This page is designated to providing needed resources to providers in the State of Mississippi regarding policies, procedures and reimbursement for the Mississippi Division of Medicaid and the Medicaid Managed Care Organizations Magnolia Health, Molina, and TrueCare.

Mississippi Division of Medicaid (DOM)

• Therapy Services Administrative Code (Title 23, Part 213). DOM’s core rulebook for outpatient speech-language pathology and audiology—definitions, covered indications, documentation, and PA requirements. Use this first when you need the legal/policy basis for coverage decisions. Mississippi Division of Medicaid –
  Link: https://medicaid.ms.gov/wp-content/uploads/2021/11/Title-23-Part-213-Therapy-Services-eff.-11.01.21.pdf
• Telemedicine Administrative Code (Title 23, Part 225). Lays out HIPAA, real-time tech, and service standards for telehealth visits—relevant when providing SLP/audiology via telehealth. Pair with any emergency updates when applicable. Mississippi Division of Medicaid –
  Link: https://medicaid.ms.gov/wp-content/uploads/2020/07/Title-23-Part-225-Telemedicine-eff-8.1.20.pdf
• DOM Fee Schedules (incl. Hearing Fee Schedule). Go here for current Medicaid rates and downloadable schedules; helpful for quick reimbursement lookups. Use the Hearing Fee Schedule for audiology-specific codes. Mississippi Division of Medicaid -+1
  Link: https://medicaid.ms.gov/providers/fee-schedules-and-rates/
  Hearing PDF: https://medicaid.ms.gov/wp-content/uploads/2021/01/Hearing-Fee-Schedule-Print-Date-01052021.pdf
• Provider Bulletins. Quarterly (and ad-hoc) DOM updates on policy, coding, and operational changes—great for catching edits that affect therapy claims. Check before implementing process changes. Mississippi Division of Medicaid –
  Link: https://medicaid.ms.gov/providers/provider-resources/provider-bulletins/
• Telligen (UM/QIO) Provider Manual. Explains utilization management processes DOM uses (including therapy sections and PA pathways). Useful when aligning documentation to UM review standards. msmedicaid.telligen.com+1
  Link: https://msmedicaid.telligen.com/wp-content/uploads/2024/07/MS-Provider-Manualv.2.pdf

Magnolia Health (MSCAN)

• Magnolia Medicaid Provider Manual (2025). Your master reference for Magnolia policies, claims, audits, appeals, and therapy services expectations. It also points to code-auditing rules that can affect SLP/audiology claims edits. magnoliahealthplan.com+1
  Link: https://www.magnoliahealthplan.com/content/dam/centene/Magnolia/medicaid/pdfs/2025%20Provider%20Manual.pdf
• Medicaid/CHIP Pre-Auth Check Tool. Quick way to see if a CPT/HCPCS needs PA before you schedule care. Use alongside your manual for code-specific confirmation. magnoliahealthplan.com
  Link: https://www.magnoliahealthplan.com/providers/preauth-check/medicaid-pre-auth.html
• Clinical & Payment Policies. Magnolia’s clinical criteria and payment policy library—where medical necessity and reimbursement rules live (e.g., evolving procedures impacting SLP/audiology). Check here when coverage hinges on policy rationale. magnoliahealthplan.com
  Link: https://www.magnoliahealthplan.com/providers/resources/clinical-payment-policies.html
• Payment Policies (Newsroom notice). Overview of Magnolia’s use of payment policies as edits in claims adjudication—handy context when troubleshooting denials. Integrate with Clinical & Payment Policies for a full picture. magnoliahealthplan.com
  Link: https://www.magnoliahealthplan.com/newsroom/payment-policies.html

Molina Healthcare of Mississippi (MSCAN)

• Molina Medicaid Provider Manual. Core guidance on Molina processes—claims, reimbursement, appeals, and prior authorization expectations. Use this to align clinic operations with Molina requirements. Molina Healthcare+1
  Link: https://www.molinahealthcare.com/providers/ms/medicaid/PDF/MS-Medicaid-Provider-Manual.pdf
• Frequently Used Forms (incl. PA Matrix & updates). Central hub for the Prior Authorization Matrix, code/benefit exceptions, and current PA update PDFs. Perfect for quick check of whether SLP/audiology services need PA and what form to use. Molina Healthcare
  Link: https://www.molinahealthcare.com/providers/ms/medicaid/forms/fuf.aspx
• PA Code Matrix (example). Matrix listing outpatient services requiring PA; pair with the updates on the Forms page for the latest quarter. Remember PA ≠ payment guarantee—still verify eligibility and benefits. Molina Healthcare
  Link: https://www.molinahealthcare.com/providers/ms/PDF/Medicaid/PA-code-matrix-q2.pdf
• Utilization Management (ePA options). Outlines electronic PA submission routes (portal and 278 transactions). Reduces turnaround time and improves tracking for therapy requests. Molina Healthcare
  Link: https://www.molinahealthcare.com/providers/ms/medicaid/resource/utilized_mgt.aspx
• Pharmacy Prior Authorization (SPBA forms). For meds tied to SLP/audiology plans of care (e.g., related Rx), use Molina’s pharmacy PA resources here. Coordinates with the medical PA process to prevent split denials. Molina Healthcare
  Link: https://www.molinahealthcare.com/providers/ms/medicaid/drug/Pharmacy-Prior-Authorization-Forms.aspx

TrueCare (d/b/a Mississippi True, MSCAN)

• TrueCare Mississippi Provider Manual (2025). The plan’s operational handbook—claims, reimbursement, referrals/PA, and quality requirements. Start here for TrueCare-specific workflow alignment. TrueCare+1
  Link: https://www.mstruecare.com/wp-content/uploads/2025/07/MS-MED-P-1902951-Mississippi-Provider-Manual_WEB.pdf
• Prior Authorization (MSCAN). Portal hub explaining how TrueCare evaluates PA (medical necessity/benefit limits) with links to submit requests. Use this before scheduling higher-cost or specialty services. TrueCare
  Link: https://www.mstruecare.com/ms/providers/provider-portal/prior-authorization/mscan/
• 2025 Prior Authorization List (MS Medicaid). Plain-English list describing services that require PA for TrueCare members; confirms network and emergency exceptions. Keep this PDF handy for front-desk scheduling checks. TrueCare
  Link: https://www.mstruecare.com/wp-content/uploads/2025/07/MS-MED-M-3939654_2025-MS-MCD-TrueCare-PA-List.pdf
• Provider Policies / Medical Policies. Centralized medical/administrative policies used to determine medical necessity and coverage—important when justifying SLP/audiology services. Cross-reference with prior auth list and manual. TrueCare+1
  Links:
  Policies hub: https://www.mstruecare.com/ms/providers/tools-resources/health-partner-policies/
  Medical policies: https://www.mstruecare.com/ms/providers/tools-resources/health-partner-policies/medical-policies/chip/

Additional Resources

• MississippiCAN Contracts/Resources (DOM). Current managed-care contracts and resources for Magnolia, Molina, and TrueCare—useful when you need contract language context. Mississippi Division of Medicaid –
  Link: https://medicaid.ms.gov/mississippican-resources/
• DOM Provider Resources hub. One-stop DOM page pointing to portals, forms, and provider tools (eligibility, claims status, etc.). Great for operational housekeeping. Mississippi Division of Medicaid –
  Link: https://medicaid.ms.gov/providers/provider-resources/