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Provider Billing Instructions

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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 2021
02 Psychiatric Inpatient Hospital Services-5010 update New - January 2021
03 Behavioral Health Services Organization New - January 2021
04/05 Psychiatric Residential Treatment Facility and PRTF2 New - February 2021
06 Chemical Dependency Treatment Center New - February 2021
10 Specialty Intermediate Care Clinic for Development and Intellectual Disabilities New - February 2021
11 Intermediate Care Facility for Individuals with Intellectual Disabilities or Developmental Disabilities New - February 2021
12 Nursing Facility New - February 2021
13 Specialized Children's Services Clinic-5010 update New - February 2021
17 Acquired Brain Injury New - February 2021
18 Private Duty Nursing New - February 2021
20 Preventive Health Services-5010 update New - February 2021
21 School Based Health Services New - February 2021
22 The Commission For Children With Special Health Care Needs-5010 update New - February 2021
23 Title V Services Provided By The Department For Social Services-5010 update New - February 2021
26 Residential Crisis Stabilization Unit New - February 2021
27/28 Target Case Management Services For Adults and Children-5010 update New - August 2017
29 Impact Plus New - August 2017
30 Community Mental Health Services New - February 2021
31 Primary Care- FQHC New - February 2021
31 Primary Care non-FQHC New - February 2021
32 Family Planning Services-5010 update New - March 2021
33 Supports For Community Living New - March 2021
34 Home Health Services-5010 update New - March 2021
35 Rural Health Services-5010 update New - March 2021
36 Ambulatory Surgical Centers-5010 update New - March 2021
37 Independent Laboratory and Radiological Services-5010 update New - March 2021
39 Renal Dialysis Services-5010 update New - March 2021
40 Early Periodic Screening Diagnosis And Treatment Services-5010 update New - August 2017
41 Model Waver II Services New - March 2021
42 Home and Community Based Waiver Services New - March 2021
43 Adult Day Care Services New - July 2020
44 Hospice Services New - July 2020
45 EarlyPeriodic Screening Diagnosis And Treatment Services New - July 2020
48 Home Delivered Meals New - July 2020
50/70 Hearing Services-5010 update New - July 2020
52/77 Vision Services-5010 update New - July 2020
55/56 Transportation Services - 55/56 Spec 16-5010 update New - July 2020
60/61 Dental Services New - July 2020
62 Licensed Professional Art Therapist New - July 2020
63 Licensed Behavioral Analyst New - July 2020
64/65 Physician Services New - October 2020
66 Behavioral Health Multi-Specialty Group New - July 2020
67 Licensed Clinical Alcohol and Drug Counselor New -July 2020
72/74/78 Advanced Registered Nurse Practitioner Services-5010 update New - July 2020
76 Multi Therapy Agency New - July 2020
79 Speech Language Pathologist New - July 2020
80 Podiatry Services-5010 update New - July 2020
81 Licensed Professional Clinical Counselor New - July 2020
82 Licensed Clinical Social Worker New - July 2020
83 Licensed Marriage and Family Therapist New - October 2020
84 Licensed Psychological Practitioner New - July 2020
85 Chiropractic Services-5010 update New - July 2020
86 Radiological Services-5010 update New - July 2020
87 Physical Therapist New - July 2020
88 Occupational Therapist New - July 2020
89 Licensed Psychologist New - January 2021
90 Durable Medical Equipment Services-5010 update New - October 2020
91 Comprehensive Outpatient Rehabilitation Facilities New - July 2020
95 Physician Assistant New -July 2020

Last Updated 5/15/2019 
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