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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.
December 18, 2015
Public Notification Revised
Notification Revised-alphabetical by last name (Excel)
Notification Revised-alphabetical by last name (PDF)
November 12, 2015
MEUPS and KYHealthNet will be down starting at 11:00 pm EST on 11/14/2015 for maintenance. The system will be back up at 9:00 am EST on 11/15/2015. We apologize for any inconvenience.
October 29, 2015
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.
October 1, 2015
ICD-10 codes are now in effect. Claims with a 10/1/2015 date of service must be submitted with the appropriate ICD-10 code(s). Inpatient hospital claims will be processed using the discharge date, with dates of October 1, 2015 requiring ICD-10 codes. Claims will not be accepted if they have a combination of ICD-9 and ICD-10 codes.
September 30, 2015
Due to issues relating to a software update that was applied to the Commonwealth’s Statewide Financial System (eMARS), there may be a delay in receiving of Medicaid payments from the payment cycle dated 9/25/15. We apologize for this delay and any inconvenience this may cause. The decision regarding the timing of the upgrade was outside the control of the Cabinet for Health and Family Services (CHFS) or the Department for Medicaid Services (DMS). CHFS and DMS staff is in hourly contact with the Finance Cabinet and CHFS will continue to remain in contact and monitor the status of payments until the software issues have been resolved and payments have been issued.
September 15, 2015
Effective October 1, 2015, claims with a 10/1/2015 Date of Service must be submitted with the appropriate ICD-10 code(s).
Inpatient hospital claims will be processed using the discharge date, with dates of October 1, 2015 requiring ICD-10 codes.
Claims will not be accepted if they have a combination of ICD-9 and ICD-10 codes.
July 29, 2015
ATTN BCCTP Providers:
Breast and Cervical Cancer Treatment Program (BCCTP) will be moving to different website effective August 5, 2015. Any confirmations numbers not submitted by 7 pm EST on August 4, 2015 will expire. The new website address is kynect.ky.gov. If you have any questions, please call 1-855-637-6576.
July 10, 2015
Providers serving Waiver members may request prior authorizations under their EPSDT PT-45 Provider Number for physical, occupational and speech therapies.
Effective immediately and until further notice, providers serving Waiver members with a prior authorization approved under a new physical, occupational or speech therapy provider type number may request to replace it with a prior authorization under their EPSDT PT-45 number. Providers serving Waiver members may also continue to submit new prior authorizations under their EPSDT PT-45 number until further notice.
Each prior authorization request must be submitted under the current EPSDT PT-45 number and include an updated Map 650 (pg 1) with the applicable EPSDT Special Services codes (S codes), requested units for each code, and start and end dates.
Please contact HP at 1-800-807-1232 for assistance with questions about submitting prior authorizations under the EPSDT PT-45 number to replace prior authorizations approved under the new provider type. For questions about the EPSDT Therapy Services procedure codes and rates or other questions about EPSDT Special Services, contact Catherann Terry at 502-564-9444, ext 2120.
May 22, 2015
Applying for Hospital and Pregnancy Presumptive Eligibility (PE) will be moving to a different web site effective June 5th. Providers will NO longer be able to submit a PE application on this site beginning June 5, 2015 onward. Any confirmation numbers received before or on June 4, 2015 will expire unless application is submitted by 7pm EST on June 4, 2015. The new web site address is kynect.ky.gov. If you have any questions, please call 855-637-6576.
May 6, 2015
In an April 26, 2015 letter sent to Providers regarding the 2015 General Assembly Legislative Changes to provider enrollment, the Department for Medicaid Services stated, “In addition, effective May 1, 2015, all applications must be submitted on the revised MAP-811 (Rev 5/2015) in order to be processed. Otherwise, the application will be returned.” Due to technical difficulties in launching the new form, DMS is advising providers that this change will not take effect until July 1, 2015. You may submit either version of the MAP 811 application (Rev 07/10 or Rev 5/2015) until July 1, 2015.
February 12, 2015
Notice to all providers.
The electronic funds transfer (EFT) update function via KYHealth Net will be disabled on March 6, 2015. In order to update your EFT, please contact provider enrollment at 1-877-838-5085 for further instructions. We apologize for any inconvenience.
