Most inpatient hospital services are covered as long as the inpatient stay is justified as medically necessary. Certain hospital outpatient and emergency room services are also covered.
Will I need to pay for Hospital Services?
- A copay of $50 will be assessed for each inpatient hospital visit.
- A copay of $3 will be assessed for each visit to the emergency room which is determined to be not an emergency.
Acute Care Hospital facilities provides both inpatient and outpatient services, including emergency room services.
- Critical Access Hospital facilities may qualify as a critical access hospital if the facility meets other state and federal criteria.
- Diagnosis Related Group (DRG) means a clinically-similar grouping of services that can be expected to consume similar amounts of hospital resources
Psychiatric Inpatient Hospitals
Other Hospital Programs
Disproportionate Share Hospital (DSH) Program prior to billing a patient and submitting hospital service expenses to Medicaid as uncompensated, a hospital uses the Indigent Care Eligibility form to determine if the patient meets DSH guidelines.
Regarding Policy, contact:
Division of Healthcare Facilities Management
275 E. Main St., 6C-B
Frankfort, KY 40621
Phone: (502) 564-6511
Email: CHFS DMS Webmaster
Regarding Billing, contact EDS at (800) 807-1232 or visit their website.
Regarding Enrollment, contact Provider Enrollment at (877) 838-5085 Monday to Friday 8 a.m. - 4:30 p.m. ET or visit their website.
Regarding Members: contact Member Services at (800) 635-2570 from 8 a.m. to 5 p.m. Eastern time Monday - Friday.
||Archive Fee Schedules
Hospital Outpatient Laboratory Fee Schedule