Molina Provider Updates/Events
Current 2025 Updates/Events
Prior Authorization (PA) Application Sunsetting in Availity Payer Spaces - Effective August 25, 2025
Provider Bulletin - Availity Claims Reconsideration - June 10, 2025
Separate Reimbursement of Certain Inpatient High Cost Drugs Provider Notice
PEMS Go Live Provider Notice - Delegates - Effective May 30, 2025
PEMS Go Live Provider Notice - Effective May 30, 2025
Billing Taxonomy Requirement Reminder
Legacy prior authorization tool retiring – Transition to Availity Essentials
In-Lieu-of Services Benefit Notice – Effective April 1, 2025
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
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
Provider Bulletin - The SSI Group Outage - March 11, 2024
EVV Claims Matching Resumes April 1, 2024 - Unmatched EVV Claims Will Deny for Payment
Provider Bulletin - The SSI Group Outage- February 29, 2024 Update
Provider Bulletin- The SSI Group Outage
Provider Notification - ProgenyHealth Partnership
LTSS Prior Authorization Fax Number Change-- Effective March 1, 2024
+Previous Updates/Events
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
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
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
American Rescue Plan Act (ARPA) Program Announcement
Impact to Explanation of Payments - DRG Value
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
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 Plus Services - Effective 9/1/2020
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
