If you are unsure about the coverage of a drug product, please contact the PBM help desk at 1-800-648-0790.

Please file adjustments for claims that may have been incorrectly paid. Only those products of the manufacturers which participate in the Federal Rebate Program will be covered by the Medicaid program. Participation may be verified in Appendix C, available at

Should you have any questions regarding any of the following messages, please contact Molina Medicaid Solutions at (800) 473-2783 or (225) 924-5040.

Attention Durable Medical Equipment (DME) Providers

Effective with date of service June 1, 2019, Medicaid guidelines for oxygen probes for use with an oximeter device are being updated. DME providers will submit the appropriate HCPCS code from the DMEPOS fee schedule to bill for these supplies. The rate on file for the HCPCS code includes reimbursement for the tape. The U5 modifier (oxygen probe for use with oximeter device, disposable) must be included on the prior authorization and claim for disposable oxygen probes. If the DME provider bills for a replacement oxygen probe, a modifier would not be used.

Medicaid will publish the new oxygen probe policy in the DMEPOS provider manual on

Questions regarding this message and fee for service claims should be directed to DXC Technology Provider Relations at (800) 473‐2783 or (225) 924‐5040. Questions regarding managed care claims should be directed to the appropriate managed care organization.