All PlansReimbursementMedium impact
Mutual News Q3 2023 Newsletter
Medical Mutual of Ohio·Family Medicine, Pediatrics, Psychiatry +1 more·Mutual News Newsletter
Effective date
Nov 1, 2023
We identified it
Jun 20, 2026
Summary
Medical Mutual released their Q3 2023 newsletter with key updates including new PO and PN modifier reimbursement policy effective November 1, 2023, and guidance on HEDIS metabolic monitoring requirements for children and adolescents on antipsychotic medications. Multiple medical policies were also revised or added between June-August 2023.
Action Required
By November 1, 2023: Billing team must implement new PO and PN Modifiers Reimbursement Policy (RP-202305) - review policy at MedMutual.com/Provider under Policies and Standards > Reimbursement Policies. For practices treating pediatric patients on antipsychotics: ensure proper coding using specified cholesterol, glucose, and HbA1c lab codes for HEDIS APM measure compliance. Update provider contracting contact number to 1-800-625-2583.