Yesterday
• Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective January 1, 2026.
The following has been added to the Medicaid Authorization Grid and requires prior authorization:
IV. Behavioral Health - Outpatient Services
R. Family Psychotherapy
Covered; Authorization Required for CPT Codes 90847
Starting January 1, 2026, Fidelis Care will require notification and concurrent review for Group Psychoeducation (Mental Health) services for any requests beyond the initial 30 visits per calendar year. Note: Substance Use Disorder (SUD) group/family therapy do not require authorization.
Requests for members can be made by email qhcmbh@fideliscare.org, fax (833-561-0098)
Last Week
• Posted by Provider Relations
Fidelis Care will host two Provider Office Hours in December 2025. 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 – December 2025
Topic: Fidelis Care – Back to Basics
When: Thursday, December 11th – 12 PM – 1 PM EST
Click here to register*
Topic: Fidelis Care and Wellcare - Quality Programs
When: Wednesday, December 17th – 10 AM – 11
Last Week
• Posted by Provider Relations
Access to quality care is important to eliminate health disparities and increase the quality and years of healthy life for all New Yorkers. The NYSDOH requires that certain Access and Availability Standards be met by PCPs, OB/GYNs, specialists, and behavioral health providers where applicable. Click here to view the full list of standards, including situations and timeframes.
For additional questions, or if we can be of assistance in any way, please contact your Fidelis Care Provider Engagement Account Manager. To find your designated representative, please click here.
Last Week
• Posted by Provider Relations
Fidelis Care has been made aware of an issue affecting providers who are unable to obtain authorizations through the Evolent/RadMD portal due to their NPI or TIN not appearing in the system.
The issue has been identified and escalated as a priority for resolution.
What to Do:
If you are unable to obtain authorizations through the Evolent/RadMD website, please contact the Evolent Call Center:
Fidelis Care (NY) – Medicaid or Exchange: 1-800-424-4952
Fidelis Care (NY) – Medicare: 1-800-424-5390
We anticipate this issue will be resolved by early next week. Once it is addressed, we will share an update.
If you have any additional questions, please
Last Week
• Posted by Provider Relations
Annual cultural competency training for participating providers is required by the New York State Department of Health. At this time, The New York State DOH will only accept the approved training offered by the United States Department of Health and Human Services (HHS), Office of Minority Health education program, Think Cultural Health, to fulfill the requirement for provider annual cultural competency training.*
Once the cultural competency training has been completed, providers need to verify completion of the program by emailing the Cultural Competency Attestation Form to:
CulturalCompetencyTrainingAttestation@fideliscare.org.
The required Cultural Competency Training needs to be completed annually by December 31st. Providers that completed
13.11.2025
• Posted by Provider Relations
Fidelis Care would like to inform our providers of plan changes that will be effective January 1, 2026.
Wellcare By Fidelis Care
Wellcare Fidelis Dual Plus (HMO D-SNP) – Plan 003
Effective January 1, 2026, the plan name will change from Wellcare Fidelis Dual Plus (HMO D-SNP) to Wellcare Fidelis Dual Align (HMO D-SNP).
Wellcare Fidelis Dual Access (HMO D-SNP)
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