Molina Provider Updates/Events

Current 2024 Updates/Events

icon PDF Demographic Data Alignment Between PEMS Master Provider File and Molina's Provider Directory

icon PDF CAHPS Provider Tips - Improving Patient Satisfaction

icon PDF Texas Incentives for Physicians and Professional Services (TIPPS) - State Fiscal Year (SFY) 2025 Changes

icon PDF New Clinical Diagnostic Laboratory Services Payment Policy

icon PDF STAR+PLUS Realignment Provider FAQs

icon PDF LTSS Billing Process for Dual-Eligible Members

icon PDF Value Added Services - Effective September 1, 2024

icon PDF How to Manage Claims in Availity

icon PDF Opt Out Notice: Medical Maternal Mental Health Treatment Network

icon PDF Provider Bulletin - Balance Billing Prohibited

icon PDF Behavioral Health Providers Appointment Availability Standards and Requirements

icon PDF Appointment Availability and After Hours Requirements

icon PDF Provider Bulletin - Optum Change Healthcare Outage - April 5, 2024

icon PDF Vision Vendor Transition for Molina Medicaid, CHIP and STAR+PLUS MMP Members – Effective May 1, 2024

icon PDF Provider Bulletin - Optum Change Healthcare Outage - March 18, 2024

icon PDF Prior Authorization Reminder Notice - Cannabis Codes

icon PDF MCG 28th Edition Provider Notice

icon PDF Provider Bulletin - Optum Change Healthcare Outage - March 11, 2024

icon PDF EVV Claims Matching Resumes April 1, 2024 - Unmatched EVV Claims Will Deny for Payment

icon PDF Provider Bulletin - Optum Change Healthcare Outage- February 29, 2024 Update 

icon PDF Provider Bulletin-Optum Change Healthcare Outage 

icon PDF Change to Room and Board Payments for Substance Use Disorder Residential Treatment – Effective March 18, 2024

icon PDF Provider Notification - ProgenyHealth Partnership

icon PDF Prior Authorization Requirement Changes- Obstetrical Labor with Delivery-- Effective February 1, 2024

icon PDF LTSS Prior Authorization Fax Number Change-- Effective March 1, 2024


2023 Updates/Events

icon PDF How to Correct Claims in Availity

icon PDF Update to Reimbursement Rates for Ambulatory Surgical Center Provider Notice

icon PDF Availity Essentials – New Appeals Functionality

icon PDF 2023 Primary Care Provider Pay-For-Quality Bonus Program Overview

icon PDF 2023 Primary Care Provider Pay-For-Quality Program Announcement Letter

icon PDF Value Added Services - Effective September 1, 2023

icon PDF Molina Legacy Provider Portal Sunsetting June 22 – 30 Day Notice

icon PDF Molina Healthcare's Legacy Provider Portal Sunsetting June 22, 2023

Spell of Illness Extension for COVID-19 Related Inpatient Hospital Claims Ending with End of PHE

Multiple COVID-19 Flexibilities for Services Ending May 11, 2023

Texas Health Steps Flexibilities for Telemedicine (Audio-visual) and Telephone (Audio-only) Delivery Training Ending May 11, 2023

icon PDF HHSC Policy Flexibility for Member State Fair Hearings ends on May 11, 2023

icon PDF Co-pays for some CHIP services will resume starting- May 12, 2023

icon PDF Update to Ambulance Transportation Services Prior Authorization and Billing Requirements - Effective April 17, 2023

icon PDF Behavioral Health Appointment Availability



icon PDF Explanation of Payment Refund Reporting on EOPs and 835 Files

icon PDF ProviderNet Sunset Notice - Effective January 1, 2023

icon PDF Notice of Change in Process - Incorrect Paper Claims Address

icon PDF Value Added Services Reference Grid - Effective September 1, 2022

icon PDF Case Management for Children and Pregnant Women Frequently Asked Questions

icon PDF Case Management for Children and Pregnant Women Prior Authorization Resources

icon PDF LTSS Billing Matrix Updates - Effective December 1, 2022

icon PDF ProviderNet Outage

icon PDF American Rescue Plan Act (ARPA) Program Announcement

icon PDF Impact to Explanation of Payments - DRG Value

icon PDF New Medicaid Benefit - Applied Behavior Analysis (ABA) Frequently Asked Questions – Effective February 1, 2022

icon PDF Molina Blank Check Issue Provider Notice

icon PDF Cigna-Molina Transition - Respite Authorization Update

icon PDF Potential Delay in Member ID Card Distribution

icon PDF Cigna-Molina Transition Provider Notice and FAQ

icon PDF Pre-Payment Correct Coding & Reimbursement Provider Overview

icon PDF Preferred Diabetic Supplies List

icon PDF Helpful Acronyms

icon PDF  After Hours Weekend Care Policy

icon PDF Value Added Services Reference Grid - Effective 9/1/2021

icon PDF EVV Recoupment Policy Notice - April 2021

icon PDF Certified Nurse Midwives May Be Reimbursed for Procedure Codes 99385 and 99386 Effective May 1, 2021 

icon PDF Maternal Opioid Misuse (MOM) Model

Healthy Texas Women Provider Resources

Healthy Texas Women

Healthy Texas Women Plus Services - Effective 9/1/2020

icon PDF Molina Healthcare of Texas ("Molina") Irving Office Notification of Address Change - Effective June 1, 2021

icon PDF Available Resources to Provide PPE for the Consumer Directed Services (CDS) Option

icon PDF Provider Memo: New Sepsis Guidelines - Effective January 1, 2021

icon PDF Molina Medicare Changes Affecting J Code Prior Authorization

icon PDF EVV Recoupment Policy Notice - December 2020

icon PDF Primary Care Provider Notice - Incontinence Vendor Change – Effective 5/1/2020

icon PDF DME Provider Notice – Incontinence Vendor Change – Effective 5/1/2020

icon PDF HHSC RFP Contract Announcement March 2020

icon PDF COVID-19 Prior Authorization Extensions Notice

icon PDF COVID-19 Provider Notice – March 11, 2020

icon PDF COVID-19 Provider Update – March 6, 2020

icon PDF Evaluation and Management (E/M) Coding and Claim Review Update – July 2020

icon PDF Molina Allowed In-Office Lab Test List, Effective 1.1.19

 

 
 


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