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Kentucky Medical Management Information System (KYMMIS)

Provider Billing Instructions

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If you need assistance, contact us by sending an e-mail to the following address:

KY EDI HelpDesk

Provider billing instructions are displayed in Adobe Acrobat formats.

Billing Instructions are for Fee For Service (FFS) providers only.

Provider Type (PT) - The first two digits of the KY Medicaid provider number.

PT	Program	Revision Date
01	Hospital Services-5010 update	New - January 2025
02	Psychiatric Inpatient Hospital Services-5010 update	New - January 2025
03	Behavioral Health Services Organization	New - January 2025
04/05	Psychiatric Residential Treatment Facility and PRTF2	New - January 2025
06	Chemical Dependency Treatment Center	New - January 2025
10	Specialty Intermediate Care Clinic for Development and Intellectual Disabilities	New - January 2025
11	Intermediate Care Facility for Individuals with Intellectual Disabilities or Developmental Disabilities	New - January 2025
12	Nursing Facility	New - January 2025
13	Specialized Children's Services Clinic-5010 update	New - January 2025
16	Certified Community Behavioral Health Centers Provider Type-16	New - January 2025
17	Acquired Brain Injury	New - January 2025
18	Private Duty Nursing	New - January 2025
20	Preventive Health Services-5010 update	New - January 2025
21	School Based Health Services	New - January 2025
22	The Commission For Children With Special Health Care Needs-5010 update	New - January 2025
23	Title V Services Provided By The Department For Social Services-5010 update	New - January 2025
26	Residential Crisis Stabilization Unit	New - January 2025
30	Community Mental Health Services	New - January 2025
31	Primary Care- FQHC	New - January 2025
31	Primary Care non-FQHC	New - January 2025
32	Family Planning Services-5010 update	New - January 2025
33	Supports For Community Living	New - January 2025
34	Home Health Services-5010 update	New - January 2025
35	Rural Health Services-5010 update	New - January 2025
36	Ambulatory Surgical Centers-5010 update	New - January 2025
37	Independent Laboratory and Radiological Services-5010 update	New - January 2025
39	Renal Dialysis Services-5010 update	New - January 2025
41	Model Waver II Services	New - January 2025
42	Home and Community Based Waiver Services	New - January 2025
43	Adult Day Care Services	New - January 2025
44	Hospice Services	New - January 2025
45	Early Periodic Screening Diagnosis And Treatment Services	New - January 2025
48	Home Delivered Meals	New - January 2025
50/70	Hearing Services-5010 update	New - January 2025
51	Administrative Services Organization	New - January 2025
52/77	Vision Services-5010 update	New - January 2025
54	Pharmacy Services	New - January 2025
55/56	Transportation Services - 55/56 Spec 16-5010 update	New - January 2025
60/61	Dental Services	New - January 2025
62	Licensed Professional Art Therapist	New - January 2025
63	Licensed Behavioral Analyst	New - January 2025
64/65	Physician Services	New - January 2025
66	Behavioral Health Multi-Specialty Group	New - January 2025
67	Licensed Clinical Alcohol and Drug Counselor	New - January 2025
72/74/78	Advanced Registered Nurse Practitioner Services-5010 update	New - January 2025
76	Multi Therapy Agency	New - January 2025
79	Speech Language Pathologist	New - January 2025
80	Podiatry Services-5010 update	New - January 2025
81	Licensed Professional Clinical Counselor	New - January 2025
82	Licensed Clinical Social Worker	New - January 2025
83	Licensed Marriage and Family Therapist	New - January 2025
84	Licensed Psychological Practitioner	New - January 2025
85	Chiropractic Services-5010 update	New - January 2025
86	Radiological Services-5010 update	New - January 2025
87	Physical Therapist	New - January 2025
88	Occupational Therapist	New - January 2025
89	Licensed Psychologist	New - January 2025
90	Durable Medical Equipment Services-5010 update	New - January 2025
91	Comprehensive Outpatient Rehabilitation Facilities	New - January 2025
95	Physician Assistant	New - January 2025

Last Updated 5/15/2019

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