Fast Facts Newsletter - July 2025
Summary
Effective 7/1/2025, non-urgent laboratory services performed by non-contracted labs for Medicaid and MinnesotaCare members are not covered, and the balance may not be billed to the member, so these members must be sent to HealthPartners contracted, in-network labs unless prior authorization is granted or the service is urgent or emergent. Formulary updates to be posted by 9/1/25 remove long-acting G-CSF products from the pharmacy benefit, and those medications are available on the medical benefit. The coverage updates add CPT codes 64596 and 64597 to the implanted peripheral nerve stimulation policy and clarify the documentation needed for lumbar spinal fusion when a member cannot complete physical therapy.
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