Effective March 31, 2025: New and Revised Clinical Payment Policies
Date: 12/30/24
Superior HealthPlan, Ambetter from Superior HealthPlan and Wellcare By Allwell present new and revised clinical payment policies as detailed below. As a result, the following policies have been posted on Superior’s Clinical, Payment and Pharmacy Policies webpage for awareness, prior to implementation:
POLICY | EFFECTIVE DATE | APPLICABLE PRODUCTS | NEW POLICY OVERVIEW OR UPDATED POLICY REVISIONS |
Allergy Testing and Therapy (TX.CP.MP.100) | March 31, 2025 | Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), CHIP, Health Insurance Marketplace (Ambetter from Superior HealthPlan | Revised Allergy Testing and Therapy policy to incorporate requirements provider medical recordkeeping requirements for allergy testing and therapy services and added provider attestation forms for non-Allergist specialty providers to policy. |
Endometrial Ablation (MC.CP.MP.106) | March 31, 2025 | Wellcare By Allwell[ HMO,HMO D-SNP] | New policy that describes the medical necessity guidelines for an endometrial ablation. |
To review all policies, please visit Superior’s Clinical, Payment and Pharmacy Polices webpage. For questions or additional information, please contact Provider Services at:
- 1-877-687-1196 (Ambetter from Superior HealthPlan)
- 1-877-391-5921 (Medicaid [STAR, STAR Health, STAR Kids, STAR+PLUS], CHIP)
- 1-800-977-7522 (Wellcare By Allwell - Medicare HMO)
- 1-877-935-8023 (Wellcare By Allwell - Medicare HMO DSNP)