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Medicaid Update: Transmittal 15-43 Medicaid Primary Care Provider Rate Permanent Extension for Qualified Physicians and Advanced Practice Registered Nurses

Thursday, November 5, 2015

The Department of Health Care Finance (DHCF) has been reimbursing qualified primary care providers 100% of the Medicare fee schedule for certain primary care services, as established under the Affordable Care Act (ACA). In Fiscal Year 2016, upon approval of a new State Plan Amendment (SPA) by the Centers for Medicare and Medicaid Services (CMS), DHCF will not only make this rate increase permanent, but will also reimburse  qualified psychiatrists, OB-GYNs and APRNs at the enhanced rate for the same services.