Ambetter Clinical Coverage/Medical Policy Updates
Ambetter from Arkansas Health & Wellness updates a select number of clinical coverage policies each month, ensuring the reviewal of all policies on an annual basis.
For a summary of pharmacy updates, please visit Provider news.
For current clinical and pharmacy policies, please visit: Clinical, Pharmacy and Payment policies.
Provider Notification
Ambetter from Arkansas Health and Wellness is amending or implementing new policies. Please see the table below for a list of these policies and their effective dates.
CP.MP.109 - Panniculectomy (PDF)
CP.MP.12 - Vagus Nerve Stimulation (PDF)
CP.MP.138 - Pediatric Heart Transplant (PDF)
CP.MP.167 - Intradiscal Steroid Injections for Pain Management (PDF)
CP.MP.169 - Trigger Point Injections for Pain Management (PDF)
CP.MP.203 - Diaphragmatic/Phrenic Nerve Stimulation (PDF)
CP.MP.250 - Lantidra (donislecel): Allogeneic Pancreatic Islet Celluar Therapy (PDF)
CP.MP.62 - Hyperhidrosis Treatments (PDF)
CP.MP.91 - Obstetrical Home Care Programs (PDF)
CP.MP.171 - Facet Joint Interventions (PDF)
CP.MP.120 - Pediatric Liver Transplant (PDF)
CP.MP.129 - Fetal Surgery in Utero for Prenatally Diagnosed Malformations (PDF)
CP.MP.164 - Caudal or Interlaminar Epidural Steroid Injections (PDF)
CP.MP.49 - Physical, Occupational, and Speech Therapy Services (PDF)
CP.MP.54 - Hospice Services (PDF)
CP.MP.110- Bronchial Thermoplasty (PDF)
CP.MP.121 - Homocysteine Testing (PDF)
CP.MP.123 - Excimer Laser Therapy for Skin Conditions (PDF)
CP.MP.139 - Low-Frequency Ultrasound and Noncontact Normothermic Wound Therapy (PDF)
ASAM 4th Edition for Youth/Adolescents
CP.MP.54 - Hospice Services (PDF)
CP.MP.107 - Durable Medical Equipment and Orthotics and Prosthetics Guidelines (PDF)
CP.MP.249 - Allogeneic Hematopoietic Progenitor Cell Therapy (PDF)
AR.CP.MP.31 - Cosmetic and Reconstructive Procedures (PDF)