Billing Requirements for Medicaid Direct Providers
Topics Related to Division of Health Benefits
Forum to be held Tuesday, June 25 in Concord.
States must revalidate the enrollment of all providers at least every five years to ensure the information on record is accurate and current.
Look for details on training in June related to these changes.
The audit will sample fee-for-service claims collected for a full year – July 1, 2024, through June 30, 2025.
Recent State Plan Amendment outlines duties of a responsible third party
New separately reimbursable CPT codes in the ambulatory surgery setting
Providers should work with their Medicaid beneficiary’s health plan and Tailored Care Manager to transition the members to 1915(i) services.
Revised policy in addition to services outlined in Maternity Coverage and Reimbursement Bulletin posted Oct. 23, 2023.