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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 - May 2019
02 Psychiatric Inpatient Hospital Services-5010 update New - May 2019
03 Behavioral Health Services Organization New - May 2019
04/05 Psychiatric Residential Treatment Facility and PRTF2 New - May 2019
06 Chemical Dependency Treatment Center New - May 2019
10 Specialty Intermediate Care Clinic for Development and Intellectual Disabilities New - May 2019
11/12 ICF/IID/DD and Nursing Facility New - May 2019
13 Specialized Children's Services Clinic-5010 update New - May 2019
17 Acquired Brain Injury-5010 update New - May 2019
18 Private Duty Nursing New - May 2019
20 Preventive Health Services-5010 update New - May 2019
21 School Based Health Services-5010 update New - May 2019
22 The Commission For Children With Special Health Care Needs-5010 update New - May 2019
23 Title V Services Provided By The Department For Social Services-5010 update New - May 2019
26 Residential Crisis Stabilization Unit New - May 2019
27/28 Target Case Management Servies For Adults and Children-5010 update New - August 2017
29 Impact Plus New - August 2017
30 Community Mental Health Services-5010 update New - September 2019
31 Primary Care- FQHC New - May 2019
31 Primary Care non-FQHC New - May 2019
32 Family Planning Services-5010 update New - May 2019
33 Supports For Community Living-5010 update New - May 2019
34 Home Health Services-5010 update New - May 2019
35 Rural Health Services-5010 update New - May 2019
36 Ambulatory Surgical Centers-5010 update New - May 2019
37 Independent Laboratory and Radiological Services-5010 update New - May 2019
39 Renal Dialysis Services-5010 update New - May 2019
40 Early Periodic Sreening Diagnosis And Treatment Services-5010 update New - August 2017
41 Model Waver II Services New - May 2019
42 Home and Community Based Waiver Services New - May 2019
43 Adult Day Care Services-5010 update New - May 2019
44 Hospice Services New - October 2019
45 EarlyPeriodic Screening Diagnosis And Treatment Services New - May 2019
48 Home Delivered Meals New - May 2019
50/70 Hearing Services-5010 update New - May 2019
52/77 Vision Services-5010 update New - May 2019
55/56 Transportation Services - 55/56 Spec 16-5010 update New - May 2019
60/61 Dental Services New - May 2019
62 Licensed Professional Art Therapist New - May 2019
63 Licensed Behavioral Analyst New - May 2019
64/65 Physician Services-5010 update New - May 2019
66 Behavioral Health Multi-Specialty Group New - May 2019
67 Licensed Clinical Alcohol and Drug Counselor New - May 2019
72/74/78 Advanced Registered Nurse Practitioner Services-5010 update New - May 2019
76 Multi Therapy Agency New - May 2019
79 Speech Language Pathologist New - May 2019
80 Podiatry Services-5010 update New - May 2019
81 Licensed Professional Clinical Counselor New - May 2019
82 Licensed Clinical Social Worker New - May 2019
83 Licensed Marriage and Family Therapist New - May 2019
84 Licensed Psychological Practitioner New - May 2019
85 Chiropractic Services-5010 update New - May 2019
86 Radiological Services-5010 update New - May 2019
87 Physical Therapist New - May 2019
88 Occupational Therapist New - May 2019
89 Licensed Psychologist New - May 2019
90 Durable Medical Equipment Services-5010 update New - May 2019
91 Comprehensive Outpatient Rehabilitation Facilities New - May 2019
95 Physician Assistant New - May 2019

Last Updated 5/15/2019 
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