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MedicaidAdministrativeMedium impact

Marketplace Policies and Medicaid Coverage

Mississippi Medicaid (DOM)·MS · Ophthalmology, Optometry, Physical Therapy +3 more·Claims & Billing
Effective date
Jul 1, 2026
We identified it
Jun 21, 2026
Days to comply
9 days

Summary

Mississippi Medicaid has multiple updates including drug formulary changes, hospital payment methodology updates, vision service claim reprocessing, passive enrollment transitions, and new virtual assistant services. Most changes are administrative with specific effective dates in July 2026.

Action Required

Before Jul 1, 2026
By July 1, 2026: Update billing systems to reflect Farxiga formulary change to non-preferred status and transition to generic dapagliflozin. Monitor remittance advices for automatic reprocessing of vision service claims (codes 92002-92371) with corrected fees. When submitting therapy PAs to Telligen, include appropriate modifiers (GN, GO, GP) that match exactly with claim modifiers to prevent denials. Review hospital discharge transportation protocols for Medicaid members.

Affected Billing Codes

92002
92004
92012
92014
92015
92018
92019
92020
92025
92060
92071
92072
92081
92082
92083
92100
92132
92133
92134
92136
92201
92202
92230
92235
92240
92242
92250
92260
92265
92270
92273
92274
92283
92284
92285
92286
92287
92310
92311
92312
92313
92325
92326
92340
92341
92342
92352
92353
92354
92355
92358
92371