Prior Authorization Changes in Response to COVID-19 Public Health Emergency

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:

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.

 

 

Department of Vermont Health Access

280 State Drive
Waterbury, Vermont 05671-1010
Phone: 802-879-5900
Fax: 802-241-0260

Department Contact List for customer service, program telephone and fax numbers, and staff email

Hours of Operation: Monday-Friday (Excluding Holidays) 7:45am - 4:30pm

Public Record Requests
Kelly Provost
DVHA Public Records Officer
AHS.DVHALegal@Vermont.gov
Visit the Agency of Administration site for the Public Records Database

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