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April 2025 Provider News

Date: 04/29/25

In this issue: 

  • General Updates - Ambetter Mid-level Reimbursement Alignment, Hepatitis C, Manual reminder
  • Quality - Immunization, Mammogram, CMS Medicare Learning network, 2025 Prescribing Aid Medicare Advantage Part- D
  • Tribal - Resource for Assistance
  • Clinical & Payment Policy - Policy updates eff 05/01/2025
  • Wellcare - Link to Medical Clinical Policy Updates     
  • Training/Education - Upcoming Training Opportunities
  • Pharmacy Updates - Medical Oncology Update, Over the Counter (OTC) Birth Control

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General Updates

Medicaid Reminder: Providers must adhere to appointment availability and wait times found in the Provider Operations Manual on pages 27-28.  

Ambetter Mid-level Reimbursement Alignment

To align with CMS guidance there will be changes to Ambetter/Marketplace mid-level reimbursement for the following provider types: 

  • Nutritionist 
  • Dietician 
  • Midwife 

These changes will align with CMS guidelines outlined in the Calendar Year (CY) 2025 Medicare Physician Fee Schedule Final Rule, which can be found here.

Hepatitis C

Our provider partners are a key stakeholder in the fight to eliminate Hepatitis C in our state! 

Coordinated Care would like to remind you that: 

  • Anti-viral MAVYRET can cure Hepatitis C.  
  • These daily pills are allowed for up to a 12-week supply at one time. 
  • Effective for claims on or after March 1, 2024, the Health Care Authority, Apple Health Fee-For-Service (FFS) has increased the maximum allowable days’ supply for Mavyret (glecaprevir/pibrentasvir). 
  • Pharmacies may dispense and submit claims for up to a 12-week (84 days) supply of Mavyret in a single fill. 
  • Mavyret is preferred and does not require prior authorization  
  • To ensure patients receive the full course of treatment, Mavyret prescriptions should be written in a manner to allow the pharmacy to dispense the entire 8-week or 12-week course of treatment. 
  • Other anti-viral medications will require review and be approved only if Mavyret is not clinically appropriate. 
  • CDC recommends that all adults 18 years and older be screened for Hep C at least once, as well as pregnant women during each pregnancy. 
  • Injection drug use is the primary risk for Hepatitis C. Any person requesting HCV screening should receive it. 
  • Direct-acting antiviral (DAA) medications can be prescribed for children aged 3 and up. 
  • Patients who have certain liver problems or are taking medicines (atazanavir or rifampin) are not eligible to take MAVYRET. 
  • Anyone licensed to prescribe direct acting anti-viral medications is allowed to screen and treat Apple Health members, including primary care doctors and pharmacists. 
  • Learn more at: 

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Quality

Medicaid Quality

Vaccine guides: Vax Northwest • Immunity Community  

Immunity Community: Building Immunity, Strengthening Community- A Virtual Training Series on Immunizations for Health Professionals

Vaccine Clinic pop up guide (PDF)

Pierce county resources

Spokane region immunizations: Vaccines & Immunization | Spokane Regional Health District  

Resources for health professionals, parents and other agencies to add brain building opportunities for children: Vroom in Healthcare | Vroom.org

Snippets from the Washington State Dept of Health’s Respiratory Illnesses Newsletter: 

National Infant Immunization Week (April 21–28) – We highlight the importance of protecting children two years and younger from vaccine-preventable diseases and recommend that children stay on track with their well-child appointments and routine vaccinations. 

National Infant Immunization Week (NIIW) is April 21–28, 2025 

Don’t let diseases of the past become a part of their future. 

In 2025, no parent should have to worry about their baby facing diseases like measles, rubella, diphtheria, or other illnesses we now have the power to prevent. But the ongoing measles outbreaks facing our nation today remind us that the progress we’ve made is fragile — and it’s up to all of us to protect it.  

