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Visit this page often to find current network notices, current and previous issues of our New Horizon Louisiana Medicaid provider newsletter, and updates to our prior authorization processes.

Network notices

2025

Informational Bulletin 25-14: Providers are Required to Revalidate Enrollment Information

Informational Bulletin  25-13: Ambulatory Surgical Centers (Hospital Outpatient and Non-Hospital) Dental Procedure Codes

Incorrect Denials – 68J

Information Bulletin 25-12: LSU Enhanced Professional Service Fee Schedule Update

Informational Bulletin 25-11 - Carrier Code Consolidation Update

Informational Bulletin 25-10 - Hospice Fee Schedule Update

Informational Bulletin 25-9: Applied Behavior Analysis (ABA) Manual Updates

Drug recall notice for fentanyl transdermal system

Incorrect Denials – 51G – Observation Claims

Informational Bulletin 25-5: Donor Human Milk Banks Provider Enrollment Exemption

Informational Bulletin 16-15 Revised: Private Third-Party Liability and Medicare Advantage Plan Update Request Change

Humana Healthy Horizons Secondary Payer Rural Health Clinic (RHC) Reimbursements

Informational Bulletin 25-04: JYNNEOS Vaccine (CPT 90611)

Informational Bulletin 25-03: Place of Service Code 27: Outreach Site/Street for Federally Qualified Health Centers and Rural Health Clinic

Informational Bulletin 25-02: Emergency Room Utilization Reduction Pilot Program

92P – Room and Board Covered Days Denial Error

Informational Bulletin 25-01: Third Party Liability Portal – Third Party Referral Module

NEMT Codes – T2001, T2002, & T2003 – Denied 51X

Informational Bulletin 24-04: Revised February 25, 2025

Informational Bulletin 24-04: Revised February 3, 2025

Informational Bulletin 21-02: Revised February 25, 2025

Informational Bulletin 21-02: Revised February 3, 2025

Informational Bulletin 19-03: Revised February 25, 2025

Informational Bulletin 19-03: Revised February 3, 2025

2024

Informational Bulletin 24-49: Durable Medical Equipment Ordering and Referring Provider Requirements

Informational Bulletin 24-48: 2025 Healthcare Common Procedure Coding System (HCPCS) Update

Informational Bulletin 24-47:  Attention Local Educational Agency (LEA) Providers: Correction to the Exclusions for the Ordering, Prescribing, Rendering NPI Requirement and Claim Recycle

CPT Code 92609 – Denial Code 615

Informational Bulletin 24-04 Updates: Managed Care Ambulance Provider Issue Resolution (Emergency and Non-Emergent) (Revised on 11.13.24)

Informational Bulletin 21-02 Update: Medicaid Managed Care Non-Emergency Medical Transportation Provider Issue Resolution (Revised 11.13.24)

Informational Bulletin 24-46: New Third Party Liability Portal Functionality

Informational Bulletin 24-45: Immunization Fee Schedule for Children: Influenza Trivalent (IIV3) – CPT 90656

Informational Bulletin 24-44:  Place of Service Code 27: Outreach Site/Street

Informational Bulletin 24-44: Immunization Fee Schedule Updates 2024-2025

Informational Bulletin 24-43: Procedure Code Modifier Utilization Listing

Informational Bulletin 24-42:  Immunization Fee Schedule Updates: 2024-2025 Influenza Vaccines and VFC

Informational Bulletin 24-41: Certification of Ambulance Transportation (CAT) Form Revision

Informational Bulletin 24-40: Carrier Code Management (CCM)

Informational Bulletin 24-7: Update LDH Breast Pump Coverage Changes Effective March 1, 2024

Informational Bulletin 24-32: Substance Use Disorder Provider Reimbursement Update

Informational Bulletin 24-22: Provider Enrollment Portal Rebaseline

Informational Bulletin 24-27: Transcranial Magnetic Stimulation (TMS) Update

Informational Bulletin 24-39: Beneficiary Third Party Liability Data Migration

Informational Bulletin 24-38 Certification of Ambulance Transportation (CAT) Form Revision

