| Category | Flexibility / Change Description | Partners UM Guidance |
| Durable Medical Equipment (DME) | All temporary DME prior authorization and quantity limit waivers for PA. | Prior authorization waived for DME requests. |
| DME | DMEPOS coverage for HCPCS A4928, surgical mask, per 20. | Prior authorization waived for DME requests. |
| Obstetrical Services | Maternal Support Services: Home Visit for Newborn Care and Assessment via telemedicine audio-visual communication (CPT code 99502). | Add GT CR modifiers if provided via temporary telehealth flexibilities. Providers are not required to obtain prior authorization prior to receiving services via telemedicine. |
| Obstetrical Services | Maternal Support Services: Home Visit for Postnatal Assessment via telemedicine audio-visual communication (CPT Code 99501).
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Add GT CR modifiers if provided via temporary telehealth flexibilities. Providers are not required to obtain prior authorization prior to receiving services via telemedicine. |
| Outpatient Specialized Therapies (OST) | Temporary telehealth flexibilities activated for audiology CPT codes 92630 and 92633. | Add GT CR modifiers if provided via temporary telehealth flexibilities. Providers do not need to submit new PA requests for service delivery via telehealth. |
| OST | Temporary telehealth flexibilities activated for occupational therapy CPT codes 97165, 97166, 97167, 97168, 97750, 92065, 92526, 97110, 97112, 97116, 97530, 97533, 97535, 97542, and 97763. | Add GT CR modifiers if provided via temporary telehealth flexibilities. Providers do not need to submit new PA requests for service delivery via telehealth. |
| OST | Temporary telehealth flexibilities activated for physical therapy CPT codes 97161, 97162, 97163, 97164, 97750, 97110, 97112, 97116, 97530, 97533, 97535, 97542, 97763, and 95992.
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Add GT CR modifiers if provided via temporary telehealth flexibilities. Providers do not need to submit new PA requests for service delivery via telehealth. |
| OST | Temporary telehealth flexibilities activated for respiratory therapy CPT codes 94010, 94060, 94150, 94375, and 99503. | Add GT CR modifiers if provided via temporary telehealth flexibilities. Providers do not need to submit new PA requests for service delivery via telehealth. |
| OST | Temporary telehealth flexibilities activated for speech-language pathology CPT codes 92630, 92633, and 96125. | Add GT CR modifiers if provided via temporary telehealth flexibilities. Providers do not need to submit new PA requests for service delivery via telehealth. |
| Personal Care Services (PCS) | Authorization for In-Home PCS delivered in a temporary alternate primary private location. | All existing PAs will be continued through the duration of the flexibility period.
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| Private Duty Nursing (PDN) | Lifting PA requirement obtained when additional PDN hours are needed to cover unscheduled school closures for beneficiaries that have a current PDN PA certification. | PDN (for pediatric and adult beneficiaries) may be provided without prior authorization.
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| PDN | Lifting the PA requirement for short-term increase in PDN hours (up to 4 weeks) for any PDN beneficiary that has a current PDN PA certification. | PDN (for pediatric and adult beneficiaries) may be provided without prior authorization. |
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