Provider
QP6-22 New Telehealth Place of Service Code 10
Program effective Date: Jan 12, 2022
Program effective Date: Jan 12, 2022
Program effective Date: Jan 03, 2022
Program effective Date: Jan 03, 2022
Program effective Date: Jan 03, 2022
Program effective Date: Jan 03, 2022
Program effective Date: Jan 03, 2022
Prior Authorization, Quantity Limit
Program effective Date: Sep 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Sep 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Aug 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Jul 01, 2025