FEP Utilization Management Guidelines - Provider Newsletter March 2024

BLUECONNECT

Providers

March 2024

In This Issue

►	March news: Executive summary

►	CMS changes delay annual fee schedule updates

►	AZ Blue welcomes you to the Availity Essentials portal

►	Introducing two new code edits

►	Prior authorization updates effective April 1

►

Where to find FEP UM guidelines

FEP Utilization Management Guidelines include hearing aid information

Looking for information about hearing aids for Federal Employee Program^® (FEP^®) members? Or inpatient skilled nursing facility services? You can find both in FEP’s Utilization Management (UM) Guidelines. We use these administrative guidelines to determine medical necessity for members with FEP plans. The guidelines cover the following topics.

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Inpatient Skilled Nursing Facility Services

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Outpatient High-Technology Diagnostic Imaging: CT/MRI/PET

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Non-emergency Air Ambulance Transport

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Hearing Aids

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Telemedicine

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Facial Gender-Affirming Surgery

FEP resources for providers

The UM guidelines are listed on a separate tab, next to the medical policies tab, on the FEP Policies and Guidelines page. The medical policies span many more topics than the UM guidelines.

Note: For additional information, you can also access FEP benefit books on the Plan Brochures page.

We have added links to the FEP UM guidelines on the AZ Blue Prior Authorization and Medical Policies page (under the FEP header) and in the provider portal at azblue.com/providers> Practice Management > Medical Policies > FEP UM Guidelines.

In This Issue

►	March news: Executive summary

►	CMS changes delay annual fee schedule updates

►	AZ Blue welcomes you to the Availity Essentials portal

►	Introducing two new code edits

►	Prior authorization updates effective April 1

►

Where to find FEP UM guidelines

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