Attention Providers of Sections 17, 28, and 65: Kepro/Atrezzo Prior Authorization Backdate Extension for Services Impacted by January 1st Rate Study Increases

Feb 24, 2023

OMS has historically allowed up to five days from the service start date to enter prior authorization (PA) information into Kepro’s Atrezzo system. To implement January 1st rate study increases for services that have new modifiers or service changes, Kepro end-dated all previous PAs/cases on February 19th. Providers will need to enter information to create new cases requesting the new code and modifier combination temporarily extending our normal window for providers to back-date prior authorizations from five days to 30 days, only for services affected by the rate study increases.

This additional time is not considered a retro-authorization; it is only to enter information to create new cases for the end-dated authorizations. These new cases will allow for the updated code/modifier combination; providers should use the same termination date and same remaining units from the original, now end-dated, authorizations.

For more details about billing and authorizations for services for Sections 17, 28 and 65, see the Behavioral Health Rate Frequently Asked Questions (FAQs) document.

Please contact your Provider Relations Specialist with questions.