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New Enrollment Required for Child Care Coordination ServicesAugust 15, 2025: This Update has been revised since its original publication. Revised information appears in red text on page 6.
Effective date
Jan 1, 2027
Identified
Aug 26, 2026
Summary
Starting January 1, 2027, Evolent Specialty Services will require prior authorization for 23 cardiology codes covering angioplasty, stent placement and atherectomy in the iliac, femoral and popliteal, tibial and peroneal, and inframalleolar arteries, plus code 92930 for placement of intracoronary stents. The requirement applies to Meridian Medicaid, Ambetter from Meridian Marketplace, and Wellcare Medicare including Wellcare Meridian Dual Align, which serve Medicaid, Marketplace and Medicare members in Michigan.
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What to do
Action · 2 steps
01Starting January 1, 2027: Billing team, get prior authorization through Evolent Specialty Services for codes 37254, 37256, 37258, 37260, 37263, 37265, 37267, 37269, 37271, 37273, 37275, 37277, 37280, 37282, 37284, 37286, 37288, 37290, 37292, 37294, 37296, 37298 and 92930 for members of Meridian Medicaid, Ambetter from Meridian Marketplace, and Wellcare Medicare including Wellcare Meridian Dual Align.
02For questions about specific codes or how these changes affect your practice, contact Provider Relations.
Original notice
New Enrollment Required for Child Care Coordination ServicesAugust 15, 2025: This Update has been revised since its original publication. Revised information appears in red text on page 6.
forwardhealth.wi.gov · Always check the source before changing claims.