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Fidelis Care Authorization Grids Effective June 1, 2022
29.04.2022 • Posted by Provider Relations

The following sections of the Fidelis Care authorization grids have been updated effective June 1, 2022.

 

The Medicaid Plan grid has been updated as follows:

 

Children’s Home and Community Based Services

7. Respite Services (Planned Respite and Crisis Respite) EFFECTIVE 6/1/22, notification is no longer needed for Respite Services.

            Pharmacy:

  • The following codes have been added to the Medicaid authorization grid and requires prior authorization:

 

  1.  
  2.  

~ authorization is required for NYM/HARP members; it is not required for CHP members

 

 

The Essential Plan and Meta-Level grids have been updated as follows:

 

Durable Medical Equipment/Supplies:

                        4. Supplies requiring authorization:

b. Electric breast pumps (codes E0602 and E0603) have been removed and no longer require authorization.

 

 

Visit:  Authorization Grids

 

COVID-19 UPDATE: Please refer to this link:  Important Updates Regarding Coronavirus COVID-19, for authorization and coding guidelines related to the COVID-19 Pandemic.

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