Policy Clarifications

This section is a list of correspondence sent out by Iowa Medicaid to clarify policy that affects each Managed Care Plan’s operation. Each of the policy clarifications listed here have been provided to the managed care plans. The managed care plans have attested to each policy clarification based on Iowa Medicaid business practices at the time of issuance.

While policy clarifications can affect providers, they may be specifically related to Managed Care Plan operational expectations. The Policy Clarifications in this section are also an important cross reference for any new informational letters and policy clarifications that have been implemented but are not yet reflected in the published Provider Manual.

Policy Clarifications (PCs) is a new tool available to our providers. In the past, PCs were made available upon request and were not made public. All historical PCs will have an issue date of April 8, 2022, for your reference.

The latest 10 Policy Clarifications appear below. To access other Policy Clarifications, use the search box, or perform an advanced search by clicking "Search Provider & Program Key Words/Year”.

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Iowa Medicaid Policy Clarifications


Letter # NameIssue DateEffective DateReplaced By
PC000269 Pic Rate Codes And Reimbursement Methodology11/15/2022Immediately
PC000265 Covid Vaccinations By Dds Clarification11/08/2022Upon Receipt
PC000267 Encounter Data Provider Crosswalk10/28/2022Immediately
PC000266 Enrollment Dates For Ihh Enrollees09/22/2022Immediately
PC000263 Emergency Dental Services Policy04/08/2022Immediately
PC000257 Ncci-Associated Modifiers_Unbundling_V204/08/2022Immediately
PC000256 Exceptions_To_Policy_(Etp)04/08/2022Immediately
PC000255 Ui Health Care State Directed Physician Payment04/08/2022Immediately
PC000254 Rate Increases04/08/2022Immediately
PC000253 Hcbs Waiver Relationship To State Plan Medicaid And Epsdt04/08/2022Immediately