We’re fortunate to live in a time when we can protect babies from more than 16 dangerous diseases that once infected and even killed thousands of children. Today, 9 out of 10 parents in the U.S. choose to vaccinate. But with misinformation spreading and preventable diseases like measles making a comeback, it’s more important than ever to affirm why making the choice to vaccinate is so important.  

Important information for parents:

We all want to protect our children. But in a world full of conflicting information, knowing who to trust can be hard. The #VaxToTheFuture campaign helps explain how we can trust that vaccines are safe, while emphasizing that risking infection with diseases they protect against is not.   

Vaccinate Your Family’s #VaxToTheFuture campaign is a bilingual initiative to remind parents, caregivers, and communities of a simple but powerful truth: a childhood free from vaccine-preventable diseases is possible, but only if we remember the lessons of the past and choose to vaccinate. 

Join us in spreading the word about the importance of infant immunization. It has never been more important for each of us to speak up for the importance and safety of routine immunization for babies. Remember to use the #VaxToTheFuture hashtag when you share on social media and tag @vaccinateyourfamily (@vaxyourfam on X/Twitter) so we can amplify your posts! 

World Immunization Week (April 24–30) – A global push for vaccine equity and access for all ages. Thank you for all you do to promote vaccines! Vaccines save lives! 

Heads up! World Immunization Week (WIW) happens around the same time as NIIW. WIW is April 24-30, 2025. It’s time to show the world that Immunization for All is Humanly Possible. Hashtags: #VaccinesWork, #Humanly Possible Check out the World Health Organization's Campaign!   

Mammograms (HEDIS Measure)
The HEDIS measure assesses women ages 50-74 who had at least one mammogram to screen for breast cancer in the past 2 years.
Does your patient have any of these risk factors? They may need to be assessed for early onset Breast Cancer:
* Reproductive history- menstrual history of starting periods before age 12 and menopause after 55
* Having dense breasts
* Breast/ ovarian cancer personal/family history orpersonal/family history of genetic mutations

Spread the word about the importance of getting regular colorectal cancer screenings, starting at age 45 years. Share the National Cancer Institute’s colorectal cancer resources to help people learn about prevention, treatment, and more. Colorectal Cancer—Health Professional Version - NCI Share awareness resources from the Centers for Disease Control and Prevention (CDC) with your networks.  

Wellcare Quality

Check out CMS Medicare Learning network here: 2025-04-17-MLNC | CMS

Raise Awareness & Understanding of Alcohol Use and Misuse 

Excessive alcohol use is a leading preventable cause of death in the U.S. During Alcohol Awareness Month, talk with your patients who drink alcohol about potential risks. 

Medicare pays for alcohol misuse screening and counseling for Medicare Part B patients who qualify. 

Encourage your patients who are at risk to get an annual screening. Find out when your patient is eligible for these screenings and counseling. If you need help, contact your eligibility service provider. 

More Information: 

2025 Prescribing Aid Medicare Advantage Part- D

  • subject to evidence of coverage 
  • Tiers 3-5 Deductible will apply 
  • Tier 6: initial coverage 
  • $0-$10 monthly for C-snp plan, 
  • $0 copay for all other plants 
  • D-Snp plans: $0 copays across all phases of coverage 
  • No coverage gap (donut hole) 2025 
  • Max $35 monthly for insulin products 

2025 Preferred Blood Glucose Meter Strips

  • One touch Verio Reflect or Verio felx meter & One Touch Verio test strips, One Touch Ultra 2 meter & One Touch ultra test strips 
  • Quantity Limits: 1 meter kit per 365 days (1 per calendar year) 100 test strips per 25 days (4 per day) 

Continuous Glucose (CGM) Systems: FreeStyle Libre or DexCom a re preferred -PAR. PA-Criteria (ALL1-4) 

  1. DM diagnosis 
  2. Insulin-treated, OR had problematic hypoglycemia documented by ONE (a. OR b.) of the following 
  • More than one level 2 hypoglycemic event (BG <54 mg/dL) that persist despite more than one attempt to adjust medications and/ or modify diabetes treatment plan. 

