Clarifications to Section 65 Medication Management Code Changes
This notice clarifies changes described in the Section 65 Medication Management Code Changes notice sent on May 16, 2025.
Medication management providers with existing authorizations for H2010 HF, H2010 HF AF, H2010 AF, and H2010 HA AF may continue to bill with these code-modifier combinations. However, medication management providers must discharge members from these authorizations in Atrezzo and submit new authorizations for H2010 or H2010 HA before November 12, 2025.
As of May 16, 2025, medication management providers must submit all new authorizations for medication management with either H2010 or H2010 HA.
Providers should carefully consider when to submit new authorizations because requesting a large volume of authorizations at once will mean that the same volume of continued stay reviews will be due at the same time.
For questions, please contact Pamela Grotton, Provider Relations Specialist.