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COMMUNITY HEALTH WORKER SERVICES FOR PREGNANT AND POSTPARTUM MEMBERS

RETROACTIVE: Effective October 1, 2023, MetroPlusHealth will reimburse Community Health Worker (CHW) services* for pregnant and postpartum populations. Medicaid members are eligible for CHW services during pregnancy and up to 12 months after the end of pregnancy, regardless of how the pregnancy ends.

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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)…

Availity Eligibility and Claim Inquiry Update

Effective on April 28, 2025, MetroPlusHealth starts a strategic partnership with Availity® to serve as our 270/271 (Member Eligibility Inquiry/Response)…

RE: eConsults Expansion

TO: All MetroPlusHealth Providers Effective as of March 1, 2025, MetroPlusHealth will reimburse eConsult services for Hospital Outpatient Departments (OPDs),…

RE: SBHC COVERED SERVICES

IMPACTED PLANS: MEDICAID & HIV SNP (also known as Partnership in Care) Dear MetroPlusHealth Provider, Effective May 1, 2025, onwards,…
last updated: March 13, 2024

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