OR 

  • One level 3 hypoglycemic even (BG<54 mg/dL) characterized by altered mental and/ or physical state requiring third-party assistance for treatment, 
  • Seen by providing in last 6 months 
  • Will have follow-up appointments ever 6 months to document adherence to both the CGM regimen and diabetes treatment plan. The Coverage Determination form for PAR requests is available on the Wellcare website.

  

Drug Class  

  

  

Medications  

 

Wellcare Dual      Liberty 

 

Wellcare Dual      Access 

 

Wellcare Dual     Reserve

 (HMO-POS D- SNP)  

Wellcare    Giveback,

 

Wellcare Simple 

(HMO-POS)  

Wellcare Dual Liberty Open, 

Wellcare Dual Access Open (PPO D-SNP)  

Wellcare Mutual of Omaha Simple Open, Wellcare 

Mutual of Omaha Premium Enhanced Open 

(PPO)  

  

  

  

  

  

  

Insulins  

Fast Acting: Insulin Aspart  

Tier 1  

Tier 3  

Tier 1  

Tier 3  

  

Short Acting: Novolin R U100  

Tier 1  

Tier 3  

Tier 1  

Tier 3  

  

Intermediate: Novolin N U-100, Humulin R U-500  

Tier 1  

Tier 3  

Tier 1  

Tier 3  

  

Long Acting: Insulin Degludec U-100 AND U-200, Insulin  

Glargine YFGN U-100, Insulin  

Glargine U-300  

  

Tier 1  

  

Tier 3  

  

Tier 1  

  

Tier 3  

  

Combinations: Novolin 70/30, Insulin Aspart Protamine-Insulin Aspart Mix 70/30  

  

Tier 1  

  

Tier 3  

  

Tier 1  

  

Tier 3  

  

Other Insulin Combinations:  

Xultophy, Soliqua  

Tier 1  

Tier 3  

Tier 1  

Tier 3  

Orals  

Biguanide: Metformin, Metformin ER (generic for Glucophage XR only)  

2nd Generation Sulfonylure: Glipizide, Glipizide XR, Glimepiride  

Thiazolidinedione:  Pioglitazone  

Alpha-Glucosidase inhibitor: Acarbose  

Meglitinide analogue:  Nateglinide, Repaglinide  

Combinations: Glipizide/ Metformin, Pioglitazone/ Metformin, Pioglitazone/ Glimepiride  

  Tier 1  

  

  

  

 Tier 6  

Tier 2: Metformin ER (generic for Fortamet)  

 Tier 1  

  

  

  

Tier 6  

Tier 2: Metformin ER (generic for Fortamet) 

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Tribal

Resource for Assistance

IHCPs have access to a dedicated email inbox for inquires regarding all lines of business at Coordinated Care (Medicaid, Marketplace/Exchange, and Medicare Advantage). Please don’t hesitate to reach out to IndianHealthCareProviderAssistance@coordinatedcarehealth.com and the team monitoring the inbox will assist or connect you with the appropriate contacts to resolve your questions. 

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Clinical Policy Updates

The below policies were updated as part of our regular monthly review in March. The policy changes are effective May 1, 2025. You will find the policies, including a description of the revisions, posted on the policy site. 

Policy Number

Policy Title

Line of Business

WA.CP.MP.37  

Bariatric Surgery 

Apple Health 

WA.CP.BH.521 

Behavioral Health Wraparound Support 

Apple Health 

CP.MP.101 

Donor Lymphocyte Infusion 

Apple Health & Ambetter 

WA.CP.BH.528 

HRSN – Intensive Behavioral Supportive Supervision 

Apple Health 

CP.MP.160 

Implantable Wireless Pulmonary Artery Pressure Monitoring 

Ambetter 

CP.MP.170 

Nerve Blocks for Pain Management 

Apple Health & Ambetter 

CP.MP.176 

Outpatient Cardiac Rehabilitation 

Ambetter 

CP.MP.246 

Pediatric Kidney Transplant 

Apple Health & Ambetter 

CP.MP.182 

Short Inpatient Hospital Stay  (only change is from 2024 to 2025 CMS Inpatient Only List)

Apple Health & Ambetter 


The below policies were updated as part of our regular monthly review in March. The policy changes are effective August 1, 2025. You will find the policies, including a description of the revisions, posted on the policy site.  

