News and updates
Pharmacy Coverage for 90-day Medications
Community Solutions members now have access to 90-day supplies of certain medications via mail order. This allows members to receive extended day supplies delivered directly to them by CVS Caremark...
Prior Authorization Requirement Removed for CPT 97129 - Effective April 15, 2022
Effective April 15, 2022, CPT 97129 will no longer require a prior authorization for Medicaid, PacificSource Community Solutions.
97129 - Therapeutic interventions that focus on cognitive...
June 2022 Drug List Change Notification
Updates on Existing Criteria
June 2022. The following changes to criteria are effective June 22, 2022:
Prior Authorization Criteria – Clinical Updates
Abilify...
Continuous Glucose Monitoring - prior authorization required
Effective June 15, 2022, PacificSource will require prior authorization for Continuous Glucose Monitoring for members on our commercial plans. This change pertains to CPT codes E2102, K0554,...
Telehealth Place of Service Code 10 - Updated Information
On March 25, 2022, a notice was posted stating that Oregon Health Authority (OHA) made the determination that POS 10 for telehealth will no longer be recognized for Medicaid claims. OHA has now...
Telehealth Place of Service Code 10 - Effective Immediately
Oregon Health Authority (OHA) recently made the determination that POS code 10 for telehealth will no longer be recognized for Medicaid claims billing. PacificSource is following this guidance...
30-day Notification – Prior Authorization Required for 58571
Effective 04/25/2022, A prior authorization requirement will be added to code 58571 Laparoscopy, Surgical, with Total Hysterectomy, for Uterus 250g or Less; with Removal of Tube(s) and/or Ovary(s)...
Delay in AIM Radiology Program Roll Out
There was unfortunately an unforeseen technical challenge delaying the roll out of the AIM Radiology Program. We estimate this to be resolved April 3, 2022. Please continue to use InTouch for...
Access To Care Survey Is Now Conducted by Phone
As a provider, you understand how access to care is vital to healthy communities. As required by Centers for Medicare and Medicaid Services (CMS) and the National Committee for Quality Assurance (...
May 2022 Drug List Change Notification
Updates on Existing Criteria:
May 2022. The following changes to criteria are effective May 22, 2022:...