MedicaidBilling CodesMedium impact
March 2025 Medicaid Information Bulletin
Utah Medicaid·UT · Wound Care, Pulmonology, General Practice +3 more·Government Programs
Effective date
Mar 1, 2025
We identified it
Jun 21, 2026
Summary
Utah Medicaid issued multiple policy updates with staggered effective dates from March to July 2025, including new adult dental benefits, telehealth policy changes, transportation restrictions, skin substitute billing updates, and durable medical equipment rental reversions. Key immediate changes include skin substitute codes now billable separately from application procedures and oxygen equipment reverting to continuous rental status.
Action Required
Immediately: Update billing system to bill skin substitute codes Q4186, Q4187, Q4101, Q4159, Q4160, Q4196, Q4197, Q4194, Q4282, Q4133, Q4132, Q4151 separately from application procedures for physician office and wound care clinic visits. By April 1, 2025: Update provider directory information in PRISM portal at https://prism.health.utah.gov/ to include required fields. Monitor for telehealth policy updates effective May 1, 2025. Change DME oxygen equipment codes E0424, E0431, E0434, E0439 back to continuous rental billing (backdated to April 1, 2023).