News and updates
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:...
Correction to Prior Notice: New Radiology Program Effective April 1, 2022
Our prior notice incorrectly listed the portal opening date as March 13, 2022. The correct portal open date is March 21, 2022 for dates of service April 1, 2022 and after. We apologize...
Access to Standards Content
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...
March 2022 drug list change notification (Medicaid)
Quantity limit updates
The following changes to the covered drug list are effective March 15, 2022:
Type of Change: Utilization management added
Epinephrine solution auto-...