Policy Number

Policy Title

Line of Business

CP.MP.55 

Assisted Reproductive Technology 

Ambetter 

CP.BH.201 

Deep Transcranial Magnetic Stimulation (TMS) for OCD 

Ambetter 

CP.MP.132 

Heart-Lung Transplant 

Apple Health & Ambetter 

WA.CP.MP.69 

Intensity-Modulated Radiotherapy 

Apple Health 

CP.MP.57 

Lung Transplant 

Apple Health & Ambetter 

WA.CP.MP.517 

Testosterone Testing 

Apple Health 

WA.CP.MP.520 

Tympanostomy Tubes 

Apple Health 


The below policies are new effective August 1, 2025. You will find the policies posted on the policy Web site. 

Policy Number

Policy Title

Line of Business

WA.CP.MP.69 

Intensity-Modulated Radiotherapy 

Ambetter 

WA.CP.MP.517 

Testosterone Testing 

Ambetter 

WA.CP.MP.520 

Tympanostomy Tubes 

Ambetter 


The below policy will be archived effective July 31, 2025.  

Policy Number

Policy Title

Line of Business

CP.MP.69 

Intensity-Modulated Radiotherapy 

Ambetter


The policies below were previously announced as revised effective on the date noted. You will find the policies posted on the policy site. 

Policy Number

Policy Title

Effective Date

Line of Business

CP.MP.62 

Hyperhidrosis treatments 

5/1/25 

Apple Health & Ambetter 

CP.MP.107 

Durable Medical Equipment (DME) and Orthotics and Prosthetics Guidelines 

5/1/25 

Apple Health & Ambetter 

CP.MP.180 

Implantable Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea 

5/1/25 

Ambetter 

WA.CP.MP.237 

CG Oncology Algorithmic Testing 

5/1/25 

Apple Health 

WA.CP.MP.219 

CG Genetic Testing Exome and Genome Sequencing 

5/1/25 

Apple Health 

V1.2025 

Concert Genetics Policies 

5/1/25 

Apple Health & Ambetter 

CP.BH.104 

Applied Behavior Analysis 

7/1/25 

Apple Health & Ambetter 

CP.BH.105 

Applied Behavioral Analysis Documentation Requirements 

7/1/25 

Apple Health & Ambetter 

WA.CP.MP.515 

Fecal Microbiota Transplantation 

7/1/25 

Apple Health 

CP.MP.121 

Homocysteine Testing 

7/1/25 

Apple Health & Ambetter 

CP.MP.82  

NICU Apnea Bradycardia Guidelines 

7/1/25 

Apple Health & Ambetter 

CP.MP.81 

NICU Discharge Guidelines 

7/1/25 

Apple Health & Ambetter 

WA.CP.MP.526 

Stem Cell Therapy for Musculoskeletal Conditions 

7/1/25 

Apple Health 

CP.MP.162 

Tandem Transplant 

7/1/25 

Apple Health & Ambetter 

WA.CP.MP.510 

Tinnitus Treatment 

7/1/25 

Apple Health 

CP.MP.163 

Total Parenteral Nutrition and Intradialytic Parenteral Nutrition 

7/1/25 

Apple Health & Ambetter 


The below genetic testing policies were previously announced to be updated effective May 1, 2025. You will find the policies, including a description of the revisions, posted on the policy site.  

