Today
• Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective May 1, 2026.
The following codes have been added to the Medicaid Authorization Grid and requires prior authorization:
III. Outpatient surgery: The following services require prior authorization:
D. Skin surgery and other dermatological procedures:
· Only the following codes continue to require authorization for any place of service: A2030, A2031, A2032, A2033, A2034, A2035, A2036, A2037, A2038, A2039, A2040, A2041, A2042, A2043, A2044, A2045, G0681, G0682, G0683, G0684, 11200, 11201, 15271, 15274, 15275, 15276, 15734, 15769-15776, 15778-15829, 17340-17999, Q4101, Q4121, Q4186, Q4195, Q4196, Q4354, Q4355, Q4356, Q4357, Q4358, Q4359, Q4360,
Monday
• Posted by Provider Relations
Pursuant to past guidance by the New York Department of Health (NYDOH), claims submitted under the medical benefit for medications must include a valid National Drug Code (NDC). Claims that do not include an NDC, or that include an NDC that does not match the billed HCPCS code, may be denied and/or not eligible for reimbursement.
Billing Guidance Reminders
Submit the HCPCS code that accurately reflects the drug administered.
Report the 11-digit NDC (5-4-2 format, no spaces or hyphens) that corresponds to the actual product administered.
Ensure the NDC matches the HCPCS code and that both align to the service documented
Last Week
• Posted by Provider Relations
Fidelis Care will host three Provider Office Hours in April 2026. During the webinars, Fidelis Care staff will be available to share information, provide an overview of provider resources, and answer your questions.
Provider Office Hours – April 2026
Topic: Fidelis Care – Back to Basics
When: Thursday, April 9th – 12PM – 1PM EST
Click here to register*
Topic: Fidelis Care and WellCare Quality Programs
When: Wednesday, April 15th – 10:00AM – 11:00AM EST
Click
Last Week
• Posted by Fidelis Care
Grants aimed at funding innovative solutions to overcome barriers to care for individuals with substance use disorders
LONG ISLAND CITY, NY [March 18, 2026] – Fidelis Care, a statewide health plan with more than 2.4 million members in New York State and a Centene Corporation company, announced the opening of the 2026 Here for Your Health behavioral health grant application cycle.
This year’s grant theme centers on innovative approaches to reducing barriers to care for individuals with substance use disorders, prioritizing programs that improve access, engagement, and continuity of care for underserved and historically marginalized populations.
Grants ranging from $10,000 to $20,000 will be