Medicare AdvantageAdministrativeMedium impact
Mutual News December 2024 Newsletter
Medical Mutual of Ohio·Mutual News Newsletter
Effective date
Apr 1, 2025
We identified it
Jun 20, 2026
Summary
Medical Mutual released their December 2024 newsletter with multiple updates including new reimbursement policies effective April 1, 2025, revised Corporate Medical Policies for numerous drugs and procedures, and new CMS quality measures for 2025 STAR ratings affecting concurrent opioid/benzodiazepine prescribing and anticholinergic medications in older adults.
Action Required
By April 1, 2025: Review and implement new Facility Billing for Professional Services (RP-202504) and Evaluation and Management Services (RP-202505) reimbursement policies at MedMutual.com/Provider > Policies and Standards > Reimbursement Policies. Immediately: Update provider contracting contact number to 1-800-625-2583. Review revised Corporate Medical Policies for applicable specialty drugs and procedures to ensure current prior authorization and coverage requirements are followed.