Policy Number

Policy Title

Line of Business

V1.2025 

CG Aortopathies and Connective Tissue Disorders 

Apple Health & Ambetter 

V1.2025 

CG Cardiac Disorders 

Apple Health & Ambetter 

V1.2025 

CG Dermatologic Conditions 

Apple Health & Ambetter 

V1.2025 

CG Epilepsy Neurodegenerative and Neuromuscular Conditions 

Apple Health & Ambetter 

V1.2025 

CG Exome and Genome Sequencing for the Diagnosis of Genetic Disorders 

Ambetter 

V1.2025 

CG Eye Disorders 

Apple Health & Ambetter 

V1.2025 

CG Gastroenterologic Disorders Non-cancerous 

Apple Health & Ambetter 

V1.2025 

CG General Approach to Genetic Testing 

Apple Health & Ambetter 

V1.2025 

CG Hearing Loss 

Apple Health & Ambetter 

V1.2025 

CG Hematologic Conditions Non-cancerous 

Apple Health & Ambetter 

V1.2025 

CG Hereditary Cancer Susceptibility 

Apple Health & Ambetter 

V1.2025 

CG Immune Autoimmune and Rheumatoid Disorders 

Apple Health & Ambetter 

V1.2025 

CG Kidney Disorders 

Apple Health & Ambetter 

V1.2025 

CG Lung Disorders 

Apple Health & Ambetter 

V1.2025 

CG Metabolic Endocrine Mitochondrial Disorders 

Apple Health & Ambetter 

WA.CP.MP.230 

CG Multisystem Inherited Disorders, Intellectual Disability and Developmental Delay 

Apple Health  

V1.2025 

CG Multisystem Inherited Disorders, Intellectual Disability and Developmental Delay 

Ambetter 

WA.CP.MP.231 

CG Prenatal Cell-Free DNA Testing 

Apple Health  

V1.2025 

CG Prenatal Cell-Free DNA Testing 

Ambetter 

V1.2025 

CG Oncology Algorithmic Testing 

Ambetter 

V1.2025 

CG Oncology Cancer Screening 

Apple Health & Ambetter 

V1.2025 

CG Oncology Circulating Tumor DNA Tumor Cells Liquid Biopsy 

Apple Health & Ambetter 

V1.2025 

CG Oncology Cytogenetic Testing 

Apple Health & Ambetter 

V1.2025 

CG Oncology Molecular Analysis Solid Tumors & Hematolgic Malignancies 

Apple Health & Ambetter 

WA.CP.MP.232 

CG Pharmacogenetics  

Apple Health 

V1.2025 v.A 

CG Pharmacogenetics (Version A) 

Ambetter 

V1.2025 

CG Preimplantation Genetic Testing 

Apple Health & Ambetter 

V1.2025 

CG Prenatal and Preconception Carrier Screening 

Apple Health & Ambetter 

V1.2025 

CG Prenatal Diagnosis Pregnancy Loss 

Apple Health & Ambetter 

V1.2025 

CG Skeletal Dysplasia Rare Bone Disorders 

Apple Health & Ambetter


The below new policies were previously announced effective on the dates noted. You will find the policies posted on the policy site. 

Policy Number

Policy Title

Effective Date

Line of Business

WA.CP.MP.510 

Tinnitus Treatment 

7/1/25 

Ambetter 

WA.CP.MP.526 

Stem Cell Therapy for Musculoskeletal Conditions 

7/1/25 

Ambetter 

WA.CP.MP.515 

Fecal Microbiota Transplantation 

7/1/25 

Ambetter


Prior Authorization Updates

The following services will require prior authorization effective July 1, 2025 

Line of Business

Code

Description

Ambetter 

J1439 

Injection, ferric carboxymaltose, 1 mg 

Apple Health 

37229 

Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with atherectomy 

Apple Health 

37227 

Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral, with transluminal stent placement(s) and atherectomy 

