Delaware Medicaid and D-SNP
Medical & Reimbursement Policies
Provider Notifications
January 5, 2024
The policies below have been updated:
- HHO-DE-RP-1135 Respite Care-Pediatric/Non-LTSS
- HHO-DE-RP-1134 Respite Care-LTSS
- HHO-DE-RP-1138 Private Duty Nursing
- HHO-DE-RP-1004 Dental Services Under the Medical Benefit
- HHO-DE-RP-1117 Annual Behavioral Health Well Check
- HHO-DE-RP-1146 Incarcerated Members
- HHO-DE-RP-1139 Radiopharmaceutical/Radiology
- HHO-DE-MP-1015 Drug Testing
February 1, 2024
The policies below have been updated:
- HHO-DE-RP-1260 Doula Services
- HHO-DE-RP-1137 Behavioral Health Under 18
- HHO-DE-RP-1124 Well Visits for Adults and Women and Children
- HHO-DE-RP-1148 Hospice Reimbursement
- HHO-DE-MP-1228 Vision Therapy (Orthoptics and Pleoptics)
March 8, 2024
The policies below have been updated:
- HHO-DE-RP-1141 Clinical Trial
- HHO-DE-RP-1130 Home Delivered Meals for LTSS Members
- HHO-DE-RP-1129 Assistant Surgeon
- HHO-DE-RP-1128 Multiple Imaging Reduction
- HHO-DE-RP-1260 Doula Services
- HHO-DE-MP-1180 Scanning Computerized Ophthalmic Diagnostic Imaging
- HHO-DE-RP-1149 Infusion Site of Care
- HHO-DE-MP-1009 Deep Brain Stimulation
- HHO-DE-MP-1008 Carpal Tunnel
- HHO-DE-MP-1257 Bioengineered Skin Replacement Therapy
- HHO-DE-MP-1105 Bone Mineral Density
March 25, 2024
The policies below have been updated:
- HHO-MP-1131 Responsive Neurostimulation
- HHO-RP-1125 SDAC-LTSS
- HHO-RP-1007 Mental Health Treatment Services Over 18
- HHO-MP-1146 Fecal Microbiota Transplantation
The policies below have been archived:
- HHO-MP-1021 Islet Cell Transplantation
- HHO-MP-1043 Treatment of Twin-Twin Transfusion Syndrome with Amnioreduction and/or Fetoscopic Laser Therapy
- HHO-MP-1155 Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers)
- HHO-MP-1146 Fecal Microbiota Transplantation
May 6, 2024
The policies below have been updated:
- HHO-DE-MP-1002 Pharmacogenomic Testing
- HHO-DE-MP-1004 Bariatric Surgery
- HHO-DE-MP-1005 Wireless Capsule Endoscopy
- HHO-DE-MP-1007 Colorectal CA Screening
- HHO-DE-MP-1022 Transcatheter Pulmonary Valve Implantation
- HHO-DE-MP-1024 Aqueous Shunts
- HHO-DE-MP-1034 Treatment of Malignant Skin Lesions
- HHO-DE-MP-1044 Cognitive Rehabilitation
- HHO-DE-MP-1050 Experimental/Investigational Services
- HHO-DE-MP-1057 Coronary Revascularization
- HHO-DE-MP-1090 Manipulation Under Anesthesia
- HHO-DE-MP-1158 Prostate disease: Diagnosis, Staging and Treatment
- HHO-DE-MP-1238 Electrical Nerve Stimulation
- HHO-DE-MP-1258 Sleep Apnea
- HHO-DE-RP-1112 Skilled Nursing Facility
- HHO-DE-MP-1026 Cardiac Rehab
- HHO-DE-MP-1074 Concussion Testing
- HHO-DE-MP-1039 Negative Pressure Wound Therapy
- HHO-DE-MP-1110 Fetal Surgery for prenatally diagnosed Malformations
- HHO-DE-MP-1117 Urinary Incontinence Therapy
- HHO-DE-MP-1131 Myoelectric Prosthetic Components for the upper limb
- HHO-DE-MP-1250 BRCA1&BRCA2 genetic mutation testing and related genetic counseling
- HHO-DE-MP-1138 Wearable Cardioverter-Defibrillator
- HHO-DE-RP-1140 Telehealth
The policies below have been archived:
- HHO-DE-MP-1021 Islet Cell Transplantation
- HHO-DE-MP-1043 Treatment of Twin-Twin Transfusion Syndrome with Amnioreduction and/or Fetoscopic Laser Therapy
- HHO-DE-MP-1195 Reproductive Technology, Assisted
- HHO-DE-MP-1196 Orthopedic Applications of Platelet-Rich Plasma
- HHO-DE-MP-1197 Placental and Umbilical Cord Blood as a Source of Stem Cells
- HHO-DE-MP-1198 Extracorporeal Shock Wave Therapy for Musculoskeletal Conditions and Soft Tissue Wounds Surgery
- HHO-DE-MP-1199 Radiofrequency Ablation of Peripheral Nerves to Treat Chronic Knee Pain
- HHO-DE-MP-1200 Subtalar Arthroereisis
- HHO-DE-MP-1202 Allergy Testing – In Vitro
- HHO-DE-MP-1137 Treatment of Hyperhydrosis
- HHO-DE-MP-1177 Electroretinography
- HHO-DE-MP-1063 Devices Used for the Treatment of Obstructive Sleep Apnea in Adults
