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Welcome to the Kentucky Medicaid Management Information System (KYMMIS)

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Site Updates

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.

November 5, 2019
Public Notification Revised
Notification Revised-alphabetical by last name (Excel)
Notification Revised-alphabetical by last name (PDF)

September 17, 2019
Attention Providers:
The Kentucky Cabinet for Health and Family Services presents the 2019 Managed Care Forums. Please see the dates and times and register for the forums.

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

March 31, 2017
Effective 3/31/2017 members who are enrolled in an MCO will no longer be receiving a KyHealth Choices card. Members will only be receiving a card from the MCO in which they are enrolled. This change is being made to reduce duplication of effort as all required Medicaid information is located on their MCO card. This change does not affect Fee For Service members.

In addition, members who have had 6 months or more loss in eligibility will not be receiving a new card.

June 29, 2016
Attention Providers:

Effective July 1, 2016, claims subject to Prudent Pay will be decreased from 19 days to 6 days.

December 22, 2015
Attention Hospice Providers
Effective for dates of service 1/1/2016 and after, Hospice providers will be able to bill for Service Intensity Add-on (SIA) payments for routine home care services provided by a registered nurse or medical social worker during the last 7 days of a patient’s life. Billing for the Service Intensity Add-on (SIA) payment should be on a separate line and/or claim from your routine home care payment billing using revenue codes 551 or 561, as appropriate. Procedure code G0299 will be required with the use of revenue code 551 and G0155 will be required with the use of revenue code 561. SIA payments must be billed in 15-minute increments (1 unit = 15 minutes) and is to be billed on a claim with occurrence code 55 and an associated occurrence date that reflects the member’s date of death. Revenue codes 551 and 561 must be billed as a single date of service per line (span-dating is not allowed). Please continue billing for your regular routine home care payments with revenue code 651 using the current billing guidelines and unit increment.

October 29, 2015
Attention:
Please note claims received prior to 3pm EST on Friday will be processed through the financial cycle on Friday night. Claims received after 3pm EST on Friday may not be processed until the next financial cycle.

Last Updated 5/15/2019 
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