ASP Fee Schedule Language
The Cabinet for Health and Family Services, Department for Medicaid Services (the
Department) in accordance with 42 CFR 44, hereby provides public notice to change
reimbursement language to read Medicare fee schedule and remove ASP language for an
effective date of July 1, 2023. Review the public notice.
Ambulance services reimbursement changes
In accordance with 42 CFR 447.205, the Kentucky Department for Medicaid Services provides public notice of changes to ambulance services reimbursement language in its state plan effective Jan. 1, 2022. The state plan language change aligns with KRS 205.5601-5603 reflecting the methodology for increasing Medicaid reimbursement for ground ambulance services.
Review the public notice
Mandatory Medicaid state plan coverage of medication-assisted treatment
The Kentucky Department for Medicaid Services issued a public notice of updates to the state plan related to medication-assisted treatment for individuals with opioid use disorder.
Review the public notice
Ambulance supplemental payment program
The Kentucky Department for Medicaid Services has issued public notice of changes to the ambulance services reimbursement language in its State Plan effective July 1, 2021.
Review the entire public notice
Public Notice page to see all public notices.
Provider Input Sought
An evaluation of the SUPPORT Act Section 1003 Demonstration Project to Increase
Provider Capacity for Substance Use Disorder Treatment and Recovery Services is taking place now. Learn more here.
Important Note for All Medicaid Providers about Programs for All-Inclusive Care for the Elderly (PACE)
PACE is now enrolling individuals in Kentucky. When checking eligibility, please determine if the individual is enrolled in PACE. If so, all services must be approved and billing submitted through the individual's PACE organization.
Medicaid Managed Care Quality Strategy
At least every three years, the Kentucky Department for Medicaid Services, in accordance with CFR §438.340, must draft and implement a written quality strategy for assessing and improving the quality of health care and services provided by Medicaid managed care organizations. The strategy has been submitted to the Centers for Medicare and Medicaid Services for review.
Review 2023 Quality Strategy Draft
Flood Recovery Resources
The Department for Medicaid Services has compiled a
list of flood recovery resources for members in affected areas of eastern Kentucky. The list includes contact information for state services, shelter information and how to help flood survivors. To make a financial donation to the relief effort, please visit the
Team Eastern Kentucky Flood Relief Fund website.
Baby Formula Shortage Resources
Resources are available for Medicaid members affected by the baby formula shortage. The Department for Public Health has published
a guide to local and national resources to help Kentuckians find formula.
Behavioral Health Code List Now Available
A list of behavioral health codes that are reimbursable by Kentucky Medicaid is now available.
Work continues on Kentucky Mobile Crisis Intervention Planning Grant project
Kentucky continues its work on a grant to expand and strengthen services for individuals experiencing behavioral health crises. Currently, a thorough review is underway of the availability and delivery of mobile crisis services in Kentucky. Review the
KY mobile crisis intervention needs assessment or visit the
Behavioral health initiatives page for more information.
DMS begins work on Kentucky Mobile Crisis Intervention Planning Grant Project
Kentucky has received a grant to expand and strengthen services for individuals experiencing behavioral health crises. Review the
MCI grant announcement for information on the grant and how to get involved.
Under the current KY HEALTH SUD 1115 Demonstration authority, the state is required to implement utilization management approaches to ensure an independent process for reviewing placement in residential treatment settings and interventions appropriate for the diagnosis and level of care.
The KY State Plan requires individuals to be assessed and meet dimensional admission criteria for approval of residential level-of-care placement in accordance with current ASAM treatment criteria for addictive, substance-related and co-occurring conditions.
Prior authorization will be reinstated effective July 1, 2022 for SUD residential and inpatient treatment services, including ASAM Levels 3.1, 3.5, 3.7 and 4.0.
Correcting Medicaid Member Incarceration Status Errors
Kentucky Medicaid has a new form providers can use to help members who are incorrectly listed as incarcerated in
KYHealthNet. Please review the
guidance for reporting incarceration errors and the new
MAP-INC form for more information.
Administrative Regulations Filed
Visit the DMS
Regulation page for recently filed regulations.
CMS health care quality core set chart packs
Each year the Centers for Medicare and Medicaid Services publishes core measures of the quality-of-care and health outcomes for adults participating in Medicaid and children enrolled in the Medicaid Children’s Health Insurance Program. Please view:
Cost Report Update
(July 14, 2020) The Centers for Medicare and Medicaid Services authorized the delay of some Medicare cost reports. The KY Department for Medicaid Services grants the same extension to providers who received an extension approval through CMS or the designated Medicare administrative contractor. Please call (502) 564-8196 if you have any questions and ask for the staff referenced below based on provider type.
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