Informational Bulletin 24-37: Immunization Fee Schedule Updates – 2024-2025 Influenza Vaccination Updates

Informational Bulletin 24-36: Informational Bulletin 24-36 Third Party Liability Carrier Code

Informational Bulletin 24-35: Informational Bulletin 24-35 Third-Party Liability Act 486 (HB655)

Observation over 48 without Auth – Incorrect Claim Denials

Informational Bulletin 24-34: Coverage of Disposable (Elastomeric) Infusion Pumps

Informational Bulletin 24-33: Open Enrollment for 2025 Medicaid Managed Care and Dental Plans

Informational Bulletin 24-32: Substance Use Disorder Provider Reimbursement Update

Informational Bulletin 24-31: Coverage of Respiratory Viral Panels (87631, 87632 and 87633)

Informational Bulletin 24-30: Vision (Eyewear) Reimbursement Rate Update

B9998 – Claims

E0601 – DME Reimbursement

“Service is inconsistent with Patient Age” Recoupment Letters

Informational Bulletin 24-29: Act 246 of the 2024 Louisiana Regular Legislative Session

Informational Bulletin 24-25: Expansion of Mental Health Professionals Update

Informational Bulletin 24-28: Appropriate Use of CARC/RARC Codes in Claims Adjudication

Informational Bulletin 19-3: Medicaid Provider Issue Resolution

Informational bulletin 24-18: Screening Mammography Coverage Update

Informational Bulletin 24-27: Transcranial Magnetic Stimulation (TMS)

Informational Bulletin 24-26: Brief Emotional Behavioral Assessment

Informational Bulletin 24-25: Expansion of Mental Health Professionals

Informational Bulletin 24-24: LDH Guidance on Brain Death Determination for Providers

Informational Bulletin 24-23: Update: Radiation Oncology Therapies

Informational Bulletin 24-22: Provider Enrollment Portal Rebaseline

LDH presents the 2024 Developmental Screening Summer Webinar Series

Notice of MCO Manual Update 6.5.2024

Informational Bulletin 24-21: Changes to Third Party Liability (TPL) Carrier Code Listing

Informational Bulletin 24-20: X-Modifier Utilization

Informational Bulletin 24-2: ASAM Criteria Updates for Adult Substance Use Services REVISED

Informational bulletin 24-19: Process for Requesting Consideration of Policy Changes and New Benefit Coverage

Informational bulletin 24-18: Screening Mammography Coverage Update, July 18, 2024

Informational bulletin 24-18: Screening Mammography Coverage Update, June 5, 2024

Informational bulletin 24-18: Quarterly eligibility wage checks, June 4, 2024

Informational bulletin 24-19: Outpatient Therapy (DBT) Manual Updates

Informational Bulletin 24-16: Proprietary Laboratory Analyses Changes, May 22, 2024

Informational Bulletin 24-17: Corneal Collagen Cross-Linking Coverage, May 22, 2024

Informational Bulletin 24-15: Preferred Drug List Update for July 1, 2024

Informational Bulletin 22-24 Update: Pediatric Day Health Care (PDHC) Reimbursement, May 14, 2024

Informational Bulletin 24-13: Applied Behavior Analysis (ABA) Manual Updates, May 6, 2024

LA School-Based Provider Enrollment Requirement – REVISED: February 22, 2024

Informational Bulletin 24-12: Managed Care Organization Provider Directory Project, May 1, 2024

Informational Bulletin 16-9 Update: 340B Policy Clarification

Louisiana Department of Health Informational Bulletin 24-9: Therapy Services in Federally Qualified Health Centers, Rural Health Clinics and American Indian Clinics

Louisiana Department of Health Informational Bulletin 24-11: Updates to the Outpatient Hospital Fee Schedule Based on NCCI MUEs

