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Mutual News December 2025 Newsletter
Medical Mutual of Ohio·Pain Management, Orthopedics·Mutual News Newsletter
Effective date
Jan 28, 2026
We identified it
Jun 20, 2026
Summary
Medical Mutual is implementing major changes including expanded prior authorization requirements for pain management and musculoskeletal services starting January 28, 2026, new reimbursement policies for facility billing and revenue code requirements, and transitioning to monthly newsletter communications.
Action Required
By January 28, 2026: Register with Cohere Health portal at www.coherehealth.com/register for all prior authorization requests. Review updated prior authorization codes at www.medmutual.com/PAL2026. By February 1, 2026: Update billing system to include valid revenue codes with corresponding HCPCS or CPT codes for all facility claims per new policy RP-202602. By April 1, 2026: Ensure therapeutic drug administration/injection services are billed only on CMS-1500 forms per policy RP-202504. Sign up for monthly email notifications on MedMutual provider website.