Home-delivered meals are Kentucky Medicaid provider type 48. To enroll and bill Kentucky Medicaid, home-delivered meals providers must be:
Covered Services
Home-delivered meals are provided to qualified Medicaid members at their place of residence. A home-delivered meals provider must meet requirements in
907 KAR 7:010. Services must be performed in the scope of practice for any provider. Listing of services in an administrative regulation is not a guarantee of payment. Providers must follow all relevant state Medicaid regulations. All services must be medically necessary.
Verify Eligibility
Verify eligibility by calling the automated voice response system at (800) 807-1301 or by using the web-based KYHealth-Net System.
Reimbursement
Home delivered meals are reimbursed per 907 KAR 7:015.
Service Authorization
Case managers approve 1915(c) HCBS waiver services. Kentucky Medicaid reviews requests for high-cost or high-skill services. If you have questions, please email the 1915(c) waiver Help Desk or call (844) 784-5614.
Claims Submission
Kentucky Medicaid currently contracts with Gainwell Technologies to process Medicaid fee-for-service claims.
Coding
Kentucky Medicaid uses the National Correct Coding Initiative edits and the McKesson Claim Check System to verify incidental or mutually exclusive codes. Kentucky Medicaid also uses Current Procedural Terminology (CPT) codes and Healthcare Common Procedure Coding system codes. Kentucky Medicaid requires the use of ICD-10 codes on all claims submitted for reimbursement. Kentucky Medicaid requires the use of CMS 1500 billing forms. Providers must bill Kentucky Medicaid using the correct CPT codes.
Claim Appeals
Appeal requests made on denied fee-for-service claims must be submitted to
DXC and include the reason for the request along with a hard-copy claim.
Timely Filing
Claims must be received the longer of either 12 months from the date of service or six months from the Medicare pay date or within 12 months of the last Kentucky Medicaid denial.
Provider Contact Information
If you can't find the information you need or have additional questions, please direct your inquiries to:
Billing Questions - Gainwell Technologies - (800) 807-1232
Provider Questions - (855) 824-5615
Prior Authorization - (844) 784-5614
Provider Enrollment or Revalidation - (877) 838-5085
KYHealth-Net assistance - Gainwell Technologies - (800) 205-4696
1915(c) HCBS waiver questions - (844) 784-5614
Department for Aging and Independent Living (DAIL) - (502) 564-6930
For more specific inquiries, view the
1915(c) waiver contacts listing.