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Molina Provider Updates/Events

Current 2025 Updates/Events

icon PDF Legacy prior authorization tool retiring – Transition to Availity Essentials

icon PDF I n-Lieu-of Services Benefit Notice – Effective April 1, 2025

icon PDF Preferred Diabetic Supplies List

2024 Updates/Events

Unblocking UM Fax Numbers Notice

PEMS Data Alignment Frequently Asked Questions

High Dollar Claim Quick Reference Guide

CANS and ANSA Assessment Submission – Fax Number Change

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

CAHPS Provider Tips - Improving Patient Satisfaction

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

New Clinical Diagnostic Laboratory Services Payment Policy

STAR+PLUS Realignment Provider FAQs

LTSS Billing Process for Dual-Eligible Members

Value Added Services - Effective September 1, 2024

How to Manage Claims in Availity

Opt Out Notice: Medical Maternal Mental Health Treatment Network

Provider Bulletin - Balance Billing Prohibited

Behavioral Health Providers Appointment Availability Standards and Requirements

Appointment Availability and After Hours Requirements

Provider Bulletin - The SSI Group Outage - April 5, 2024

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

Provider Bulletin - The SSI Group Outage - March 18, 2024

Prior Authorization Reminder Notice - Cannabis Codes

MCG 28th Edition Provider Notice

MCG What's New for Payers in the 28th Edition

Provider Bulletin - The SSI Group Outage - March 11, 2024

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

EVV Best Practices to Avoid EVV Claims Mismatches

Provider Bulletin - The SSI Group Outage- February 29, 2024 Update

Provider Bulletin- The SSI Group Outage

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

Provider Notification - ProgenyHealth Partnership

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

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

How to Correct Claims in Availity

Update to Reimbursement Rates for Ambulatory Surgical Center Provider Notice

Availity Essentials – New Appeals Functionality

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

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

Value Added Services - Effective September 1, 2023

Molina Legacy Provider Portal Sunsetting June 22 – 30 Day Notice

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

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

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

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

Behavioral Health Appointment Availability

Explanation of Payment Refund Reporting on EOPs and 835 Files

ProviderNet Sunset Notice - Effective January 1, 2023

Notice of Change in Process - Incorrect Paper Claims Address

Value Added Services Reference Grid - Effective September 1, 2022

Case Management for Children and Pregnant Women Frequently Asked Questions

Case Management for Children and Pregnant Women Prior Authorization Resources

LTSS Billing Matrix Updates - Effective December 1, 2022

ProviderNet Outage

American Rescue Plan Act (ARPA) Program Announcement

Impact to Explanation of Payments - DRG Value

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

Molina Blank Check Issue Provider Notice

Cigna-Molina Transition - Respite Authorization Update

Potential Delay in Member ID Card Distribution

Cigna-Molina Transition Provider Notice and FAQ

Pre-Payment Correct Coding & Reimbursement Provider Overview

Helpful Acronyms

After Hours Weekend Care Policy

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

EVV Recoupment Policy Notice - April 2021

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

Maternal Opioid Misuse (MOM) Model

Healthy Texas Women Provider Resources

Healthy Texas Women

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

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

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

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

Molina Medicare Changes Affecting J Code Prior Authorization

EVV Recoupment Policy Notice - December 2020

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

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

HHSC RFP Contract Announcement March 2020

COVID-19 Prior Authorization Extensions Notice

COVID-19 Provider Notice – March 11, 2020

COVID-19 Provider Update – March 6, 2020

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

Molina Allowed In-Office Lab Test List, Effective 1.1.19

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