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June 29, 2016
Effective July 1, 2016, claims subject to Prudent Pay will be decreased from 19 days to 6 days.
June 10, 2016
For 2016, CMS will be hosting several Payment Error Rate Measurement (PERM) conference calls to providers for 2016. Please click on the Provider Call information to learn when the calls will be available.
April 22, 2016
Public Notification Revised
Notification Revised-alphabetical by last name (Excel)
Notification Revised-alphabetical by last name (PDF)
March 30, 2016
Due to system errors, Medicaid is extending benefits to all members through April 30th. If the member was eligible in March, the member will automatically be eligible in April.
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
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 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.