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Thank you for visiting the Kentucky Medicaid Website. Please use the navigation buttons at the left to navigate the site. If you have any questions, send email to: KY EDI HelpDesk


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Site Messages

October 19, 2020

Each year Kentucky Medicaid is required to provide an Upper Payment Limit demonstration for CMS on DME codes covered by Kentucky Medicaid. This demonstration must reflect reimbursement rates for Kentucky Medicaid are set at or below the rates for the same codes listed by Medicare. Kentucky Medicaid was notified by CMS that we were out of compliance and must make adjustments to our fee schedule. To bring Kentucky Medicaid into compliance the Department for Medicaid Services immediately ordered a rate change adjustment to the 2020 DME fee schedule retroactive to 1/1/2020. This resulted in paid claims with any codes having rate decreases to automatically trigger a recoupment. The recoupment was in error. The recouped amounts will be reprocessed and repaid. Kentucky Medicaid apologizes for the late notice and any inconvenience that this has or may cause. The new effective date of the rates is 11/15/20.

September 30, 2020
Public Notification Revised
Notification Revised-alphabetical by last name (Excel)
Notification Revised-alphabetical by last name (PDF)

July 22, 2020
Provider Relief Fund

The Department of Health and Human Services (HHS) has confirmed that for those providers who missed the deadline to apply for relief fund payments from the first general distribution, The deadline has been extended to Aug. 28, 2020. Providers may review the
News Article
Provider Relief Fund Website
Fact Sheet
FAQs
Recorded Webinar from June 25
Medicaid Provider Distribution application form and Instructions (Please download and read before going to the Enhanced Provider portal)
Enhanced Provider Relief Fund Payment Portal currently open to Medicaid/Medicaid managed care/CHIP Providers and dentists

For additional information, please call the Provider Support Line at (866) 569-3522; for TTY, dial 711 from 7 a.m. to 10 p.m. Central Time, Monday through Friday. Service staff members are available to provide real-time technical assistance, as well as service and payment support.

June 19, 2020
Kentucky Level of Care System (KLOCS)

New Kentucky Level of Care System (KLOCS) is an electronic system which streamlines and automates the current Level of Care (LOC) paper process. Starting August 3, 2020, all Nursing facilities, ICF/IID facilities, and Institutionalized Hospice Service Providers will be required to use KLOCS in order to receive payment. Individuals who administratively handle LOC applications may attend a free 2-part webinar series on KLOCS system functionality. Attendees will be able to ask questions during the live webinars. To accommodate providers' schedules, the same 2-part series will be offered on multiple dates.

April 15, 2020
2020 Census be counted for Kentucky, complete your census today. For more information go to 2020census.gov.

March 23, 2020
Provider Telehealth or Telephonic Health Services FAQs

March 16, 2020
COVID-19 Alert
- For the latest information on the novel coronavirus in Kentucky, please visit kycovid19.ky.gov

Important Message: Kentucky Medicaid has issued guidance to providers regarding COVID-19.
Provider Letter A-105: COVID-19 Guidance for all Medicaid providers
Provider Letter: COVID-19 Guidance for 1915(c) HCBS waiver providers
Provider Letter: COVID-19 and Telehealth for 1915(c) HCBS waiver providers
Provider Letter: COVID-19 and Waiver Provider Certification and Monitoring
Provider Letter: COVID-19 ABI and MPW Assessments
Provider Letter: COVID-19 and Model II Assessments

November 6, 2019
Beginning January 1, 2020, beneficiaries and providers must use the new Medicare Beneficiary Identifier (MBI) to receive services and submit Medicare claims. With limited exceptions, CMS will reject claims submitted with the HICN and will reject all eligibility transactions submitted with the HICN. Sister Agencies, Managed Care Organizations, and Fiscal Agents that use the HICN need to make sure they are able to receive and process the MBI before the end of the transition period on December 31, 2019. In addition, you should have updated anything with the HICN, such as ID cards, beneficiary letters, training materials, or call center scripts with the MBI.

June 28, 2019
Telehealth Message
On 7/1/2019, the Telehealth regulation expanding service locations and allowable providers becomes effective. By now you should have received a provider letter from Kentucky Medicaid that outlines the use of two letter modifiers that would capture the location of both the telehealth provider of service and the location of the recipient. It has been discovered that many of the modifier combinations we chose are not HIPAA compliant and/or are out of the Industry Standard. Because of the fact that claims could be denied due to this error, DMS is postponing the two-letter modifier requirement and will allow claims to be processed without them. Providers will still be required to place the “02” place of service modifier so that the claim will be adjudicated as a Telehealth claim. The Department for Medicaid Services apologizes for any confusion caused by this oversight and thanks you for your time and attention to this decision. When a viable solution is developed to address this data need, we will notify our partners and providers alike.

March 28, 2018
Please ONLY submit Map-24 forms to Carewise Health for Fee for Service members by faxing to the following numbers.

1-800-807-8843
1-800-807-7840

to discharge a member from a psychiatric facility or nursing facility.

In addition, if they are not sent this way they may not get reviewed or processed. Thank you

Last Updated 5/15/2019 
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