MedicaidAdministrativeHigh impact
January 2022 Medicaid Information Bulletin
Utah Medicaid·UT·Government Programs
Effective date
Jan 1, 2022
We identified it
Jun 21, 2026
Summary
Utah Medicaid issued comprehensive policy updates effective January 1, 2022, including new COVID-19 vaccination counseling billing with CPT 99401-CR, provider enrollment validation requirements by July 1, 2022, and expanded pharmacist prescribing authority. Multiple pharmacy billing changes, drug list updates, and administrative requirements also take effect.
Action Required
Immediately: Begin billing COVID-19 vaccination counseling visits using CPT 99401 with CR modifier directly to fee-for-service Medicaid (bypass managed care). By July 1, 2022: All Utah Medicaid providers must validate enrollment in PRISM system, including updating CLIA certificates in Step 5, completing EDI enrollment in steps 8, 9, and 13, and selecting at least one specialty in step 3. Update pharmacy billing systems with new Health Choice Utah PBM information (BIN: 610830, PCN: RRXHCU). Claims will be denied without proper CLIA certification and enrollment validation.