MedicaidPrior AuthMedium impact
March 2024 Medicaid Information Bulletin
Utah Medicaid·UT · Genetics, Pharmacy·Government Programs
Effective date
Mar 1, 2024
We identified it
Jun 21, 2026
Summary
Utah Medicaid has made three key changes: COVID-19 vaccine administration through pharmacies now requires 'MA' code for $40 administration fee, Whole Genome Sequencing no longer requires prior authorization and adds new PLA codes, and housing services provider manual has been updated with new enrollment requirements.
Action Required
By March 1, 2024: Billing team must update system to remove prior authorization requirements for Whole Genome Sequencing services. Add new PLA codes 0094U, 0425U, and 0426U to billing system for rapid and ultra-rapid WGS services. For pharmacies: ensure 'MA' code is submitted in professional service code field for COVID-19 vaccine administration to receive $40 administration fee, otherwise only vaccine cost and dispensing fee will be paid.