Our providers know that everything from rules and regulations to best practices and cutting-edge innovations are always evolving across the healthcare landscape.
From timely reminders about combating antibiotic resistance to updates on Medicaid, Medicare, and more, our news service gives our providers the up-to-date information they need to deliver the best care possible.
Important & Urgent Notifications
December 03, 2025
Medicaid Update – Medicaid Coverage of Point of Care Syphilis Testing
December 03, 2025
Medicaid Update – New York State Medicaid Coverage of Therapeutic Transcranial Magnetic Stimulation
November 14, 2025
Announcing our new Utilization Management (UM) Software System
November 14, 2025
Medicaid Drug Rebate Program – Billing Guidance for Practitioner-Administered Drugs
November 12, 2025
NYS Medicaid Vision Care Codes Manual – Reminder on Billing for Contact Lens Fitting Services
November 09, 2025
RE: Updated Guidance on Home and Community Based Services (HCBS) Compliance (Action Required)
October 20, 2025
Notification of Billing Updates: Dual Diagnosis (DD) – Inpatient Services
September 24, 2025
New Rate (Rate Code) and Other Billing Codes Combination for Health Home Plus and Assisted Outpatient Treatment (AOT)
September 24, 2025
RE: Person-Centered Planning Training
03 Dec
Medicaid Update – Medicaid Coverage of Point of Care Syphilis Testing
TO: All Primary Care Providers Effective immediately, MetroPlusHealth will cover Point of Care (POC) Syphilis Testing to ensure equitable access and screening to help…
03 Dec
Medicaid Update – New York State Medicaid Coverage of Therapeutic Transcranial Magnetic Stimulation
TO: Behavioral Health Providers Effective November 1, 2025, Therapeutic Transcranial Magnetic Stimulation (TMS) is a covered benefit under Current Procedural Terminology…
14 Nov
Announcing our new Utilization Management (UM) Software System
TO: All MetroPlusHealth Providers MetroPlusHealth is excited to announce we are transitioning to a new internal Utilization Management (UM) software…
14 Nov
Medicaid Drug Rebate Program – Billing Guidance for Practitioner-Administered Drugs
TO: All Providers Dear Valued MetroPlusHealth Provider, MetroPlusHealth is committed to keeping our provider network informed of important Department of…
12 Nov
NYS Medicaid Vision Care Codes Manual – Reminder on Billing for Contact Lens Fitting Services
TO: All Vision Care Providers This is a reminder of the New York State Medicaid regulations for vision care billing…
09 Nov
RE: Updated Guidance on Home and Community Based Services (HCBS) Compliance (Action Required)
TO: All Primary Care Providers Dear Valued MetroPlusHealth Provider, The New York State Department of Health (DOH) has issued updated…
20 Oct
Notification of Billing Updates: Dual Diagnosis (DD) – Inpatient Services
IMPACTED PLANS: Medicaid, HIV SNP, HARP and MAP Dear MetroPlusHealth Provider, This memo is to provide notification of billing updates…
24 Sep
New Rate (Rate Code) and Other Billing Codes Combination for Health Home Plus and Assisted Outpatient Treatment (AOT)
IMPACTED PLANS: Medicaid, HIV SNP, and HARP DOH has released guidelines for providers to use the new Medicaid rate code…
24 Sep
RE: Person-Centered Planning Training
IMPACTED PLANS: MAP and MLTC Dear Valued MetroPlusHealth Provider, The New York State Department of Health is now offering training…
23 Sep
RE: Updated Rates for Health Home Plus 2.84% COLA, Retro-effective April 1, 2024
TO: Health Homes Providers DOH has released guidance to notify that (retro) effective April 1, 2024, the Medicaid rates for…
17 Sep
RE: PROS Billing & Claiming Manual Update
IMPACTED PLANS: MEDICAID, HIV SNP, HARP, and MAP OMH has released an updated PROS Billing and Claiming Manual to clarify…
17 Sep
Project TEACH Training Series
MetroPlusHealth is pleased to invite you to participate in the upcoming Project TEACH training series, focused on Child and Adolescent…
15 Sep
Availity Eligibility and Claim Inquiry Update
MetroPlusHealth is continuing to offer additional resources to meet the needs of our provider network. We are expanding our partnership…
25 Aug
Re: Doula Services
IMPACTED PLANS: Medicaid, HIV SNP, HARP and EP Dear MetroPlusHealth Provider, Effective April 1, 2025, MetroPlusHealth will cover doula services…
29 Jul
REMINDER: Mobile Crisis and Crisis Residence Benefit and Billing Guidance – Language Interpreter Services
IMPACTED PLANS: Medicaid, SNP, HARP, MAP and Child Health Plus Dear MetroPlusHealth Provider, OMH has combined the previous issued guidance…
10 Jun
RE: Updated Billing Changes to the Telehealth Audio-Only Modifier Use for OMH-Licensed/Designated Outpatient Programs Grid and Audio-Only Modifier Change
IMPACTED PLANS: Medicaid, HIV SNP, HARP, and MAP Dear MetroPlusHealth Provider, Effective July 1, 2025, OMH providers should use modifier…
10 Jun
Lab Reimbursement Policy
Dear Valued Provider, MetroPlusHealth is committed to keeping our provider network informed of important policies. This notice serves as a…
06 Jun
29-I Health Facility Billing Manual Update – Procedure Code 98016
IMPACTED PLANS: MEDICAID and HIV SNP Dear MetroPlusHealth Provider, Effective as of January 1, 2025, the Office of Mental Health…
29 Apr
RE: HEALTH HOMES ADDED TO ELIGIBLE PROVIDERS FOR COMMUNITY HEALTH WORKERS
TO: ALL PROVIDERS Dear MetroPlusHealth Provider, Effective April 1, 2025, the New York State Department of Health has released notice…
17 Apr
RE: TELEHEALTH – CHANGES TO AUDIO-ONLY BILLING
TO: ALL PROVIDERS As of January 1, 2025, per New York State Medicaid updated guidance, the American Medical Association (AMA)…
11 Apr
RE: eConsults Expansion
TO: All MetroPlusHealth Providers Effective as of March 1, 2025, MetroPlusHealth will reimburse eConsult services for Hospital Outpatient Departments (OPDs),…
08 Apr
RE: SBHC COVERED SERVICES – DELAYED
Previously, DOH released an anticipated carve in date of May 1, 2025, for School-Based Health Center services (SBHCs) to be…
01 Apr
URGENT MESSAGE FOR YOUR PATIENTS AND THEIR PAID CAREGIVERS
Your patients who participate in the Consumer Directed Personal Assistance Program (CDPAP), and/or their personal assistant(s), must take IMMEDIATE ACTION…
01 Apr
RE: New Medicare Behavioral Health Utilization Management (BHUM) and ABA Fax Line
TO: All Behavioral Health Providers Effective April 1, 2025, MetroPlusHealth will have a new Medicare BHUM fax number, below: BHUM…
19 Mar
RE: Doula Services IMPACTED PLANS: Medicaid, HIV SNP, HARP and EP
TO: MetroPlusHealth Doula and OB/GYN Providers RE: Doula Services IMPACTED PLANS: Medicaid, HIV SNP, HARP and EP Dear MetroPlusHealth Provider,…
Provider Support
last updated: June 3, 2024
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