Provider Policy Update

Date: 09/15/18

Buckeye is implementing new policies that may impact your practice or facility. The policies will apply to all products
including Medicaid, MyCare, Allwell (Medicare DSNP & HMO) and Ambetter (Exchange). Please see the following summary of the policies:

• Non-obstetrical Pelvic and Transvaginal Ultrasounds: define payment criteria for multiple non-obstetrical ultrasound images in a single session.
• Monitored Anesthesia Care: outlines the indications for when Monitored Anesthesia Care is considered medically necessary Gastrointestinal Endoscopy.
• Place of Service Mismatch: the purpose of this policy is to identify instances in which a procedure code is billed with an inappropriate place of service per CPT/HCPCS guidelines.

You may also access the detailed policies on our provider website. Please review the policies and contact Buckeye Provider Services at 1-866-296-8731 with any questions. Thank you for your partnership and the care you provide to Buckeye members.