- HHO-DE-MP-1064 Diagnosis and Treatment of Obstructive Sleep Apnea for Adults
- HHO-DE-MP-1065 Diagnosis and Treatment of Obstructive Sleep Apnea in Pediatric Individuals
June 20, 2024
The policies below have been updated:
- HHO-DE-MP-1088- Electroencephalogram (EEG) Technologies
- HHO-DE-MP-1099- Corneal Surgery to Correct Refractive Errors, Phototherapeutic Keratectomy and Corneal Collagen Cross-Linking Surgery
- HHO-DE-MP-1116- Contraceptive Management
- HHO-DE-MP-1126- Transcatheter Mitral Valve Repair/Replacement
- HHO-DE-MP-1169-Diagnosis and treatment of sexual male dysfunction
- HHO-DE-MP-1170- Autonomic nervous function testing
- HHO-DE-MP-1193- Biofeedback
- HHO-DE-MP-1047 Medication for Opioid Use Disorder
- HHO-DE-MP-1130 Treatment of Benign or Premalignant Skin Lesions
- HHO-DE-MP-1156 Treatment of Abnormal Uterine Bleeding and Fibroids
- HHO-DE-MP-1190 Hearing Loss and Implants
- HHO-DE-MP-1203 Noncovered Services and Procedures
- HHO-DE-MP-1211 Gene Expression Profiling in Tumor Tissue
- HHO-DE-MP-1234 Transcatheter Closure Devices for Septal Defects
- HHO-DE-MP-1242 Allergy Skin Testing
- HHO-DE-RP-1005 Facility Based Mental Health Services
- HHO-DE-RP-1131 Tobacco Cessation
The policies below have been archived:
- HHO-DE-MP-1160 Eligible Providers
- HHO-DE-MP-1161 Hospital Admission Provisions (Benefits after contract termination)
- HHO-DE-MP-1179 Rhinomanometry
- HHO-DE-MP-1157 Endovascular/Endoluminal Stent Grafts
- HHO-DE-MP-1225 Endobronchial Valve Surgery
- HHO-DE-MP-1235 Gastric Electrical Stimulation, Gastric Pacing
- HHO-DE-MP-1151 Percutaneous Left Atrial Appendage Closure (LAAC) Device
- HHO-DE-MP-1062 Concurrent Care
July 11, 2024
The policies below have been updated:
- HHO-DE-MP-1205 Testing for Genetic Disease
- HHO-DE-MP-1214 Mammography
- HHO-DE-MP-1218 Ablation of Miscellaneous Solid Tumors
The policies below have been archived:
- HHO-DE-MP-1154-001 Physical Medicine
- HHO-DE-MP-1239 Telestroke
September 9, 2024
The policies below have been updated:
- HHO-DE-MP-1219 Photodynamic Therapy with Porfirmer Sodium
- HHO-DE-MP-1229 Ultraviolet Light Therapies
- HHO-DE-MP-1233 Second Surgical Assistant for Cardiovascular Surgery
- HHO-DE-MP-1259 Transplants
The policies below have been archived:
- HHO-DE-MP-1017 Kidney Transplant
- HHO-DE-MP-1124 Liver Transplant
- HHO-DE-MP-1051 Small Bowel, Small Bowel/Liver and Multivisceral Transplant
- HHO-DE-MP-1108 Heart/Lung
- HHO-DE-MP-1221 Corneal Transplant
October 3, 2024
The policies below have been updated:
- HHO-DE-RP-1118 Inpatient Readmissions for Acute Care an Inpatient Admissions
- HHO-DE-RP-1111 Home Health Services
November 15, 2024
The policies below have been updated:
- HHO-DE-MP-1152 Cardiac Monitors
- HHO-DE-MP-1011 Genetic Testing for Congenital Abnormalities
- HHO-DE-MP-1204 Genetic Testing for Cystic Fibrosis
- HHO-DE-MP-1207 Genetic Testing for Colorectal Cancer Susceptibility
- HHO-DE-MP-1210-002 Oncologic Genetic Testing Panels
- HHO-DE-MP-1237-002 Posterior Tibial Nerve Stimulation
- HHO-DE-MP-1253-002 Ultrasound Guidance for Joint, Tendon, Tendon Sheath, and Trigger Point Injections
- HHO-DE-MP-1003-002 Abdominoplasty and Panniculectomy
- HHO-DE-MP-1148-002 Electrical Bone Growth Stimulation- Spinal
- HHO-DE-MP-1149-002 Nonspinal Bone Growth Stimulation
- HHO-DE-MP-1208-002 Maternal Genetic Testing: Fetal Aneuploidy Testing Using Noninvasive Cell-Free Fetal DNA
- HHO-DE-MP-1265-001-Esketamine
- HHO-DE-RP-1006-001-Residential Treatment Services-SUD
- HHO-DE-RP-1120-002 Chiropractic Benefits and Services
- HHO-DE-RP-1122-002 Ambulatory Surgical Centers
The policies below have been archived:
- HHO-DE-MP-1187 Cardiac Ablation Procedures
- HHO-DE-MP-1048 Artificial Pancreas
- HHO-DE-MP-1162 Electroconvulsive Therapy
- HHO-DE-MP-1175 Home Prothrombin Time INR Monitoring for Anticoagulation Management
- HHO-DE-MP-1143 Physician Certification and Recertification of Home Health Services