November 2025
National and Announcements
New year, extended telehealth benefits
Important IOP and PHP billing changes
Training
NORTHEAST: Get ready for 2 new MGBHP D-SNP plans
Northeast
MA: Need a prior auth? Reach for STAR
NY: TMS treatment available for NY Medicaid
Central
CO: Plan ahead and help members find you in 2026
MN: Prior authorization changes coming
Southeast
FL: Ultimate Health Plans members move to Optum
West
CA: Welcoming 3,500 Medicare Advantage members
October 2025
National and Announcements
Psychotherapy and E/M billing: As easy as 1-2-3
Updated National Network Manual
Training
NJ: Got questions about NJ FamilyCare?
Northeast
MA: MGBHP expands D-SNP plans in 8 counties
MA: Be Seen: Update AOE in the portal
NY: Medicaid OASAS billing changes coming
Central
MI: LOCUS and MichiCANs screenings required
MN: Provide care to those who care for us
Multiple: Medica to exit select markets in 2026
Southeast
LA: Important opioid treatment changes
West
AZ: Welcoming 2,000 seniors by year-end 2026
CA: Required annual articles are here
September 2025
National and Announcements
Don’t forget the rendering provider NPI on claims
Meet Medallion: Our new credentialing partner
Did you earn a National Gold Card prior authorization waiver?
Effective Sept. 1, 2025: Optum ABA Supplemental Clinical Criteria has been updated
Northeast
NY: Are your patients engaged?
Central
MO: Are you showing up in member searches?
NE: Don’t stall; update your license today
Southeast
August 2025
National
Check your Gold Card waiver status starting Sept. 1
National Network updates: effective Oct. 1, 2025
Timely Appointment Standards for Individual and Family Plan Members
The importance of metabolic testing for patients with severe mental illness
Northeast
NH: Confused about Behavioral Health Integration and collaborative care billing?
NY: Medicaid providers: OASAS outpatient rehab billing code changes
Central
OH: Prevent Medicaid claim edits and get paid faster
West
CA: California Network Manual updates
CA: The annual Provider Appointment Availability Survey begins this month
July 2025
National and Training
Level of care updates in 4th Edition Criteria affect national authorization exemptions for SUD PHP
Northeast
NY: Do your HCBS referrals and authorizations comply with the new guidelines?
Southeast
Central
WI: Forward Health Medicaid: Check out these tips to reduce common claim denials for timelier claim payments
West
CA: Just In: MY2024 Appointment Availability Survey results are now available
CO: Rocky Mountain Health Plans providers — update your email so you don’t miss key alerts
June 2025
National and Training
This month, the Provider Express homepage will have a new look for easier navigation
Northeast
NY: Starting July 1, providers must bill with modifier 93 for Medicaid audio-only telehealth claims
NY: Plan now for required audits
PA: Coverage for Children’s Health Insurance Program enrollees expands to 12 more counties June 16
Central
KY: Medicaid prior authorizations are back
MN: Start early to submit claims for dates of service through Dec. 31, 2024 before the June 30 deadline
West
CA: Support for providers affected by the southern CA wildfires available until Sept. 15, 2025
May 2025
National and Announcements
You can now check status and submit medical records for payment reviews online 24/7
Review this quick reference guide for key 2025 American Medical Association CPT code updates
There's no need to call us to report discharges — you can now use the secure provider portal
Northeast
MA: Review the MassHealth requirements for post-hospital discharge planning and tracking homelessness.