Apple Health 

42145 

Palatopharyngoplasty 

Apple Health 

E2402 

Negative pressure wound therapy electrical pump, stationary or portable 

Apple Health 

L1833 

Knee orthosis, adjustable knee joints, positional orthosis, rigid support, off-the-shelf 

Apple Health 

L0650 

Lumbar-sacral orthosis (LSO), sagittal-coronal control, with rigid anterior and posterior frame/panel(s), lateral strength provided by rigid lateral frame/panel(s), off-the-shelf 

Apple Health 

L0648 

Lumbar-sacral orthosis (LSO), sagittal-coronal control, with rigid anterior and posterior frame/panels, off-the-shelf 

Apple Health 

L0637 

Lumbar-sacral orthosis (LSO), sagittal-coronal control, with rigid anterior and posterior frame/panels, prefabricated item, customized to fit 

 

Due to changes in reimbursement and benefit limitations for Apple Health members which were effective April 1, 2025, we will no longer require prior authorization for G0481 (Definitive Drug Testing, 8-14 Drug Classes) effective July 1, 2025. Please remember that the benefit limit for definitive drug testing is now 12 total services per year. 

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Wellcare

Please visit this link for the upcoming Medical Clinical Policy Updates, for Wellcare that will be going into effect April 20th, 2025. 

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Training/Education

Suicide Prevention Provides an overview of the topic of suicide, signs, and symptoms, and how caregivers should respond in times of crisis. The training will dive into the rates of youth suicide, risk factors, and proactive steps to take for prevention. May 8th 2pm – 3:30pm Registration link

Supporting LGBTQIA+ Youth in Foster Care This training was developed through Amara with input from Coordinated Care and other community organizations. It is for caregivers and professionals who work in the child welfare setting. May 9th 11am – 12:30pm Registration link

Trauma and Food This training will discuss the reasons behind food-related issues such as eating too fast, hiding and stealing food, arguing over meal selections, etc. It is designed for those treating, supporting and caring for youth who have experienced trauma and may now have "quirky" behaviors around food. We will discuss how trauma affects childhood development, as well as offer practical and easy ideas to help regarding food. May 13th 10am – 11:30am Registration link

Understanding Behavioral Health Stigma A historical and current look at why mental health concerns can often meet with bias or stigma. This training provides a chance for open discussion on what has happened historically and the current barriers that may continue to get in the way of behavioral health solutions. May 21st 2pm – 3:30pm Registration Link

ACE's (Adverse Childhood Experiences): This training explains the Adverse Childhood Experiences (ACEs) study and identifies all 10 ACEs. All childhood experiences, especially traumatic events, have an impact on people as they mature. This training explores the long-term effects that adverse childhood experiences have on physical and mental health. Preventative measures, resiliency, and how to address the needs of children with a high ACEs score are all discussed. Personal ACE's test provided. May 8, 2025, 12:01 - 01:30 Register

Trauma Informed Care & Discipline: We all need discipline in our lives to function well in society. For youth especially, boundaries and consistency help provide safety and security. How does a caregiver or professional provide that understanding to a child, and then possibly consequences for inappropriate behavior, who is not attached to the foster family and has significant trauma in their lives? This training discusses this topic with ideas and tips, as well as an overview of why children with traumatic history can be so challenging. May 20, 2025 12:01 - 01:30 Register 

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Pharmacy

Medical Oncology Update- Ambetter

Prior Authorization requests for the following HCPCS codes need to be verified by Evolent.

HCPCS

Generic Name

Brand Name

Medical PA

Pharmacy PA

Impact Description

J3590 

DENOSUMAB-DSSB INJECTION 

OSPOMYV 

Yes 

Yes 

FDA new release approval 2/13/25 

(biosimilar to Prolia) 

Effective date 10/1/25 

J3590 

DENOSUMAB-DSSB INJECTION 

XBRYK 

Yes 

Yes 

FDA new release approval 2/13/25 

(biosimilar to Xgeva) 

Effective date 10/1/25 

 

Over the Counter (OTC) Birth Control - Medicaid 

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