New Payment Policy: Problem-Oriented Visits with Surgical Procedure (CC.PP.052) & Problem-Oriented Visits with Preventative Visits (CC.PP.057)

Date: 09/11/26

Managed Health Services (MHS) is announcing a new payment policy that applies to providers. This update supports consistent, accurate, and timely claims processing.

Effective Date

This policy is effective 9/19/2026. Claims processed on or after this date will follow the updated guidance. Line of Business: Marketplace

What Providers Should Do

1. Review the full payment policy Clinical Payment Policies | Ambetter from MHS Indiana
2. Validate billing and coding workflows align with the policy
3. Share this information with internal billing teams or vendors
   
   

Why This Policy Matters

This update helps ensure compliance with applicable requirements and promotes consistent reimbursement practices.

Resources & Support

• Payment Policy: Clinical Payment Policies | Ambetter from MHS Indiana
• Contact: (877) 647-4848 | Monday–Friday, 8:00 a.m.–8:00 p.m. EST

As always, thank you for being our partner in care. If you have any questions or require assistance, please contact the MHS Contact Center.