Louisiana Department of Health Informational Bulletin 19-3: Medicaid Provider Issue Resolution

Louisiana Department of Health Informational Bulletin 24-4: Managed Care Ambulance Provider Issue Resolution

Louisiana Department of Health Informational Bulletin 24-10: LEAs and Respective Billing Agencies – Changes to NCCI MUE Edits

Dialectical Behavior Therapy (DBT) ARPA Incentives, March 1, 2024

2024 Emergency Medical Transportation Methodology Update and Air Ambulance Mileage Rate Increase

LDH Breast Pump Coverage Changes, March 1, 2024

Notification of amendment to LAC 50:XIII.801 – Nursing Recruitment and Retention

NAMI Ask the Expert: How Employment Supports Mental Recovery webinar on April 18, 2024

Louisiana Department of Health Informational Bulletin 24-6: LDH Newborn/Deemed Eligible MCO Assignment Mismatch Corrections

Outpatient Hospital Claims Reimbursement

LDH Member Reassignment Policy Core Elements, March 4, 2024

LDH Medicaid Provider Issue Resolution, Revised March 4, 2024

Class Action Notice – A.A. V. Abraham

LDH Behavioral Health Services Manual Update – effective February 5, 2023

Louisiana Department of Health Informational Bulletin 24-5: Pediatric Day Health Care (PDHC) Policy Reminder, February 7, 2024

Louisiana Department of Health Informational Bulletin 15-17: Billing for Specialized Mental Health and Substance Use Services for Dual Eligibles

Managed Care Organization Manual effective 02.02.2024 Managed Care Organization Manual | La Dept. of Health

Managed Care Organization Manual Revision Log February 2, 2024 Managed Care Organization Manual | La Dept. of Health

Louisiana Department of Health Informational Bulletin 24-3: Immunization Fee Schedule Updates, January 31, 2024

Louisiana Department of Health Informational Bulletin 24-4 February 2, 2024

Louisiana Department of Health Informational Bulletin 23-11: 2024 Diabetic Supplies Pharmacy Benefit update

Louisiana Department of Health Informational Bulletin 24-1 2024 Healthcare Common Procedure Coding System (HCPCS) Update

Louisiana Department of Health Informational Bulletin 24-2 2024 ASAM Criteria Updates for Adult Substance Use Services

2023

Louisiana Department of Health Informational Bulletin 23-22 Administration of Respiratory Syncytial Virus Vaccines

RHC/FQHC Secondary Claims Processing Error

LA Provider Crisis Response Services, Appendix D, Appendix F, and Appendix E-11

EPSDT Pediatric Payment Error Denial Issue 33

Identified System Edit Causing Improper 61T Denials

LDH MCO Manual 12.13.2023 Updates Managed Care Organization Manual | La Dept. of Health

LDH Informational Bulletin 23-21: Tobacco Cessation Counseling – Expanded

Managed Care Organization Manual effective 12.05.2023

Louisiana Department of Health Informational Bulletin 18-5

LA Medicaid Recently Policy Updates Webpage

Managed Care Organization Manual effective 11.08.2023

LA School-Based Provider Enrollment Requirement effective - 9.8.2023

Revised ACT appendix in the BH Services Provider Manual

Louisiana Medicaid Email: State Directed Payment Program Manual Updated 9.22.2023

Provider Communication Notice: Payment for Out of State Hospital Claims

LDH Informational Bulletin 23-18: Managed Care Organization Credentialing for Medical Staff of Hospitals, Federally Qualified Health Centers, and Rural Health Clinics

LDH Informational Bulletin 23-17: Coverage for Portable Oxygen Concentrators

LDH Behavioral Health Services Manual Update – effective August 25, 2023

LDH Informational Bulletin 23-16: Physician-Administered Drug Reimbursement Update

LDH Informational Bulletin 23-14: Electronic Visit Verification for Home Health Services

