Insurance Updates
Anthem
Recoupment Request for No Prior Authorization
The KAC is aware that providers have been receiving recoupment requests for lack of prior authorization. In late 2019/early 2020, the KAC was successful in stopping Anthem from requiring prior authorization for chiropractors through AIM in Kentucky. Providers should...
Anthem Update – Modifier Rules and Guidelines for “Always Therapy” Codes
Recently, Anthem announced they were changing their modifier rules for physical medicine and rehabilitation codes. This change took effect November 1, 2021. These codes and modifiers align with the codes the Centers for Medicare & Medicaid Services (CMS) has...
Humana
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WellCare
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Passport
Modifiers
Passport is now requiring “Always therapy codes” to be billed with the GP modifier. This was presented in the ENews here http://passporthealthplan.com/wp-content/uploads/2019/07/Therapy-Modifiers.pdf . Providers will need to...
Preauthorization
The KAC Insurance Relations Committee has some exciting news for your practice. Passport Health Plan has announced in its most recent ENews that Effective August 1st, 2019 Passport will no longer require preauthorization for treatment in your office. Over the...
Humana Medicaid
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Aetna Better Health
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Medicare
2025 Medicare Fee Schedule for Chiropractors
The fee schedule below is current as of 1/14/2025. Please note, facility fees are listed on the top row. Most chiropractors are NOT in a facility so please make sure you're looking at the correct line. The 2025 Medicare deductible is $257, an increase in $17 from...
Humana Medicare Advantage notice to patients
Some KAC members have contacted us about a Humana Medicare Advantage notice their patients received regarding 2025 coverage changes. The notice, part of the Annual Notice of Changes, highlights updates to the plan but doesn’t reflect full coverage details. It states...
Miscellaneous
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