Due to the COVID-19 Public Health Emergency, Vermont Medicaid is taking steps to ensure Vermonters have access to necessary care and that health care professionals can deliver that care in a safe and timely way.
Prior authorizations are required for the following services:
- Imminent Harm List
- Refer to the Preferred Drug List
- Services found on the Fee Schedule
- Items not found on the Waived Prior Authorization List (updated 9/25/2020)
Prior authorizations are not required for the following services:
Since the announcement that COVID-19 restrictions have been lifted in VT there has been an increase in questions about COVID-19 related billing. Although the state of emergency has been lifted for VT, the federal state of emergency and waivers related to the COVID-19 public health emergency are still in place. Prior authorizations that are currently waived continue to be waived under the federal public health emergency. The DVHA COVID-19 webpage is regularly updated and additional information will be provided when those restrictions will be re-implemented.
- Imaging Services - Imaging Service Prior Authorization No Longer Required
Effective June 1, 2021, imaging services will no longer be conducted by eviCore. DVHA will no longer require prior authorization for imaging codes. As always, please refer to DVHA’s fee schedule and to the DVHA COVID-19 webpage for codes waived during the Public Health Emergency.
- Durable Medical Equipment and Supplies — including continuous glucose monitors obtained from a pharmacy
- Dental Services including orthodontia
Information can be found at:
AHS Global Commitment Register, policy GCR 20-039.