November 17, 2014
Effective December 1, 2014, Licensed Professional Art Therapists and Applied Behavior Analysts applications will be accepted. However, these two new provider types will not be allowed to enroll until January 1, 2015. The enrollment requirements can be found on the Provider Enrollment website located at
October 30, 2014
Important KYHealthNet Announcement
Providers who are already enrolled in KY Medicaid are now able to access their provider enrollment file online through KYHealthNet
If you already have access to KYHealthNet, you are now able to view your contract dates, licensure information, physical, correspondence and pay to address, phone number, fax number, taxonomy, NPI, group practice provider is affiliated with, providers that participate in group practice, annual disclosure of ownership (ADO), and revalidation dates. Once you log on to KYHealthNet, click on the Provider Status tab to access your file.
If you do not have access to KYHealthNet, please visit
Healthnet page for instructions on how to sign up for this feature. If you have questions, please contact the EDI Department at HP by email or by phone at (800) 205-4696.
May 14, 2014
-Important Notice Regarding Non-Emergency Medical Transportation which will begin on July 1, 2014 for members in Ballard, Calloway, Carlisle, Fulton, Graves, Hickman, Marshall, and McCracken counties. Read the notice located at
April 8, 2014
Notice to All Stakeholders
In light of the recent passing of House Resolution 4302
, the Department of Health and Human Services (HHS) cannot adopt the ICD-10 code set as the standard until at least October 1, 2015. The Kentucky Department for Medicaid Services (DMS) and Hewlett Packard Enterprise (HP) will continue to move forward with the goal of remediating the fiscal agent system and conducting end-to-end external testing by October 1, 2014. Providers and Clearinghouses are encouraged to contact HP's
EDI helpdesk if they would like to test with DMS/HP when external testing begins June 2014.
DMS will continue to post updates to this site as more information about the delay and new implementation timelines are made available.
If you have questions, you may submit them through the mailbox.
November 22, 2013
Below is a list of new provider types that we anticipate enrolling effective 1/1/2014 due to Medicaid expansion under the Affordable Care Act.
Please note that the new provider types are subject to change pending CMS approval. In addition, the regulations and enrollment requirements for each provider type are still being developed.
Starting November 18, 2013, providers may submit an enrollment application for these new provider types. Although enrollment requirements are still being determined, each entity/individual must be licensed and submit their NPI documentation as well as SSN or FEIN verification. Applications will be held and processed once CMS approval is received and the regulations and enrollment requirements are finalized. DMS will provide new information as it becomes available.
As with the current enrollment process, if a provider will be contracting with an MCO the provider will need to submit their application through the MCO of their choice.
New Provider Types
18 – Private Duty Nursing Agency
79 – Speech Language Pathologist
799 – Speech Language Pathologist Group
81 – Licensed Professional Clinical Counselor
819 – Licensed Professional Clinical Counselor Group
83 – Licensed Marriage and Family Therapist
839 – Licensed Marriage and Family Therapist Group
84 – Licensed Psychological Practitioner
849 – Licensed Psychological Practitioner Group
97 – Behavioral Health Multi-Specialty Group
The QMB limitation will be removed from these provider types effective 1/1/2014 subject to CMS approval. If you are currently enrolled in this provider type you will automatically be transitioned:
82 – Licensed Clinical Social Worker
87 – Physical Therapist
879 – Physical Therapist Group
88 – Occupational Therapist
889 – Occupational Therapist Group
89- Licensed Psychologist
899 – Licensed Psychologist Group
April 11, 2013
If you are enrolling in KY Medicaid and will be participating with any of the MCO’s (Managed Care Organizations),
you will need to send your enrollment application to one of the MCO’s of your choice.
Do not submit enrollment applications directly to KY Medicaid unless you are
NOT participating with any of the MCO’s.
Coventry - 855-300-5528
Humana Caresource - 855-852-7005
Passport - 800-578-0775
Wellcare - 877-389-9457
Anthem - 800-880-2583
December 21, 2012
Attention Providers Kentucky Medicaid Enhanced Primary Care Payments Update
Effective January 1, 2013, healthcare providers who provide eligible primary care services to Medicaid clients are eligible to be paid the Medicare rates effective calendar years (CY) 2013 and 2014. The enhanced rate is available for fee for service providers who are fee for service providers with Kentucky Medicaid and eligible providers who are enrolled in the Kentucky managed care program. For more information, refer to the “What’s New” section of the DMS website at http://chfs.ky.gov/dms.
Thank you for your attention to this announcement.