LDH Informational Bulletin 23-13: Anesthesia Policy for Pain Management

Humana Healthy Horizons in Louisiana Chiropractic Payment Network Notification

LDH Crisis Regional Tour 2023 – Save The Date

LDH Informational Bulletin 23-12: Midwifery Services Reimbursement Rate Update – Revised August 18, 2023

Mental Health Rehabilitation (MHR) Billing Guidance

Informational Bulletin 22-10: Termination of the Non-Emergency Medical Transportation Temporary Mileage Rate Increase – effective August 1, 2023

Informational Bulletin 22-38: New Information about Medicaid Provider Enrollment

LDH Informational Bulletin 23-11 Diabetic Supplies Coverage as a Pharmacy Benefit – revised September 26, 2023

LDH Informational Bulletin 23-10 COVID-19 Laboratory Test Update of HCPS codes U0003. U0004, U0005 – Revised July 14, 2023

Update Humana Dental Program Fee Schedule – effective July 1, 2023

American Rescue Plan Act of 2021 (ARPA) Provider Incentive

Assertive Community Treatment (ACT) behavioral health provider manual updates

Louisiana Department of Health Informational Bulletin 23-09 – effective June 15, 2023

Louisiana Department of Health Informational Bulletin 21-9 – effective June 15, 2023

The Louisiana Department of Health is consolidating Provider Type codes used for Mental Health Rehabilitation Agency and Behavioral Health Rehab Provider Agency – published June 7, 2023

Louisiana Department of Health retired several Informational Bulletins related to the COVID-19 Public Health Emergency – published May 15, 2023

Rural health clinic and federally qualified health center payment variances identified – published May 10, 2023

Private third-party liability and Medicare Advantage Plan request submission update – effective May 4, 2023

Mental health services reimbursement issue identified – effective May 2, 2023

Coverage of Makena (17-Hydroxprogesterone Caproate) for prevention of preterm birth – effective April 6, 2023 (published May 1, 2023)

Comprehensive dental care for adults with developmental or intellectual disabilities residing in an intermediate care facility – effective May 1, 2023

General anesthesia and facility reimbursement increase for dental treatment – effective March 24, 2023 (published April 24, 2023)

Hospital observation claims payment issue – effective April 19, 2023 (published April 14, 2023)

LDH policy update: Home Health Services Reimbursement Rate Update – effective April 3, 2023 (published April 14, 2023)

LDH policy update: Early and Periodic Screening, Diagnosis, and Treatment Personal Care Services (EPSDT-PCS) – effective May 11, 2023 (published April 13, 2023)

Identified system edit causing improper 69i denials – effective April 12, 2023

Information from LDH about available options for pursuing resolution of issues with Medicaid managed care organizations and the state’s fee-for-service claims processor, Gainwell Technologies – revised June 15, 2023

Community psychiatric supportive treatment payment error – effective April 7, 2023

Immunization update – Pneumococcal vaccine (15 valent) for ages 0 - 18 – effective April 3, 2023

Reimbursement for portable oxygen content units

Information about how to resolve claims payment issues for transportation providers – effective Mar. 27, 2023

Louisiana Department of Health telemedicine and telehealth health plan advisory updates – effective Mar. 17, 2023 (Updated May 24, 2023)

Louisiana Department of Health Behavioral Services Provider Manual Updates – effective Mar. 10, 2023

Act 143 Implementation – effective Mar. 1, 2023

Federally Qualified Health Center and Rural Health Clinic Claims Payment Issue – effective Feb. 24, 2023

Louisiana Department of Health Informational Bulletin 19-3

53Y Claim Denial Communication – effective Feb. 3, 2023

Procedure for Submitting 148 Admission Forms – effective Jan. 25, 2023

Enteral Formula Reimbursement Changes – effective Jan. 1, 2023

Louisiana New Horizon Medicaid provider newsletter

Louisiana New Horizon Medicaid provider newsletter

Louisiana New Horizon Medicaid provider newsletter archive

Volume IV

Volume III

Volume II

Volume I

Louisiana Medicaid

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