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Medicaid Update: Transmittal #12-04 Reimbursement and Adjustments


The purpose of this Transmittal is:

  • To explain recent and proposed changes in Medicaid reimbursement rates for physician
    and specialty services.
  • To notify you of implementation of the National Correct Coding Initiative (NCCI) related
    edits that are mandated by the Center for Medicare and Medicaid Services (CMS).
  • To notify you of adjustments for claims subject to Utilization Review Limits.
  • To make you aware of upcoming reprocessing of claims related to the above issues.