Payment Policy
This notice is to clarify a segment of Fidelis Care's payment policy language applicable to all Fidelis Care Medicaid markets. Fidelis Care's payment policies are based on publicly distributed guidelines from established industry sources such as the Centers for Medicare and Medicaid Services (CMS), the American Medical Association (AMA), state health care agencies and medical specialty professional societies.
If you have questions about this information, please contact your Provider Relations representative.
- 3-Day Payment Policy: CC.PP.500 (PDF)
- Appropriate Place of Service (POS) Billing (PDF)
- Inpatient Notification: CPP-101 (PDF)
- Emergency Department Facility Coding: CPP-105 (PDF)
- Emergency Department Radiology Utilization: CPP-106 (PDF)
- Review of NOS, NEC, and Unlisted Codes: CPP-107 (PDF)
- Intensity Modulated Radiation Therapy (IMRT): CPP-108 (PDF)
- Inpatient Readmission: CPP-123 (PDF)
- Pre-Pay Code and Modifier Validation: CPP-152 (PDF)
- Inhaled Nitric Oxide for Preterm Infants: CPP-135 (PDF)
- Inpatient Hospital Short Stays: CPP-147 (PDF)
- Ultrasound in Pregnancy CP.MP.38 (PDF)
- Sepsis Diagnosis: CC.PP.073 (PDF)
- Pre-Payment and Post-Payment Review: CPP-102 (PDF)
- E/M Overcoding Policy: CPP-110 (PDF)
- Maximum Units for Reimbursement Policy: CPP-111 (PDF)
- Allergy Testing: CPP-112 (PDF)
- Breast Cancer Screening: CPP-113 (PDF)
- Renal Dialysis: CPP-114 (PDF)
- Long-Acting Reversible Contraception: CPP-125 (PDF)
- Procedure to Procedure Associated Modifiers: CPP-127 (PDF)
- Abdominal Aneurysm: CPP-129 (PDF)
- Comprehensive Payment Integrity: CPP-136 (PDF)
- Robotic Assisted Surgery: CPP-137 (PDF)
- Severe Malnutrition Policy: CPP-145 (PDF)
- GI Pathogen Nucleic Acid Detection Panel Testing Policy: CP.MP.209 (PDF)