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Provider Billing Instructions

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Provider billing instructions are displayed in Adobe Acrobat formats.

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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 - October 2022
02 Psychiatric Inpatient Hospital Services-5010 update New - December 2022
03 Behavioral Health Services Organization New - October 2022
04/05 Psychiatric Residential Treatment Facility and PRTF2 New - October 2022
06 Chemical Dependency Treatment Center New - October 2022
10 Specialty Intermediate Care Clinic for Development and Intellectual Disabilities New - October 2022
11 Intermediate Care Facility for Individuals with Intellectual Disabilities or Developmental Disabilities New - October 2022
12 Nursing Facility New - October 2022
13 Specialized Children's Services Clinic-5010 update New - October 2022
16 Certified Community Behavioral Health Centers Provider Type-16 New - October 2022
17 Acquired Brain Injury New - October 2022
18 Private Duty Nursing New - October 2022
20 Preventive Health Services-5010 update New - October 2022
21 School Based Health Services New - October 2022
22 The Commission For Children With Special Health Care Needs-5010 update New - October 2022
23 Title V Services Provided By The Department For Social Services-5010 update New - October 2022
26 Residential Crisis Stabilization Unit New - October 2022
30 Community Mental Health Services New - October 2022
31 Primary Care- FQHC New - October 2022
31 Primary Care non-FQHC New -October 2022
32 Family Planning Services-5010 update New - October 2022
33 Supports For Community Living New - October 2022
34 Home Health Services-5010 update New - October 2022
35 Rural Health Services-5010 update New - October 2022
36 Ambulatory Surgical Centers-5010 update New - October 2022
37 Independent Laboratory and Radiological Services-5010 update New - October 2022
39 Renal Dialysis Services-5010 update New - October 2022
41 Model Waver II Services New - October 2022
42 Home and Community Based Waiver Services New - October 2022
43 Adult Day Care Services New - October 2022
44 Hospice Services New - November 2022
45 EarlyPeriodic Screening Diagnosis And Treatment Services New - October 2022
48 Home Delivered Meals New - October 2022
50/70 Hearing Services-5010 update New - October 2022
52/77 Vision Services-5010 update New - October 2022
54 Pharmacy Services New - October 2022
55/56 Transportation Services - 55/56 Spec 16-5010 update New - October 2022
60/61 Dental Services New - October 2022
62 Licensed Professional Art Therapist New - October 2022
63 Licensed Behavioral Analyst New - October 2022
64/65 Physician Services New - December 2022
66 Behavioral Health Multi-Specialty Group New - October 2022
67 Licensed Clinical Alcohol and Drug Counselor New - October 2022
72/74/78 Advanced Registered Nurse Practitioner Services-5010 update New - October 2022
76 Multi Therapy Agency New - October 2022
79 Speech Language Pathologist New - October 2022
80 Podiatry Services-5010 update New - October 2022
81 Licensed Professional Clinical Counselor New - October 2022
82 Licensed Clinical Social Worker New - October 2022
83 Licensed Marriage and Family Therapist New - October 2022
84 Licensed Psychological Practitioner New - October 2022
85 Chiropractic Services-5010 update New - October 2022
86 Radiological Services-5010 update New - October 2022
87 Physical Therapist New - October 2022
88 Occupational Therapist New - October 2022
89 Licensed Psychologist New - October 2022
90 Durable Medical Equipment Services-5010 update New - October 2022
91 Comprehensive Outpatient Rehabilitation Facilities New - October 2022
95 Physician Assistant New - October 2022

Last Updated 5/15/2019 
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