MedicaidAdministrativeHigh impact
May 2024 Medicaid Information Bulletin
Utah Medicaid·UT·Government Programs
Effective date
May 1, 2024
We identified it
Jun 21, 2026
Summary
Utah Medicaid has issued multiple policy updates effective May 1, 2024, including prohibition of balance billing Medicaid members, removal of prior authorization requirements for specific spinal MRI codes, and enrollment restrictions for FQHCs and RHCs to single taxonomy codes.
Action Required
Immediately: Stop balance billing any Medicaid members - accept Medicaid/MCO payment as full reimbursement including deductibles and copays. Update billing system to remove prior authorization requirements for spinal MRI codes 72141, 72142, 72146, 72147, 72148, 72149, and 72156. FQHC and RHC providers must verify enrollment is limited to single taxonomy codes (261QF0400X or 261QR1300X). Billing team should review all Medicaid member accounts for inappropriate balance billing. Failure to comply with balance billing prohibition may result in referral to Utah Office of Inspector General.