Update: LifeScan Products to Be Removed in 2025 Click to Enlarge Starting January 1, 2025, LifeScan diabetic supplies, including OneTouch meters, test strips, and lancets, are no longer to be included on the NYRx Preferred Diabetic Supply List. This change requires New
Get Your 2025 Medicare Fee Schedule Now Click to Enlarge The January 2025 Medicare Fee Schedule is now available. Stay up to date on essential payment details for your practice. Email Heather Lopez in the Physician Payment and Practice division at [email protected] to request your copy
NYRx Updates: Important Resources and Support for Physicians Click to Enlarge The NYRx Education & Outreach (E&O) team has shared key updates for providers and prescribers across New York State. Highlights include enhancements to the Preferred Drug List (PDL), expanded 90-day supply options for maintenance medications,
NYRx Diabetic Supply Program Update: LifeScan Products to Be Removed in 2025 Click to Enlarge Starting January 1, 2025, LifeScan diabetic supplies, including OneTouch meters, test strips, and lancets, will no longer be included on the NYRx Preferred Diabetic Supply List. This change requires New York
Anthem Notification of Authorization Fax Number Changes Click to Enlarge Anthem is in the process of shutting down specific authorization fax channels. This article notifies you that the fax numbers below will be decommissioned December 15, 2024. Look for future notifications as other authorization fax