NJ: Review the UnitedHealthcare Community Plan of New Jersey requirements for member access to care
RI: As of Sept. 1, 2025, Optum will no longer manage behavioral health benefits for Rhode Island members
Southeast
VA: DMAS enrollment required to provide and get paid for services to Virginia Medicaid members
Central
IN: Learn how the Outpatient Care Engagement program streamlines care delivery while improving outcomes
April 2025
National and Announcements
April 24: Two-factor authentication is required to access the Provider Express secure portal
Learn how Emotional Wellbeing Solutions can expand patient relationships and your business
Make it easy for members to find you: update your provider data today
Northeast
MA: Removal of restrictions for certain Community Support Programs requires using updated billing codes
NY: How to increase patient engagement to improve outcomes
Southeast
VA: Billing update for outpatient services delivered under supervision
Central
TX: Texas Medicaid now covers Certified Family Partner support for caregivers of children and youth
West
CA: New state regulations require at least one mental health screening during pregnancy and postpartum
March 2025
National
Digital ABA Authorization Saves Time
Closing gaps: HEDIS measure updates
Annual wellness visits: Spring is the time to plant healthy habits
Northeast
Southeast
FL: Caregivers get some care now, too
FL: Medicaid now covers alternative services
Central
KY: Community-based support is available
West
CA: New California network manual
January/February 2025
National
New year, new National Network Manual
How you request IOP services is changing
What's new for Platinum in 2025?
Oxford behavioral membership has a new home
Northeast
MA: Professional development at your fingertips
NY: New! Child Health Plus adds benefits in 2025
NY: Updated reimbursement rates for Commercial plans
NY: Take two of these for better health
NY: Partner with us to support HARP members in recovery
VA: How you submit prior authorizations is changing
Southeast
TN: Attention out-of-network providers: Commercial Prior Authorization request submission change
Central
KY: Look out 2025 – We're ready to grow
MN and TX: Welcome XO Health
NM: Turquoise Care members get a lift
NM and TX: Providence Employee Health Plan change
West
AK, CA, MT and WA: Providence Employee Health Plan change
CA: Don't delay! Respond quickly to records requests
Announcements
CPT code 96146 has been added to the National Gold Card code exemption list
The STAR submission tool is available to all – training is now optional
Training
November 2024
National
Connecting care, mind and body - the benefits of value-based care
Updated state-specific mobile crisis listings now available
Attend a free webinar on Nov. 21 and learn about the Surest health plan
Help more patients find your SUD programs
More convenience ahead for the online STAR prior authorization tool
Does the HIPAA privacy rule always rule?
Central
Change to UnitedHealthcare Community Plan of Minnesota Medicaid coverage for 2025
Northeast
Pennsylvania: Now you can submit prior authorization requests online any time
New Hampshire: Optum will no longer manage behavioral health benefits for Harvard Pilgrim Stride
West
CA: Key reminders for providers
WA: Benefits administration change for Premera Blue Cross Medicare Advantage
Highlight your trauma expertise in the Optum provider directory so members can find you at a glance
Southeast
Florida: New Areas of Attested Expertise Available to you in 2025
Louisiana: Learn what you need to do so you can assist those in crisis
Louisiana: Submitting Commercial prior authorization requests is easier with a new online process
Mississippi: Submit your prior authorization requests online any time
October 2024
National
Medicare prior authorization list is now online
National Gold card waivers effective Oct. 1
Free, live, accredited webcast Nov 6: Lethal Means Saftey: Critical focus in suicide prevention
2023 claim audits coming for Oscar Health Plan members
Feel the need for speed? The Provider Express secure portal delivers!
Central
Northeast
New York: Foster care provider education updated
West
Arizona: New appointment availability training required for Medicare providers
California: You'll start seeing the standard Optum logo on provider and member communications
September 2024
National
Go for the Gold Card - check your waiver status today
Central
Texas: Texas moms need you. Help them find you by identifying as a maternal mental health provider.
Northeast
Connecticut: Numbers don’t lie. Except on outdated ID cards
New York: Notification required for SUD complex care
Rhode Island: Enroll with Medicaid to prevent claim denials
August 2024
July 2024
National
Want to Provide Intensive Outpatient Services to Medicare Members?
New areas of expertise show providers’ military affiliations
Merchant ID needed to process Care Cash debit cards
Updated National Network Manual now available
Transition to ASAM 4th Edition criteria underway
Central
NE: Claims being denied for one of these common reasons?
Training
Diversify Your Business With EAP Referrals
Announcements
It’s Now Easier to Find Prior Authorization Information on Provider Express
Update your communication preferences in My Practice Profile