Medicare Advantage home health care: Clarifications about adding disciplines and substituting services provided by clinicians with lower-level credentials

Effective June 1, 2021, CareCentrix^® manages authorizations for home health care services for Medicare Plus Blue^SM and BCN Advantage^SM members.

Here are some clarifications on this new program:

• For Medicare Plus Blue members who receive services in Michigan, you don't need to submit requests to add disciplines to existing 30-day episodic authorizations that have already been approved by CareCentrix.
• For BCN Advantage members, you don't need to update approved authorizations when services are provided by a clinician with a lower-level credential than the clinician who was authorized by CareCentrix.

See the detailed provider alert to learn more about these clarifications, including information to help you determine which HCPCS codes are associated to revenue codes by discipline.

Posted: July 2021
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network