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MedicaidBilling CodesMedium impact

November 2024 Medicaid Information Bulletin

Utah Medicaid·UT · Pulmonology, Ophthalmology, Psychiatry·Government Programs
Effective date
Nov 1, 2024
We identified it
Jun 21, 2026
Days to comply

Summary

Utah Medicaid rescinded September 2024 changes that converted home ventilator codes E0465-E0468 from continuous to capped rental, reverting them back to continuous rental effective April 1, 2023. Additional updates include changes to mental health residential treatment transition days, psychiatric hospital IMD coverage limits, and closure of spectacle fitting codes 92340-92353.

Action Required

Action needed
By November 1, 2024: Billing team must update DME billing systems to process home ventilator codes E0465-E0468 as continuous rental items (not capped rental). Stop billing spectacle fitting codes 92340, 92341, 92342, 92352, and 92353 as these services are now included in eyeglass reimbursement rates. Update mental health billing to reflect 7-day (not 14-day) transition periods for residential treatment facilities with 17+ beds and 60-day maximum coverage for psychiatric hospital IMD admissions for ages 21-64.

Affected Billing Codes

E0465
E0466
E0467
E0468
92340
92341
92342
92352
92353