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Administrative (Non-Clinical Topics)

Document Title Document Type Document Size Effective Date
Abortion - (A006)  PDF 75kB 09/21/2017
Anti-Stockpiling Limits - (A009)  PDF 61kB 01/01/2021
Authorized Generics - (A008)  PDF 69kB 02/15/2021
Category III Current Procedural Terminology (CPT®) codes - (0558)  PDF 73kB 11/15/2020
Clinical Trials – (A003)  PDF 85kB 02/17/2021
COVID-19 Convalescent Plasma - (A013)  PDF 102kB 02/18/2021
Custodial and Non-Skilled Services - (A012)  PDF 76kB 09/01/2020
Emergency Room Services - (A005)  PDF 69kB 10/01/2020
Long Term Care Hospitals (LTCH)  - (A011)  PDF 72kB 09/01/2020
Midwife, Home Birth and Non-Clinical Maternal Services - (A002)  PDF 86kB 02/15/2021
Non-Participating Laboratory Services - (A001)  PDF 61kB 01/15/2021
Patient Assessments: Medical Necessity Decision Assist Guideline for Evaluations and Re-evaluations - (CPG 111)  PDF 221kB 07/15/2020
Preventive Care Services - (A004)  PDF 342kB 03/01/2021
Oct 10, 2018